Adrienne B. Hancock

Intonation and Gender Perception: Applications for Transgender Speakers

Intonation is commonly addressed in voice and communication feminization therapy, yet empirical evidence of gender differences for intonation is scarce and rarely do studies examine how it relates to gender perception of transgender speakers. This study examined intonation of 12 males, 12 females, six female-to-male, and 14 male-to-female transgender speakers describing a Norman Rockwell image. Several intonation measures were compared between biological gender groups, between perceived gender groups, and between male-to-female (MTF) speakers who were perceived as male, female, or ambiguous gender. Speakers with a larger percentage of utterances with upward intonation and a larger utterance semitone range were perceived as female by listeners, despite no significant differences between the actual intonation of the four gender groups. MTF speakers who do not pass as female appear to use less upward and more downward intonations than female and passing MTF speakers. Intonation has potential for use in transgender communication therapy because it can influence perception to some degree.

The Role of Self- and Listener Perceptions of Femininity in Voice Therapy

ABSTRACT Voice therapy, especially during male-to-female transition, typically targets acoustic measures of voice. Self-perception of femininity may be a valuable measure to incorporate into clinical protocols and empirical investigations of treatment efficacy. Speech samples of 20 male-to-female transgender and 10 cisgender speakers were rated by speakers and 25 listeners. Mean fundamental frequency (Fo) and semitone range, but not perturbations, of the speakers voice were strongly related to speaker- and listener-rated femininity. Listener-rated femininity strongly correlated with speakers self-rated femininity. Results of this study provide guidance and methodology for incorporating the speakers self-perceptions of overall and vocal femininity into voice therapy.

Adolescent male-to-female transgender voice and communication therapy

UNLABELLED Current research to describe and evaluate effectiveness of voice and communication therapy for male-to-female transgender people is limited to adults. This paper provides rationale, procedures, and outcomes from voice and communication therapy for a male-to-female transgender adolescent 15 years of age. Treatment addressed vocal hygiene, breath support, fundamental frequency, intonation, resonance and vocal quality, and rate. Positive acoustic, perceptual, and client self-report outcomes confirm treatment effectiveness for this adolescent. LEARNING OUTCOMES The reader will be able to recognize common aspects of transgender voice and communication therapy provided by a speech-language pathologist. The reader will also be able to explain the effectiveness of therapy provided to an adolescent speaker.

Influence of Communication Partner’s Gender on Language

Forty participants (20 male) had 3-minute conversations with trained male and female communication partners in a repeated-measures, within-subject design. Eighty 3-minute conversations were transcribed and coded for dependent clauses, fillers, tag questions, intensive adverbs, negations, hedges, personal pronouns, self-references, justifiers, and interruptions. Results suggest no significant changes in language based on speaker gender. However, when speaking with a female, participants interrupted more and used more dependent clauses than when speaking with a male. There was no significant interaction to suggest that the language differences based on communication partner was specific to one gender group. These results are discussed in context of previous research, communication accommodation theory, and general process model for gendered language.

Real Enough: Using Virtual Public Speaking Environments to Evoke Feelings and Behaviors Targeted in Stuttering Assessment and Treatment

PURPOSE Virtual reality environments (VREs) are computer-generated, 3-dimensional worlds that allow users to experience situations similar to those encountered in the real world. The purpose of this study was to investigate VREs for potential use in assessing and treating persons who stutter (PWS) by determining the extent to which PWSs affective, behavioral, and cognitive measures in a VRE correlate with those same measures in a similar live environment. METHOD Ten PWS delivered speeches-first to a live audience and, on another day, to 2 virtual audiences (neutral and challenging audiences). Participants completed standard tests of communication apprehension and confidence prior to each condition, and frequency of stuttering was measured during each speech. RESULTS Correlational analyses revealed significant, positive correlations between virtual and live conditions for affective and cognitive measures as well as for frequency of stuttering. CONCLUSIONS These findings suggest that virtual public speaking environments engender affective, behavioral, and cognitive reactions in PWS that correspond to those experienced in the real world. Therefore, the authentic, safe, and controlled environments provided by VREs may be useful for stuttering assessment and treatment.

Effects of testosterone on the transgender male voice

There is sparse prospective data on the effects of testosterone therapy on the voices of transgender men (also referred to as trans men or female‐to‐male transsexuals). Our aim was to investigate the timing and degree of voice deepening over 12 months among an ethnically diverse sample of transgender men. This was a prospective 12‐month study at an academic outpatient endocrinology clinic and speech and voice center. The participants were seven transgender men naïve to testosterone therapy. All patients received two voice assessments at baseline and one assessment at 3, 6, 9, and 12 months while on intramuscular testosterone esters. Serum testosterone and estradiol concentrations were measured at baseline and every 3 months. All seven transgender men reached a cisgender male mean fundamental frequency (MF0) within 6 months of testosterone therapy and four continued to experience a decrease after 6 months. The mean decrease in MF0 after 12 months of testosterone therapy was 6.4 semitones (49 Hz). Several patterns emerged regarding the extent and timing. For example, some participants showed no decrease in MF0 within the first 3 months of testosterone therapy, whereas others showed their greatest decrease in MF0. We concluded that transgender men who start testosterone therapy display different patterns of voice lowering. Clinicians should counsel transgender men that they may or may not experience voice lowering within the first 3 months of testosterone therapy and that the majority of voice deepening will occur within 6–9 months.

Perceptions of Gender and Femininity Based on Language: Implications for Transgender Communication Therapy

Recent research presents a picture of diminishing gender differences in language. Two experiments examined whether language use can predict perceptions of gender and femininity; one included male and female speakers telling a personal narrative, the other also included male-to-female transgender speakers and analyzed an oral picture description. In each experiment, raters read transcribed samples before judging the gender and rating the femininity of the speaker. Only number of T-units, words per T-unit, dependent clauses per T-unit, and personal pronouns per T-unit emerged as different between gender groups. As none of the variables were strongly correlated with perceptual judgments, regression analysis was used to determine how combinations of linguistic variables predict female/feminine ratings. Results from these two studies demonstrate that gender-related differences in language use for these two contexts are limited, and that any relationship of language to perceptions of gender and femininity is complex and multivariate. This information calls into question the utility of training key language features in transgender communication therapy.

The social validity of script training related to the treatment of apraxia of speech

Background: Social validity is an important yet under-examined aspect of treatment efficacy that determines how the effects of treatment are perceived by people other than the clinician/researcher. This is particularly true of treatments to improve the speech of adults with acquired neurogenic disorders. Aims: The purposes of this investigation were to evaluate the social validity of a modified script training treatment protocol, to explore how aspects of a clients speech correspond to varying rater judgements, and to determine which of the listener ratings were most predictive of ratings of overall quality. Methods & Procedures: A total of 124 young, naïve listeners were asked to rate the quality of speech of an 81-year-old woman with moderate–severe apraxia of speech during utterances with varying levels of script correctness (low, medium, high), number of errors (low, high), and rate (slow, faster). Judgements were made on the understandability, ease of production, naturalness, and overall quality of speech. Outcomes & Results: All main effects and interactions were statistically significant. As script correctness, speaking rate, and number of errors increased, listener ratings were significantly more favourable. Interactions demonstrated increasing correctness, error, and rate with significantly more favourable listener ratings. The listener ratings that predicted improved perceptions of overall quality, weighted highest to lowest, were: understandability, naturalness, and ease of production. Error types were analysed and revealed that phrase repetitions appeared to be perceived positively and that unintelligible words and interjections appeared to be perceived negatively. Conclusions: The modified script training protocol applied to a woman with marked apraxia of speech appeared to be socially valid with these naïve raters. Listeners appeared to be sensitive to the amount and the quality of speech output generated by the speaker. Listeners appeared to perceive struggle behaviours as negative, increased speech output (including repetitions and empty speech) as positive, faster speech (closer to a normal speakers average word per minute) as preferable to slow speech, and more understandable speech and more natural speech as better quality speech. Based on these data, the accuracy and fluency of script production are important treatment goals.

Trans Male Voice in the First Year of Testosterone Therapy: Make No Assumptions

Purpose The purpose of this study was to prospectively examine changes in gender-related voice domain of pitch measured by fundamental frequency, function-related domains of vocal quality, range, and habitual pitch level and the self-perceptions of transmasculine people during their first year of testosterone treatment. Method Seven trans men received 2 voice assessments at baseline and 1 assessment at 3, 6, 9, and 12 months after starting treatment. Results Vocal quality measures varied between and within participants but were generally within normal limits throughout the year. Mean fundamental frequency (MF0) during reading decreased, although to variable extents and rates. Phonation frequency range shifted down the scale, although it increased in some participants and decreased in others. Considering MF0 and phonation frequency range together in a measure of habitual pitch level revealed that the majority of participants spoke using an MF0 that was low within their range compared with cisgender norms. Although the trans men generally self-reported voice masculinization, it was not correlated with MF0, frequency range, or habitual pitch level at any time point or with MF0 note change from baseline to 1 year of testosterone treatment, but correlations should be interpreted with caution due to the heterogeneous responses of the 7 participants. Conclusion In trans men, consideration of voice deepening in the context of objective and subjective measures of voice can reveal unique profiles and inform patient care.

Influence of Listener Characteristics on Perceptions of Sex and Gender

Inclusion of sex-atypical voices in speech perception protocols can reveal variations in listener perception and is particularly applicable in developing guidelines for transgender speech treatment. Ninety-three listeners, divided into four groups based on sex and sexual orientation, provided auditory-perceptual measures of sex and gender display for 21 cisgender men, 21 cisgender women, and 22 transgender women. There was no significant evidence that those listener characteristics were influential, except transgender women were perceived as significantly more feminine by nonstraight compared with straight listeners.