Interdisciplinary Program in Sweden Related to Transgender Voice

Abstract

Gender incongruence occurs when there is a discrepancy between gender identity and a person's sex assigned at birth and their bodily appearance. Sweden was the first country in the world to pass a law regulating a person's legal right to change gender. There are six psychiatric gender teams in Sweden responsible for diagnostic assessments and coordination of gender confirming medical interventions. Extended gender teams include endocrinologists, speech-language pathologists, phoniatricians, gynecologists, dermatologists, and surgeons. All male-to-female (MtF) and female-to-male (FtM) transgender individuals are referred for voice assessment when a gender dysphoria diagnosis has been confirmed. Voice assessment includes questionnaires and voice recordings in habitual and loud voice and voice range profiles. Voice and communication therapy is provided for both MtF and FtM individuals. Pitch-raising surgery can be considered and pre- and post-operative voice therapy is required for optimal results. The Swedish Association for Transsexual Health was launched 2004. The national guidelines were recently updated to make those more congruent with WPATH's Standards of Care version 7. A national quality registry for Gender Dysphoria has been accepted for financial support. The registry will in the future be a unique source to provide data concerning patient satisfaction, safety, and life quality.