Association between Subjective and Objective Voice Masculinity in Hormone Naïve Trans Male Individuals

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Objective: The aim of this study is to investigate the association between subjective and objective masculine vocal quality in hormone-naïve trans-male individuals. Methods: Twenty-seven hormone-naïve trans-male individuals were recruited for the study. All the study participants had applied to undergo the gender transition process and been referred to the Voice Clinic. The Self-Perception of Voice Masculinity (SPVM) scale and the mean fundamental frequency (F0) were used to assess any association between subjective and objective vocal masculinity. Results: The mean age of study participants was 25.3 years. The median F0 lay within the normal limits for cisgender females. However, in 12 out of 27 cases, F0 lay within the gender-ambiguous frequency range. SPVM scores were higher in this ambiguous group, a result with a strong tendency toward statistical significance (p=0.053). A moderate negative correlation between SPVM and F0 scores was observed (r= -0.484, p=0.027). The s moking frequency was high, with 77.8% of individuals in the group as a whole being smokers. Not only were F0 values of smokers lower than those of non-smokers, but their SPVM scores were also higher. Conclusion: The findings from this study indicate that diversity in objective and subjective voice parameters exists even within the hormone naïve period. There appear to be several factors which influence F0 to a significant extent. Accordingly, a more comprehensive approach is called for when assessing transgender voice at all stages of the gender-affirming medical treatment process. The high frequency of smoking amongst the trans-male population should also be noted as it constitutes a serious health hazard.