The efficacy of gender-affirming voice and communication therapy—a systematic review

BACKGROUND: The World Professional Association for Transgender Health (2022) recommend voice and communication therapy within their standards of care for transgender and gender-diverse individuals; however, there is currently limited data to address the efficacy of interventions for this population beyond changes to fundamental frequencies. This systematic review will explore (1) the efficacy of voice and communication therapy for supporting trans and gender-diverse individuals in decreasing gender incongruence and will (2) consider the most effective modes and models of intervention for attaining this goal.

STUDY DESIGN: Systematic review.

METHODS: A systematic literature search was undertaken through the online databases Scopus, Cochrane Library, PsycInfo, and PubMed, based upon a population, intervention, comparison, outcomes search strategy, with an additional paper being included from manual citation searches. For inclusion, studies were required to address purely non-surgical interventions and, to appropriately align with a contemporary understanding of therapeutic efficacy, to include patient self-rating outcome measures alongside acoustic measures.

RESULTS: Eight pertinent studies were included from the searches. The results of all eight studies indicated changes in acoustic measures, listener perceptions, and self-perceptions following therapeutic intervention for participants of varying ages and backgrounds.

CONCLUSIONS: Voice and communication interventions appear to improve quality of life, vocal function, and social participation in transgender and non-binary individuals and support movements of acoustic and perceptual measures to more closely reflect an individual's gender. Further, much larger studies are required to (1) compare modes and models of intervention and to (2) assess the efficacy of therapeutic intervention for wider transgender populations.