Keywords

Speech Voice Masculinization Therapy Acoustic Gender

Subject Categories

Communication Sciences and Disorders | Speech and Hearing Science | Speech Pathology and Audiology

Abstract

Gender-diverse individuals often seek speech-language pathology services to align their vocal presentation with their gender identity. While voice and communication therapy is available for both transfeminine and transmasculine individuals, the latter face unique challenges due to limited documentation of clinical approaches and outcomes. Beyond hormone replacement therapy, evidence-based behavioral interventions for achieving desired vocal characteristics safely and effectively remain underrepresented in the literature, creating an imbalance in available treatment approaches. Therefore, the purpose of this project was to examine voice masculinization therapy by defining therapeutic approaches, characterizing acoustic outcomes following intervention, and describing the impact of therapy on vocal health measures. An in-depth retrospective medical file review was conducted for individuals who completed voice masculinization therapy at the gender-affirming voice center at the University of Cincinnati. Patients were included if they had documented voice therapy goals and clinical approaches, pre- and post-therapy acoustic recordings, and behavioral health information relevant to vocal hygiene (e.g., smoking history, reflux diagnosis). Seven patients met inclusion criteria, including six non-binary individuals and one transgender man, with a mean age of 27 years. Results indicated that all patients had individualized goals targeting pitch, resonance, intonation, and vocal health. Only one patient had a gender-neutral pitch goal. On average, patients decreased their speaking fundamental frequency in short sentences and in Rainbow Passage sentences. Patients also decreased F1 by 12.0 Hz and F2 by 56.9 Hz, suggesting darker resonance. Vocal tract length and cepstral peak prominence were maintained throughout therapy, supporting the hypothesis of limited circumlaryngeal muscle tension and preserved vocal quality. In conclusion, voice masculinization therapy addressed a broad range of voice-related parameters, with acoustic measures trending toward masculinization while maintaining vocal health. These findings increase awareness of intervention approaches and outcome measures that support vocal masculinization and overall vocal well-being.

Completion Date

2026

Semester

Summer

Committee Chair

Victoria McKenna

Degree

Master of Arts (M.A.)

College

College of Health Professions and Sciences

Department

Communication Sciences and Disorders

Format

PDF

Document Type

Thesis

Language

English

Release Date

8-15-2027

Available for download on Sunday, August 15, 2027

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