ObjectiveThis study aims to investigate the speech characteristics and assess the potential risk of voice fatigue and voice disorders in Chinese transgender women. MethodsA case-control study was conducted involving transgender women recruited in Shanghai, China, from 2022 to 2024. The participants included 15 transgender women (TW), 20 cisgender men (CISM), and 20 cisgender women (CISW). Acoustic parameters, including formants (F1, F2, F3, F4), cepstral peak prominence (CPP), jitter, shimmer, harmonic-to-noise ratio (HNR), noise-to-harmonics (NHR), fundamental frequency (fo), and intensity, were analyzed across vowels, passages, and free speech. Additionally, the Voice Handicap Index-10 (VHI-10) and the Voice Fatigue Index (VFI) were administered to evaluate voice-related concerns. Results(1) The F1 of TW was significantly higher than that of CISW for the vowels /i/ and /u/, and significantly higher than that of CISM for the vowels /a/, /i/, and /u/; The F2 was significantly lower in TW compared to CISW for the vowels /i/ and /u/, and significantly higher than CISM for the vowels /a/ and /u/. F3 was significantly lower in TW than in CISW for the vowels /a/ and /i/. The F4 formant was significantly lower in TW than in CISW for the vowels /a/ and /i/, but significantly higher than in CISM for the vowel /u/. (2) The fo of TW was significantly lower than that of CISW for the vowels /a/, /i/, /u/, during passage reading, and in free speech, but was significantly higher than CISM during passage reading and free speech. Additionally, TW exhibited significantly higher intensity compared to CISW for the vowel /a/ and during passage reading. (3) Jitter in TW was significantly higher than in CISW for the vowels /i/ and /u/, and significantly lower than in CISM during passage reading and free speech. Shimmer was significantly higher in TW compared to both CISW and CISM across the vowels /a/, /i/, during passage reading, and in free speech. The harmonic-to-noise ratio (HNR) in TW was significantly lower than in both CISW and CISM across all vowels, during passage reading, and in free speech. The NHR was significantly higher in TW than in CISW across the vowels /a/, /i/, /u/, during passage reading, and in free speech, and significantly higher than in CISM for the vowels /a/, /i/, during passage reading, and in free speech. The CPP in TW was significantly lower than in CISW during passage reading and free speech, and significantly lower than in CISM across all vowels, during passage reading, and in free speech. (4) The VHI-10 scores were significantly higher in TW compared to both CISM and CISW. ConclusionsTransgender women exhibit certain acoustic parameters, such as fo and some of the formants, that fall between those of CISW and CISM without undergoing phonosurgery or voice training. The findings suggest a potential risk for voice fatigue and the development of voice disorders as transgender women try to modify their vocal characteristics to align with their gender identity.
Read full abstract