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Laryngology/Broncho-Esophagology

(212) Gender-Affirming Voice Therapy Duration and Satisfaction

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Chanticha Laohakittikul, MD

    Clinical Instructor
    Otorhinolaryngology Department, Faculty of Medicine, Khon Kaen University, Thailand
    San Francisco, CA, United States

    • Co-Author(s)

  • Grant E. Gochman, Other

    Medical Student
    Stritch School of Medicine, Loyola University Chicago
    Chicago, Illinois, United States

  • Sarah L. Schneider, MS, CCC-SLP

    Associate Professor, Speech Pathology Director, Co-Director UCSF Voice and Swallowing Center
    Otolaryngology - Head and Neck Surgery, University of California, San Francisco
    San Francisco, California, United States

    • Senior Author(s)

  • VY

    VyVy N. Young, MD

    Associate Professor
    UCSF Voice and Swallowing Center
    San Francisco, California, United States

Disclosure(s):
Chanticha Laohakittikul, MD: No relevant relationships to disclose.
Grant E. Gochman, Other: No relevant relationships to disclose.
Sarah L. Schneider, MS, CCC-SLP: No relevant relationships to disclose.
VyVy N. Young, MD: No relevant relationships to disclose.


Introduction: Current literature involving gender-affirming voice therapy (GAVT) for gender-expansive individuals is limited. This study describes treatment duration and satisfaction in this population.

Methods: A retrospective cohort study of gender-expansive patients receiving gender-affirming treatment at a tertiary voice center. Data collected: age, sex assigned at birth, gender identity, race, ethnicity, number/frequency of GAVT, Voice Handicap Index-10 (VHI-10), Trans Women Voice Questionnaire (TWVQ)(as appropriate), Gender Congruence Scale (GCS), patient and voice therapist (SLP) assessment of treatment satisfaction, and surgical data. Descriptive statistics are reported.

Results: 82 gender-expansive patients [trans female (n=65), trans male (n=5), non-binary (n=12)] sought gender-affirming voice care. Mean age was 33.6±10.7 years. Majority were assigned male at birth (n=71). Mean presentation VHI-10 was 15.7±8. In the first year of treatment, patients had mean 5.7±3.1 (range 1-16, median 5) GAVT sessions, biweekly (n=36, 44%) or monthly (n=12, 15%). 62% (n=51) of patients were satisfied/very satisfied, 23% (n=19) fairly satisfied, and 10% (n=8) unsatisfied with GAVT outcomes. SLP impression of GAVT outcome was more variable: 15% (n=12) completely met voice goals and 11% (n=9) had excellent GAVT response. Most patients (39%, n=32) were making good progress, with further treatment recommended. SLP referred 11% (n=9) back to the laryngologist for surgery consideration; 7% (n=6) underwent Wendler glottoplasty.

Conclusions: Voice therapy plays a vital role in gender-affirming voice care and often requires more sessions (mean 5.7) than the literature-reported average (~4) for other voice diagnoses. Appropriate expectations should be set for patients, treating clinicians, and third-party payors about anticipated duration of GAVT.