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Community Partners Facilitate Access to Voice and Communication Services for Transgender and Gender-Diverse People Open Access

BACKGROUND: Voice training for transgender and gender nonconforming individuals is in demand, yet is often inaccessible- especially for individuals of minority race or socioeconomic status. To reduce the identified access barriers of cost, availability, and general knowledge of services, clinicians at the GW Speech and Hearing Center partnered with Whitman Walker Health to pilot a program to help people in the urban Washington DC area feminize their voice and communication. METHOD: A 3-hour Saturday afternoon “Voice Feminization” workshop was held at a local safe-space for LGBTQ community members. Nine transgender women and gender non-conforming individuals (all assigned male at birth) learned and practiced adjusting their voice characteristics of pitch, resonance/quality, and intonation in small groups lead by six graduate speech-language pathology clinicians and two licensed speech-language pathologists. Outcome measures included changes (pre-workshop vs. post-workshop) in voice fundamental frequency (pitch), the most salient gender-marker of voice, and post-workshop participant ratings of their voice and the workshop program. Each participant rated the following on a 5 point likert scale: overall workshop, structure of the workshop, content of the workshop, effectiveness of the training, pleasantness/helpfulness of staff, day and time of workshop, length of workshop, do you feel you made progress. Seven of the participants were available for follow-up via phone interview. RESULTS: Speaking pitch (mean fundamental frequency) increased (i.e., feminized) after the workshop by a mean of 2.84ST (SD = 3.71ST, Range = 0.9 – 4.61ST). Changes in intonation, measured by F0 range during speech, varied by individual: 5 increased and 3 deceased their range. All participants felt they made progress during the workshop, rating progress as “very good” on the post-workshop survey (M = 4.11, SD = 1.05). For program evaluation, all areas on the survey were rated as “good” (3) or better on the 1-5 scale. Participants viewed the overall workshop to be “very good” with a mean rating of 4.22 (SD=.67, n=9). Also with mean ratings of 4.22 were content of the workshop, effectiveness of training, and day/time of workshop. Category with highest mean rating (4.89) was pleasantness/helpfulness of staff. Comments indicating desire for a longer workshop were consistent with lowest mean ratings being for structure of the workshop (3.65) and length of workshop (3.22). Comments gathered from participants two weeks after the workshop via follow-up phone calls were consistent with post-workshop data. Generally, participants felt the need to practice their more feminized voice, particularly with a focus on resonance. DISCUSSION: Due to the high ratings of the overall workshop, and quantitative improvement, it is recommended that similar workshops be created with time modifications to benefit the target population and their experience with voice feminization.

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