Journal of voice : official journal of the Voice Foundation · 2026
Further Validation of the GENDER-Q Voice Sound and Voice Distress Scales in 5424 Transgender and Gender Diverse Adults: An Examination of Construct Validity.
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Rae Charlene, Son Isabelle, Lamarche Anick, Kaur Manraj N, Morrison Shane D, Young-Afat Danny, Cornacchi Sylvie D, van de Grift Tim C, Pang John H, Mullender Margriet G, Graesser Jack G, Laungani Alexis, Satterwhite Thomas, Armstrong Kathleen A, Coon Devin, Kaoutzanis Christodoulos, Lava Christian X, Del Corral Gabriel A, Ganor Oren, Liang Fan, Mundy Lily R, Pusic Andrea L, Klassen Anne F
Аннотация
INTRODUCTION: Measuring outcomes of treatments that seek to align a person's voice with their gender identity is important for improving gender-affirming care (GAC). The objective of this study was to assess the construct validity of the GENDER-Q Voice Sound and Voice Distress scales.
METHODS: An international field test study of the GENDER-Q was undertaken, which finalized the development of the scales. Participants were 18 years of age or older, and were seeking or had received GAC in the past 5 years, and completed the Voice Sound and Voice Distress scales. Predefined hypotheses of expected group differences and associations with other GENDER-Q scales were tested using independent samples t test, analysis of variance, and Pearson correlation coefficient. Acceptance of at least 75% of hypotheses was considered sufficient evidence of construct validity, as per COnsensus-based Standards for the Selection of Health Measurement InstrumeNts criteria.
RESULTS: A total of 5424 participants were included in the analysis with a mean age of 32.8 years (standard deviation = 12.3; range 18-83 years). The sample was comprised of 33.6% men, 36.8% women, 23.8% non-binary, and 5.7% another gender. Voice therapy was undertaken by 21.4% of participants, and 30.5% wanted this therapy. Fewer participants had undergone voice-related surgery (1.7%), with 10% wanting this surgery. Results supported 16 of 18 (89%) hypotheses for the Voice Sound scale, and 18 of 19 (95%) hypotheses for the Voice Distress scale.
CONCLUSION: The GENDER-Q Voice Sound and Voice Distress scales demonstrated construct validity. These scales can be used to assess voice-related outcomes for adults aged 18 years and older who are seeking or receiving gender-affirming voice interventions.
METHODS: An international field test study of the GENDER-Q was undertaken, which finalized the development of the scales. Participants were 18 years of age or older, and were seeking or had received GAC in the past 5 years, and completed the Voice Sound and Voice Distress scales. Predefined hypotheses of expected group differences and associations with other GENDER-Q scales were tested using independent samples t test, analysis of variance, and Pearson correlation coefficient. Acceptance of at least 75% of hypotheses was considered sufficient evidence of construct validity, as per COnsensus-based Standards for the Selection of Health Measurement InstrumeNts criteria.
RESULTS: A total of 5424 participants were included in the analysis with a mean age of 32.8 years (standard deviation = 12.3; range 18-83 years). The sample was comprised of 33.6% men, 36.8% women, 23.8% non-binary, and 5.7% another gender. Voice therapy was undertaken by 21.4% of participants, and 30.5% wanted this therapy. Fewer participants had undergone voice-related surgery (1.7%), with 10% wanting this surgery. Results supported 16 of 18 (89%) hypotheses for the Voice Sound scale, and 18 of 19 (95%) hypotheses for the Voice Distress scale.
CONCLUSION: The GENDER-Q Voice Sound and Voice Distress scales demonstrated construct validity. These scales can be used to assess voice-related outcomes for adults aged 18 years and older who are seeking or receiving gender-affirming voice interventions.