Trans Voice Literature Review №2

Found a few more recent articles from 2024.

4. Bøyesen, B., & Hide, Ø. (2024). Using Twang and Medialization Techniques to Gain Feminine-Sounding Speech in Trans Women. Journal of Voice. https://doi.org/10.1016/j.jvoice.2024.10.020

   TL;DR: Two weeks to five months of training (each participant decided when their training ended. All five participants successfully raised F0, F1, and F2 (but not F3) using twang and medialization. Participants were rated as feminine after treatment.

   The first one hour session: Participants were guided to a bright and easily produced sound in their highest frequencies, above the register shft. It was important to get the tongue position right to ensure forward resonance placement and then to make a twangy sound. Then, participants were introduced to medialization. Establish an adequate onset in a desirable frequency range, which required diminishing differences in resonance and keeping that forward tone placement that arose in twang. Phonation was initiated with an easy glottal onset to avoid falsetto quality (Using test words that started with a vowel). Once the tone was strong and established, the soft onset was involved, while keeping the same resonant placement and forward tongue position. By that point, words starting with consonants could be used.

   Sessions before generalization: Using short responding words in the new voice, then phrases that occur in common or challenging situations. Remembering to use bright resonance in speech quality and forward tone placement with twang, medialization and vowel formation with easy glottal onset, medialization with soft onset for words starting with consonants. Short and longer sentences were uttered in a chanting manner in the frequency area and scope.

   Continuing sessions: By now, the participants can practice on their own. The participants were reminded to train their sensitivity by feeling vibrations in the lips, teeth, nostrils, and in the front part of the hard palate. Voice recordings were used as reference during self training.

   Results: F0 went from 139Hz to 199Hz (compare: 112Hz masc, 210Hz fem); F1 went from 659Hz to 784Hz (compare: 612Hz masc, 746Hz fem); F2 went from 1171Hz to 1243Hz (compare: 1055Hz masc, 1251Hz fem); and F3 did not significant change. The authors suggest that F1 is controlled by the oral cavity openness, F2 by the laryngeal height or pharyngeal narrowing, and F3 by lip spread.

   Review: Despite the small sample size, this study shows promise. The tongue position, possibly the same as in Kawitzky et al. [1] and Carew et al. [2], is used here to counteract falsetto, and likely as a side effect increases F2. This means that F0 and F1 are potentially both increased by the Twang component.

5. Leyns, C., Bostyn, L., & D’haeseleer, E. (2024). Self-Perception and Listener Perceptions at Long-Term Follow-Up of a Gender-Affirming Voice Training Program for Transgender Women. Journal of Voice. https://doi.org/10.1016/j.jvoice.2024.10.032

   TL;DR: 10 weeks of effective training. PET and ART as in Leyns et al. [3], with 34 participants. Perception of femininity decreased over the one year and three months post training. Worth noting that average femininity post training was in the androgynous range, and ended a bit lower than that (more masculine, but not fully masculine).

   Review: This is a much needed followup to Leyns et al. [3]. It shows that long term the efficacy holds somewhat, though the initial gender ratings leave a bit to be desired - getting closer to feminine would be a goal for future versions of the study.

6. Hawley, J. L. & Hancock A. B. (2024). Incorporating Mobile App Technology in Voice Modification Protocol for Transgender Women. Journal of Voice, Vol. 38, No. 2. https://doi.org/10.1016/j.jvoice.2021.09.001

   TL;DR: 10-11 weeks of training, but only four participants. During to the app-lead phase, each participant had occasional sessions with a clinician to help avoid falsetto (by lowering target frequency) and demonstrating lip spreading and forward tongue carriage srategies. Each participant used a different tool: 1. Online Videos, 2. Pitch meter app, 3. Voice feminization recordings, 4. Eva: a self-guided app. If the participant had trouble employing the aforementiond strategies, they would be given guidance on facilitating control of the larynx (eg, breath control). All participants ended up in the androgynous range for vocal rating at the end.

   Results: Participant 1 overcorrected into falsetto and spent the study working down to a reasonable F0, going from 240Hz in week 1 down to 172Hz by the end. Participants 2 and 3 saw decent F0 increases from 137Hz to 190Hz and 142Hz to 196Hz respectively. Participant 4 saw the sharpest increase in F0 during the experiment, going from 112Hz to 175Hz, but overcorrected into falsetto and so spent the last few weeks working back towards a sustainable voice.

   Review: This study does employ resources that general people have access to (apps), but supplements it with resources we don't have ready access to (SLP's). Whether the apps could work on their own remains uncertain, but the overcorrection into falsetto remains concerning regardless.

7. Holmberg, J., Södersten, M., Linander, I., & Nylén, F. (2024). Perception of Femininity and Masculinity in Voices as Rated by Transgender and Gender Diverse People, Professional Speech and Language Pathologists, and Cisgender Naive Listeners, Journal of Voice. https://doi.org/10.1016/j.jvoice.2024.07.034

   TL;DR: Speech Language Pathologists (SLP's) rate the masculinity and femininity of voices differently than both transgender/gender diverse (TGD) and cisgender naïve listeners. SLP's rated cis men as more masculine than the other raters, cis women as more feminine than the other raters, nonbinary transmasc speakers as more feminine than the other raters, and tended take less of a side for trans women, trans men, or detransitioning women than the other raters.

   Review: I'll have to take the time to review the studies I've included here to determine whether the raters were SLP's or not. If so, then we have to take those ratings with more skepticism.

This is another interesting crop of articles, all more recent than the previous set. Lots of questions raised here, with at least a few things I could try out in the future.