Access to Gender-Affirming Voice and Communication Services for Gender-Diverse People of Color
Open AccessPurpose: To explore current barriers to gender-affirming voice and communication services provided by speech-language pathologists as they may relate to one’s race and gender socio-cultural positionings.Method: Survey of 90 gender diverse people using snowball sampling throughout the United States. The survey included closed and open-ended questions regarding individual’s knowledge of and access to voice and communication services provided by speech-language pathologists. The survey’s questions mapped to barriers to healthcare accessibility as conceptualized by Levesque, Russell, and Harris in 2013.Results: The majority of gender-diverse individuals are not currently satisfied with their voice and communication, yet do not access services provided by speech-language pathologists.. Though not statistically significant, primary reasons for not accessing services may differ based on race. While 14% of gender-diverse POC reported they were already satisfied with their voice and communication, 29% of the white gender-diverse people reported this. Further, gender-diverse people of color report affordability and knowledge of processes as primary barriers at higher rate than do white gender-diverse people.Primary reasons for not accessing services may also vary by gender expression, which was categorized as transfeminine, transmasculine, or non-binary for purposes of this study. Though differences did not reach statistical significance, the proportion of transmasculine and non-binary people satisfied with their voices was almost double the proportion in the transfeminine group. Most transmasculine and non-binary people indicated they didn’t know services existed for them, whereas most transfeminine people indicated affordability was the primary barrier. This indicates a need for increased awareness of the goals of voice and communication services besides the common misconceptions of voice and communication services only targeting a feminine-sounding voice. Conclusion: Race-based disparities in access to gender-affirming voice services are not statistically significant, possibly because so few gender-diverse folks who are dissatisfied with their voice are accessing it, regardless of their race. However, as folks become more knowledgeable and are able to make informed decisions and begin to seek, reach, pay, and eventually engage in services to obtain positive outcomes, disparities should continue to be monitored using models of care such as Levesque, Harris, and Russell (2013) so that race-based disparities observed in other healthcare services do not occur for voice and communication needs.
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