Trans Erkeklerde Uzun Dönem Androjen Tedavisinin Sesle İlişkili Sonuçları

Year 2020, Volume: 6 Issue: 1, 53 - 58, 12.01.2020

Seher Sirin , Aslıhan Polat

https://doi.org/10.30934/kusbed.649898

Cited By: 1

Abstract

Amaç: Bu çalışmanın amacı trans
erkek bireylerde uzun süreli androjen tedavisinin sesle ilişkili sonuçlarını
değerlendirmektir.

Yöntem: En az bir yıldır hormon
tedavisi gören trans erkek bireyler değerlendirmeye alındı. Sesin Erkeksiliğini
Algısal Değerlendirme (SPVM) ölçeği, trans erkekler için uyarlanmış Transseksüel
Ses Anketi (a-TVQ^FtM), Sesle ilişkili Yaşam Kalitesi (V-RQOL) ve
fundamental frekans (f0) ses sonuç ölçütleri kullanıldı.

Bulgular: Çalışmaya dahil edilen 13
trans erkek bireyin yaş ortalaması 26.15 idi. Medyan SPVM skoru 4 olup biraz
erkeksi algılandığı gözlendi. Medyan f0 skoru 119 Hertz idi ve Türk erkek
normatif verilerinden farklı değildi. Medyan a-TVQ^FtM skorlarındaki
azalma eğilimi ve medyan V-RQOL ölçek skorlarında artış eğilimi, medyan f0
skorlarının düşüşü ile uyumlu idi. İki bireyin f0’ı cinsiyet belirsiz ses
aralığındaydı ve % 15,4'lük bir başarısızlık gözlendi. Cinsiyeti belirsiz ses
aralığında olan bu iki bireyden biri sesini nötral algılarken diğeri sesini çok
erkeksi algıladı.

Sonuç: Karşı cins hormon tedavisi,
tedavi isteyen trans erkek bireyler için erkeksi ses elde etmede etkilidir. Ses
perdesini düşürücü etkisi, trans bireylerin sesle ilgili yaşam kalitesinde,
özellikle de ses kimliği ile ilişkili anlamlı iyileşme sağlamaktadır. Bazı
olgularda, erkek ses aralığı elde edilemeyebilir. Böyle bir durumda, tedavi
sonuçları ve ek müdahalelerin gerekliliği dikkatle değerlendirilmelidir.

Keywords

Ses, Hormon tedavisi, transseksüel, testosteron, yaşam kalitesi, öz algı

Voice-related Outcomes after Long-Term Androgen Treatment in Trans Males

Abstract

Objective: The aim of this study was to evaluate voice-related
outcomes of long-term androgen treatment in trans male individuals.

Methods: Trans male individuals who were under hormone
treatment for at least one year were evaluated. Self-Perception of Voice
Masculinity (SPVM) scale, adapted Transsexual Voice Questionnaire for trans
males (a-TVQ^FtM), Voice-related Quality of Life (V-RQOL), and the
mean fundamental frequency (f0) were used to assess voice outcomes.

Results: Of the thirteen trans male individuals in this
study, the mean age was 26.15 years. The median SPVM was 4, which equated to
“somewhat male”. The
median f0 was 119 Hz and did not differ
from Turkish cisgender male normative data. The median a-TVQ^FtM scores showed a decreasing trend and the
median V-RQOL scale scores showed an increasing trend in accordance with the
decrease of median f0 scores. Two individuals were within a gender ambiguous f0
range and a failure rate of 15.4% was observed. Of these two individuals who
were still within a gender ambiguous f0 range, one perceived his voice as
gender neutral, while the other one perceived his voice as very male.

Conclusion: Cross-sex hormone treatment was largely effective
in voice masculinization for trans male individuals seeking treatment. Its
pitch lowering effect is associated with a significant improvement in the
voice-related quality of life of trans individuals, especially in vocal
identity. In some cases, a cisgender male frequency may not be achieved. This
situation should be evaluated with caution when discussing treatment outcomes
and the necessity of additional interventions. 

Keywords

Voice, hormone therapy, transgender, testosterone, quality of life, self-perception

References

• Bouman WP, Schwend AS, Motmans J, et al. Language and trans health. Int J Transgend. 2017;18(1):1-6.
• Coleman E, Bockting W, Botzer M, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, Version 7. Int J Transgend. 2012;13(4):165-232.
• Hardy TL, Boliek CA, Wells K, Dearden C, Zalmanowitz C, Rieger JM. Pretreatment acoustic predictors of gender, femininity, and naturalness ratings in individuals with male-to-female gender identity. Am J Speech Lang Pathol. 2016;25(2):125-37.
• Irwig MS. Testosterone therapy for transgender men. Lancet Diabetes Endocrinol. 2017;5(4):301-311.
• Gelfer MP, Mordaunt M. Pitch and intonation. In Adler RK, Hirsch S, Mordaunt M, editors. Voice and Communication Therapy for The Transgender/Transsexual Client: A Comprehensive Clinical Guide. San Diego, CA: Plural Publishing; 2012:187-224.
• Azul D, Nygren U, Södersten M, Neuschaefer-Rube C. Transmasculine people's voice function: A review of the currently available evidence. J Voice. 2017;31(2):261.e9-261.e23.
• Dacakis G, Davies S, Oates JM, Douglas JM, Johnston JR. Development and preliminary evaluation of the transsexual voice questionnaire for male-to-female transsexuals. J Voice. 2013;27(3):312-320.
• Dekker MJ, Wierckx K, Van Caenegem E, et al. A European Network for the Investigation of Gender Incongruence: Endocrine Part. J Sex Med. 2016;13(6):994-9.
• Bultynck C, Pas C, Defreyne J, Cosyns M, den Heijer M, T’Sjoen G. Self-perception of voice in transgender persons during cross-sex hormone therapy. Laryngoscope. 2017;127(12):2796-2804.
• Watt SO, Tskhay KO, Rule NO. Masculine voices predict well-being in female-to-male transgender individuals. Arch Sex Behav. 2018;47(4):963-72.
• Bultynck C, Pas C, Defreyne J, Cosyns M, T’Sjoen G. Organizing the voice questionnaire for transgender persons. Int J Transgend. 2019;1-9. doi: 10.1080/15532739.2019.1605555.
• Taskin A, Aydınlı FE, Başar K, Yılmaz T, Özcebe E. Investigating the validity and reliability of the Turkish version of the transsexual voice questionnaire (TVQMtF). Paper presented at: 3rd Biennal of EPATH Conference Inside Matters. On Law, Ethics and Religion; April 11-13, 2019; Rome. Completed Text book, 2019, pp. 80-81, Rome, Italy.
• Sirin S, Polat A. Psychometric evaluation of adapted transsexual voice questionnaire for Turkish trans males. Paper presented at: VoiceIstanbul. International Conference on Voice in All Aspects; September 16-19, 2019; Istanbul. Abstract book, 2019, pp.27, Istanbul, Turkey.
• Hogikyan ND, Sethuraman G. Validation of an instrument to measure voice-related quality of life (V-RQOL). J Voice. 1999;13(4):557- 69.
• Tezcaner ZC, Aksoy S. Reliability and Validity of the Turkish version of the voice-related quality of life measure. J Voice. 2017;31(2):262.e7-262.e11.
• Demirhan E, Unsal ME, Yilmaz C, Ertan E. Acoustic voice analysis of young Turkish speakers. J Voice. 2016;30(3):378.e21-5.
• Ziegler A, Henke T, Wiedrick J, Helou LB. Effectiveness of testosterone therapy for masculinizing voice in transgender patients: A meta-analytic review. Int J Transgend. 2018;19(1):25-45.
• Azul D. Transmasculine people’s vocal situations: a critical review of gender-related discourses and empirical data. Int J Lang Commun Disord. 2015;50(1):31-47.
• Cosyns M, Van Borsel J, Wierckx K, et al. Voice in female-to-male transsexual persons after long-term androgen therapy. Laryngoscope. 2014;124(6):1409-14.
• Van Borsel J, De Cuypere G, Rubens R, Destaerke B. Voice problems in female-to-male transsexuals. Int J Lang Commun Disord. 2000;35(3):427-42.
• Nygren U, Nordenskjöld A, Arver S, Södersten M. Effects on voice fundamental frequency and satisfaction with voice in trans men during testosterone treatment - A longitudinal study. J Voice. 2016;30(6):766.e23-766.e34.
• Deuster D, Matulat P, Knief A, et al. Voice deepening under testosterone treatment in female-to male gender dysphoric individuals. Eur Arch Otorhinolaryngol. 2016;273(4):959-65.
• Scheidt D, Kob M, Willmes K, Neuschaefer-Rube C. Do we need voice therapy for female-to-male transgenders? In: Murdoch BE, Gooze J, Whelan B-M, et al., editors. 2004 IALP-Congress-Proceedings. Brisbane: Speech Pathology Australia; 2004:1-6.
• Hancock AB, Childs KD, Irwig MS. Trans male voice in the first year of testosterone therapy: make no assumptions. J Speech Lang Hear Res. 2017;60(9):2472-2482.
• Van Borsel J, de Pot K, De Cuypere G. Voice and physical appearance in female-to-male transsexuals. J Voice. 2009;23(4):494-7.
• Damrose JE. Quantifying the impact of androgen therapy on the female larynx. Auris Nasus Larynx. 2009;36(1):110-2.
• Pegoraro Krook MI. Speaking fundamental frequency characteristics of normal Swedish subjects obtained by glottal frequency analysis. Folia Phoniatr (Basel). 1988;40(2):82-90.
• Klatt DH, Klatt LC. Analysis, synthesis, and perception of voice quality variations among female and male talkers. J Acoust Soc Am. 1990;87(2):820-857.
• Sirin S, Polat A, Alioğlu F. Voice-related gender dysphoria: quality of life in hormone naive trans male individuals. Anadolu Psikiyatri Derg 2019. doi: 10.5455/apd.41947.