Background/Aim: Scales used to collect perceptual ratings related to a speaker’s gender are widely used in gender affirming voice training for trans individuals. Such scales may be used as outcome measures to gain insight into whether training has helped clients meet personal goals related to gender expression. These scales are also widely used in general research investigating the relationship between vocal characteristics and perceptions of speaker gender. However, past studies in these areas have varied in the terminology used to label rating scales and the impact of this variation is currently unknown. Additionally, research has not yet fully explored the relationship between self- and listener ratings of trans participant voices and trans participant satisfaction with voice, and whether or not these relationships change after trans participants undertake gender affirming voice training. This research paper aimed to explore these relationships and address these research gaps. Methods: A group of 34 trans participants were asked to rate their voices before and after participating in gender affirming voice training. Trans participant voice samples from before and after training were also presented to a group of 25 listeners for rating. Perceptual ratings were made on two visual analogue scales (VAS) with anchors “very feminine/very masculine” and “very female/very male.” Trans participants also rated their satisfaction with their current voice on a VAS with anchors “very satisfied/very unsatisfied.” Correlation coefficients were calculated to investigate the relationship between collected ratings. Results: Differences in scale labels were found to have minimal impact on ratings made by both trans participants and listeners. Trans participant self-ratings were found to correlate with listener ratings, but this correlation was not strong. Trans participant self-ratings had a consistently stronger relationship with their self-rated vocal satisfaction. The study contributed new findings that these differences may be more pronounced after trans participants have completed voice training. Discussion/Conclusion: This study suggests that results from past studies that have used differently labelled scales to collect ratings related to gender perception based on voice are suitable to compare. This study also discusses the implications reported differences between trans participant self-ratings and listener ratings may have for research and clinical practice.

1.
Wylie
K
,
Barrett
J
,
Besser
M
,
Bouman
WP
,
Bridgman
M
,
Clayton
A
,
.
Good practice guidelines for the assessment and treatment of adults with gender dysphoria
.
Sex Relatsh Ther
.
2014
;
29
(
2
):
154
214
.
2.
World Professional Association for Transgender Health
.
Standards of care for the health of transsexual, transgender, and gender-conforming people
[Internet]. 7th ed.
2011
. Available from: https://www.wpath.org/publications/soc.
3.
Davies
S
,
Papp
VG
,
Antoni
C
.
Voice and communication change for gender nonconforming individuals: giving voice to the person inside
.
Int J Transgend
.
2015
;
16
(
3
):
117
59
.
4.
Vincent
B
.
Introducing trans terminology
. In:
Transgender health: a practitioner’s guide to binary and non-binary trans patient care [e-book]
.
Jessica Kingsley Publishers
;
2018
. p.
17
38
. Available from: http://ebookcentral.proquest.com/lib/latrobe/detail.action?docID=5403637.
5.
Mills
M
,
Stoneham
G
,
Georgiadou
I
.
Expanding the evidence: developments and innovations in clinical practice, training and competency within voice and communication therapy for trans and gender diverse people
.
Int J Transgend
.
2017
;
18
(
3
):
328
42
.
6.
Oates
J
.
Evidence-based practice in voice training for trans women
. In:
Adler
R
,
Hirsch
S
,
Pickering
J
, editors.
Voice and communication therapy for the transgender/transsexual client: a comprehensive clinical guide
. 3rd ed.
San Diego, CA
:
Plural Publishing
;
2019
. p.
87
103
.
7.
Kalra
MA
.
Voice therapy with a transsexual
. In:
Gemme
R
,
Wheeler
CC
, editors.
Progress in sexology. Perspectives in sexuality (behavior, research, and therapy)
.
Boston, MA
:
Springer
;
1977
. p.
77
84
.
8.
Dacakis
G
.
Considerations for intake and assessment
. In:
Adler
R
,
Hirsch
S
,
Pickering
J
, editors.
Voice and communication therapy for the transgender/transsexual client: a comprehensive clinical guide
. 3rd ed.
San Diego, CA
:
Plural Publishing
;
2019
. p.
105
26
.
9.
Hancock
AB
,
Siegfriedt
LL
.
Transforming voice and communication with transgender and gender-diverse people: an evidence-based process
.
San Diego, CA
:
Plural Publishing
;
2020
.
10.
Mills
M
,
Stoneham
G
.
The voice book for trans and non-binary people: a practical guide to creating and sustaining authentic voice and communication
.
London, UK
:
Jessica Kingsley Publishers
;
2017
.
11.
Azul
D
,
Hancock
AB
.
Who or what has the capacity to influence voice production? Development of a transdisciplinary theoretical approach to clinical practice addressing voice and the communication of speaker socio-cultural positioning
.
Int J Speech Lang Pathol
.
2020
;
22
(
5
):
559
70
.
12.
Oates
J
,
Dacakis
G
.
Transgender voice and communication: research evidence underpinning voice intervention for male-to-female transsexual women
.
Perspect Voice Voice Dis
.
2015
;
25
(
2
):
48
58
.
13.
Leung
Y
,
Oates
J
,
Chan
SP
.
Voice, articulation and prosody contribute to listener perceptions of speaker gender: a systematic review and meta-analysis
.
J Speech Lang Hear Res
.
2018
;
61
(
2
):
266
97
.
14.
Hancock
AB
,
Krissinger
J
,
Owen
K
.
Voice perceptions and quality of life of transgender people
.
J Voice
.
2011
;
25
(
5
):
553
8
.
15.
McNeill
EJ
,
Wilson
JA
,
Clark
S
,
Deakin
J
.
Perception of voice in the transgender client
.
J Voice
.
2008
;
22
(
6
):
727
33
.
16.
Dacakis
G
,
Oates
JM
,
Douglas
JM
.
Further evidence of the construct validity of the transsexual voice questionnaire (TVQMtF) using principal components analysis
.
J Voice
.
2017
;
31
(
2
):
142
8
.
17.
Dacakis
G
.
Long-term maintenance of fundamental frequency increases in male-to-female transsexuals
.
J Voice
.
2000
;
14
(
4
):
549
56
.
18.
Pasricha
N
,
Dacakis
G
,
Oates
J
.
Communicative satisfaction of male-to-female transsexuals
.
Logoped Phoniatr Vocol
.
2008
;
33
(
1
):
25
34
.
19.
Quinn
S
,
Oates
J
,
Dacakis
G
.
The experiences of trans and gender diverse clients in an intensive voice training program: a mixed-methodological study
.
J Voice
.
2021 Feb 2
. Epub ahead of print.
20.
Quinn
S
,
Swain
N
.
Efficacy of intensive voice feminisation therapy in a transgender young offender
.
J Commun Disord
.
2018 Mar 1
;
72
:
1
15
.
21.
Holmberg
EB
,
Oates
J
,
Dacakis
G
,
Grant
C
.
Phonetograms, aerodynamic measurements, self-evaluations, and auditory perceptual ratings of male-to-female transsexual voice
.
J Voice
.
2010
;
24
(
5
):
511
22
.
22.
Owen
K
,
Hancock
AB
.
The role of self- and listener perceptions of femininity in voice therapy
.
Int J Transgend
.
2010
;
12
(
4
):
272
84
.
23.
Addington
DW
.
The relationship of selected vocal characteristics to personality perception
.
Speech Monogr
.
1968
;
35
(
4
):
492
503
.
24.
Van Borsel
J
,
de Pot
K
,
De Cuypere
G
.
Voice and physical appearance in female-to-male transsexuals
.
J Voice
.
2009
;
23
(
4
):
494
7
.
25.
Andrews
ML
,
Schmidt
CP
.
Gender presentation: perceptual and acoustical analyses of voice
.
J Voice
.
1997
;
11
(
3
):
307
13
.
26.
Hancock
A
,
Colton
L
,
Douglas
F
.
Intonation and gender perception: applications for transgender speakers
.
J Voice
.
2014
;
28
(
2
):
203
9
.
27.
Boersma
P
.
Praat, a system for doing phonetics by computer
.
Glot Int
.
2001
;
5
(
9/10
):
341
7
.
28.
International Phonetic Association
.
Handbook of the International Phonetic Association: a guide to the use of the International Phonetic Alphabet
.
Cambridge University Press
;
1999
.
29.
Australian/New Zealand Standard
.
Acoustics: recommended design sound levels and reverberation times for building interiors
.
2016
. Available from: https://infostore.saiglobal.com/en-au/Standards/AS-NZS-2107-2016-1882409/.
30.
Patel
RR
,
Awan
SN
,
Barkmeier-Kraemer
J
,
Courey
M
,
Deliyski
D
,
Eadie
T
,
.
Recommended protocols for instrumental assessment of voice: American Speech-Language-Hearing Association expert panel to develop a protocol for instrumental assessment of vocal function
.
Am J Speech-Language Pathol
.
2018
;
27
(
3
):
887
905
.
31.
Švec
JG
,
Granqvist
S
.
Tutorial and guidelines on measurement of sound pressure level (SPL) in voice and speech
.
J Speech Lang Hear Res
.
2018
;
61
(
3
):
441
61
.
32.
The Audacity Team
.
Audacity (2.2.2) [software program]
.
1999–2018
. Available from: http://audacity.sourceforge.net/.
33.
Fairbanks
G
.
Voice and articulation drillbook
. 2nd ed.
New York, NY
:
Harper and Row
;
1960
.
34.
Carew
L
,
Dacakis
G
,
Oates
J
.
The effectiveness of oral resonance therapy on the perception of femininity of voice in male-to-female transsexuals
.
J Voice
.
2007
;
21
(
5
):
591
603
.
35.
Hancock
A
,
Helenius
L
.
Adolescent male-to-female transgender voice and communication therapy
.
J Commun Disord
.
2012
;
45
(
5
):
313
24
.
36.
Hinkle
D
,
Wiersma
W
,
Jurs
S
.
Applied statistics for the behavioral sciences
. 5th ed.
Boston
:
Houghton Mifflin
;
2003
.
37.
Fiani
CN
,
Han
HJ
.
Navigating identity: experiences of binary and non-binary transgender and gender non-conforming (TGNC) adults
.
Int J Transgend
.
2019
;
20
(
2–3
):
181
94
.
38.
Garrison
S
.
On the limits of “trans enough”: authenticating trans identity narratives
.
Gend Soc
.
2018
;
32
(
5
):
613
37
.
39.
Killermann
S
.
Genderbread person v4.0 [Internet]
.
2017
. Available from: https://www.genderbread.org/resource/genderbread-person-v4-0.
40.
Haskell
JA
,
Baken
RJ
.
Self-perception of speaking pitch levels
.
J Speech Hear Disord
.
1978
;
43
(
1
):
3
8
.
41.
Azul
D
.
On the varied and complex factors affecting gender diverse people’s vocal situations: implications for clinical practice
.
Perspect Voice Voice Disord
.
2015
;
25
(
2
):
75
86
.
42.
Hancock
AB
,
Pool
SF
.
Influence of listener characteristics on perceptions of sex and gender
.
J Lang Soc Psychol
.
2017
;
36
(
5
):
599
610
.
43.
International Commission of Jurists
.
The Yogyakarta principles plus 10: additional principles and state obligation on the application of international human rights law in relation to sexual orientation, gender expression and sex characteristics to complement the Yogyakarta principles [Internet]
.
2017
. Available from: http://yogyakartaprinciples.org/wp-content/uploads/2017/11/A5_yogyakartaWEB-2.pdf.
You do not currently have access to this content.