Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Otolaryngology-Head and Neck Surgery, Division of Laryngology, Mount Sinai Health System, New York, New York.
J Voice. 2024 Jan;38(1):214-218. doi: 10.1016/j.jvoice.2021.07.017. Epub 2021 Sep 23.
Treatment options to assist patients to produce a more perceptually feminine voice include voice therapy (VT) and surgeries to elevate pitch such as the Wendler glottoplasty (WG). The Trans Woman Voice Questionnaire (TWVQ) is a validated quality of life measure for trans women's self-reported perceptions of their voice and is frequently administered before and after such interventions. The 30 statements broadly pertain to how feminine a patient feels their voice is, how effortful it is to produce their voice, and how their voice impacts them psychosocially, making it a useful and specific outcome measure when treating trans females for voice concerns.
To compare quality of life outcomes between VT and VT with adjunct WG (VT+WG) based on changes in ratings of individual statements on the TWVQ.
A retrospective case series of 31 trans female patients treated was completed. A total of 17 patients underwent VT and 14 underwent VT with adjunctive WG. Ratings for each of the 30 TWVQ statements were compared before and after treatment for each group. Wilcoxon rank-sum tests were used to compare rating changes before and after treatment. Spearman rank-order correlation tests were used to assess the association between total TWVQ score and "current voice" rating.
WG was associated with statistically significantly improved ratings for every statement on the TWVQ except one. In contrast, VT was associated with statistically significant improvements in 16 of the 30 statements, which largely pertained to patient emotions surrounding their voice rather than physical aspects such as pitch and dysphonia. Furthermore, while both WG+VT and VT improved the "current voice" rating significantly, WG improved the score by nearly 1 unit more. Lastly, we found a positive association between the total TWVQ score and current voice rating, indicating that lower scores were associated with more self-perceived feminine-sounding voices (P < 0.01).
Both VT and VT+WG result in improvements in the TWVQ. The specific statements on the TWVQ offer insight into specific quality of life treatment outcomes, with VT associated with improvements in mostly psychosocial aspects of voice production and VT+WG with both psychosocial and physical aspects.
帮助患者产生更可感知的女性化声音的治疗选择包括语音治疗（VT）和提高音调的手术，如 Wendler 声门成形术（WG）。跨性别女性声音问卷（TWVQ）是一种经过验证的生活质量衡量标准，用于衡量跨性别女性对自己声音的自我感知，并经常在这些干预措施前后进行管理。这 30 个陈述广泛涉及患者对自己声音的女性化感觉、产生声音的费力程度以及声音对他们心理社会的影响，因此在治疗跨性别女性的声音问题时，这是一种有用且具体的结果衡量标准。
根据 TWVQ 中个别陈述的评分变化，比较 VT 和 VT 联合 WG（VT+WG）治疗的生活质量结果。
完成了一项对 31 名接受治疗的跨性别女性患者的回顾性病例系列研究。共有 17 名患者接受了 VT 治疗，14 名患者接受了 VT 联合 WG 治疗。比较了每组治疗前后每个 TWVQ 陈述的评分。Wilcoxon 秩和检验用于比较治疗前后的评分变化。Spearman 秩相关检验用于评估 TWVQ 总分与“当前声音”评分之间的关联。
WG 与 TWVQ 上的每一个陈述的评分改善都具有统计学意义，除了一个陈述。相比之下，VT 与 30 个陈述中的 16 个陈述的评分改善具有统计学意义，这些陈述主要涉及患者对声音的情绪，而不是音高和发声困难等物理方面。此外，尽管 WG+VT 和 VT 都显著改善了“当前声音”评分，但 WG 使评分提高了近 1 个单位。最后，我们发现 TWVQ 总分与当前声音评分之间存在正相关，这表明得分越低，自我感知的女性化声音越高（P<0.01）。
VT 和 VT+WG 均可改善 TWVQ。TWVQ 的具体陈述提供了有关特定生活质量治疗结果的深入了解，VT 与语音产生的心理社会方面的改善有关，而 VT+WG 则与心理社会和物理方面的改善有关。
