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

项目摘要 变性人(TG；性别认同与出生时指定的性别不匹配)个人服务不足，目标 暴力，以及产生负面健康后果的风险更高。许多TG患者报告说，发出声音 与他们的性别认同相一致是确认他们的性别认同的关键。有各种各样的性别 肯定可提供的服务，但医疗干预，如手术或激素不能确保 对声乐性别的满意度。修改声音通常是首选的干预措施。其中一个主要目标是 因为声音改变是将基频(Fo)改变为性标准值，但人们知之甚少 关于发声所需的潜在变化，以适应所需的声音。研究表明， Tg个体为达到预期目标而使用的补偿策略具有非典型的模式特征 发声，符合发声功能亢进(VH)。这可能解释了为什么发声抱怨的频率很高。 在TG扬声器中。总而言之，尽管高危人群存在严重的健康需求，但在严格执行 之前的研究，缺乏证据来确定语音产生的子系统之间的变化 甘油三酯个体的习惯性和期望值。因此，这项提案的目标是评估我们的概念性 语音修改模型：1)将语音修改为更一致的性别将导致效率较低 发声，从而增加VH的迹象；以及2)实现发声所需的fo变化的幅度 性别满意度将与VH衡量标准的变化幅度相对应。这项观察性研究 将测量TG成年人的VH，这些成年人对自己习惯性的声音不满意，希望有更多的性别- 和谐的声音。 只有表示希望改变自己的性别以变得更加一致的TG个人才会 为这项研究招募的。在目标1中，我们将收集呼吸运动学、声学、空气动力学、喉镜、 自我感知和听者听觉--当个体产生他们的习惯和 所需的fo。这一目标将确定TG个体用来改变他们的Fo的补偿策略。目标2将 检查获得满意所需的声带性别变化与 产生所需fO所需的VH量度的变化程度。这一目标将确定这种关系 声乐性别满意度与产生期望音调时所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 关于TG人群中发声功能的信息，这对于提供基于证据的 嗓音障碍的评估和治疗。

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.