Further Validation of the GENDER-Q Voice Sound and Voice Distress Scales in 5424 Transgender and Gender Diverse Adults: An Examination of Construct Validity.

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.