LUKIMON - project

Trans women are presumed male at birth and identify as women. Many people experience an incongruence between their gender identity and the gender they were assigned at birth, which can lead to suffering, so-called gender dysphoria. People with gender dysphoria can receive treatment such as hormones and surgery to adapt their body to their gender identity.

Some want voice training to adapt their voice towards their gender identity. Gender affirming voice training aims for trans women to find a voice that they are satisfied with and to be perceived by others in accordance with their gender identity. There are studies indicating that gender affirming voice training has positive effects. However, larger treatment studies are needed, which is the reason for this international collaboration project.

Among other things, we want to find out

• The effectiveness of gender affirming voice training for trans women.
• What outcome measures should be used when evaluating such voice training?
• What predictors are related to good treatment results?

The project is ethically approved by La Trobe University Human Research Ethics Committee (HEC17-042) and by the Ethics Review Authority (2016 / 2483-31 / 2, 2018 / 1145-32 and 2019-01710).

Progress of the project

The recruitment of participants is completed. The goal was to recruit 40 trans women in Sweden and 40 in Australia during a period of two years starting in 2018. Eighty-one persons were recruited, of which 74 completed the entire training program (31 at K/KI and 43 at LU).

The voice training was given, according to a strict treatment protocol, one 45 minutes session per week between 8 and 12 sessions. Two speech language pathologists led the voice training program at LU and three at K/KI. Data collection consisted of audio voice recordings when reading a standard text and narrating to a series of pictures, and data from several voice and life quality questionnaires.

Data collection was completed four times:

• at intake to the study (T1),
• after 3 months without intervention (T2),
• after completing voice training (T3) and
• after 3 months follow-up (T4).

The data collection is completed.

Part of the data analysis is finished. We consider the results from ratings of satisfaction with voice, social participation and how others perceive the voices as primary outcomes. Analysis of acoustic data such as fundamental, formant frequencies, and voice sound pressure level are regarded as secondary outcomes that will help us to understand why some voices, in a listening test, were perceived female and others not after the voice training program.

The results will be presented both at a group and individual level and focus on reliable and clinically meaningful differences. Within the project, we have developed an area-specific questionnaire regarding self-efficacy, which is about what the patients think about their own ability to change their voice. Two conference papers have been presented at international conferences and one article has recently been published (Dacakis et al 2022).

Project group