Effect of producing a desired fundamental frequency on measures of vocal hyperfunction in transgender speakers

产生所需基频对跨性别说话者声音功能亢进测量的影响

• 批准号: 10761717
• 负责人: Nichole Houle
• 金额: $ 6.95万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10761717
• 关键词: Acoustics; Address; Adult; Affect; Auditory; Auditory Perception; Behavior Therapy; Clinical; Communication; Compensation; Complement; Dimensions; Discrimination; Distress; Emotional; Evidence based treatment; Exhibits; Fatigue; Feminization; Frequencies; Future; Gender; Gender Identity; Goals; Health; Hormones; Individual; Intervention; Knowledge; Larynx; Link; Masculine; Measures; Medical; Modeling; Modification; Observational Study; Operative Surgical Procedures; Outcome; Patients; Pattern; Perception; Personal Satisfaction; Phonation; Physiology; Population; Populations at Risk; Production; Reporting; Research; Risk; Risk Reduction; Speech; Symptoms; Training; Underserved Population; Violence; Voice; Voice Disorders; Voice Quality; Work; assigned female at birth; assigned male at birth; cisgender; emotional distress; evidence base; gender affirming care; gender diversity; habituation; high risk; improved; kinematics; psychologic; recruit; respiratory; satisfaction; sex; sex assigned at birth; social; stressor; transfeminine; transgender; transmasculine; vocalization

Project Summary Transgender (TG; gender identity does not match sex-assigned at birth) individuals are underserved, targets of violence, and at higher risk for negative health outcomes. Many TG individuals report that producing a voice congruent with their gender identity is crucial to affirming their gender identity. There are a variety of gender affirming services available, but medical interventions, such as surgery or hormones do not do not ensure satisfaction with vocal gender. Voice modification is often the preferred intervention. One of the primary goals for voice modification is to alter fundamental frequency (fo) towards sex-normative values, but little is known about the underlying changes to vocalization required to habituate a desired fo. Research suggests that the compensatory strategies used by TG individuals to attain a desired fo are characterized by atypical patterns of vocalization, consistent with vocal hyperfunction (VH). This may explain the high frequency of vocal complaints in TG speakers. In sum, despite a critical health need in an at-risk population, there is a gap in the rigor of the prior research, with a lack of evidence identifying changes in the subsystems of voice production between the habitual and desired fo of TG individuals. Therefore, the goal of this proposal is to evaluate our conceptual model of voice modification: 1) that altering fo to be more gender congruent will result in less efficient vocalization, thus increasing signs of VH; and 2) the magnitude of the change in fo required to achieve vocal gender satisfaction will correspond to the magnitude of change in measures of VH. This observational study will measure VH in TG adults who are not satisfied with their habitual voice and desire a more gender- congruent voice. Only TG individuals who have expressed a desire to change their fo to become more gender congruent will be recruited for this study. In Aim 1, we will collect respiratory kinematic, acoustic, aerodynamic, laryngoscopic, self-perceived, and listener auditory-perceptual measures of VH when individuals produce their habitual and desired fo. This aim will identify the compensatory strategies used by TG individuals to alter their fo. Aim 2 will examine the relationship between the desired change in vocal gender needed to achieve satisfaction and the degree of change in measures of VH necessary to produce a desired fo. This aim will identify the relationship between vocal gender satisfaction and the compensatory strategies used when producing a desired fo. Together, these aims will provide a roadmap for future evidence-based treatment: clinicians will gain baseline information about vocal function within the TG population, which is critical for providing evidence-based assessment and treatment of voice disorders.

项目概要 跨性别者（TG；性别认同与出生时指定的性别不匹配）个体得不到充分服务，是 暴力，并面临更高的负面健康结果风险。许多 TG 人士报告说，发出声音 与他们的性别认同一致对于确认他们的性别认同至关重要。性别有很多种 确认可用的服务，但手术或激素等医疗干预措施并不能确保 对声音性别的满意度。语音修改通常是首选干预措施。主要目标之一 声音修改是将基频（fo）改变为性别规范值，但知之甚少 关于习惯所需的声音所需的发声的根本变化。研究表明， TG 个体为获得所需的 fo 所使用的补偿策略的特点是非典型模式 发声，与声乐功能亢进（VH）一致。这或许可以解释为什么声音抱怨的频率很高 在 TG 扬声器中。总而言之，尽管高危人群存在迫切的健康需求，但其严格性方面仍存在差距。 先前的研究缺乏证据来识别语音产生子系统之间的变化 TG 个体的习惯性和期望性。因此，该提案的目标是评估我们的概念 声音修改模型：1）将 fo 更改为更加性别一致会导致效率降低 发声，从而增加 VH 的迹象； 2) 实现发声所需的 fo 变化幅度 性别满意度将与 VH 指标的变化幅度相对应。这项观察性研究 将测量 TG 成年人的 VH，这些成年人对自己的习惯声音不满意并希望获得更多性别的声音 一致的声音。 只有那些表示希望改变自己的性别以使其性别更加一致的 TG 个体才会被 为这项研究招募。在目标 1 中，我们将收集呼吸运动学、声学、空气动力学、喉镜、 当个体产生习惯性和 所需的 fo。这一目标将确定 TG 个体用来改变其 fo 的补偿策略。目标2将 检查实现满意度所需的声乐性别变化与 产生所需 fo 所需的 VH 测量值的变化程度。这个目标将确定关系 声音性别满意度与产生期望的 fo 时使用的补偿策略之间的关系。 总之，这些目标将为未来的循证治疗提供路线图：临床医生将获得基线 有关 TG 人群发声功能的信息，这对于提供基于证据的信息至关重要 声音障碍的评估和治疗。