Irineu Roxane de Alencar, Ribeiro Vanessa Veis, Dornelas Rodrigo, Aguiar Andréa Gomes de Oliveira, Santos Heloisa Helena, Behlau Mara
Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS. Av. Gov. Marcelo Déda, São José, Lagarto, Sergipe, Brazil, 49400-000.
Speech-Language Pathology Department, Universidade de Brasília, UNB. Asa Norte, Brasília, Federal District, Brazil, 70.910-900.
J Voice. 2025 Feb 11. doi: 10.1016/j.jvoice.2025.01.027.
To validate the Trans Woman Voice Questionnaire (TWVQ) in Brazilian Portuguese for measuring vocal self-perception in transgender women.
This is a quantitative, methodological study. The validation process included steps for assessing validity, reliability, and responsiveness. The sample had five voice specialists, 85 transgender women, and 40 cisgender women. The voice specialists evaluated the TWVQ items using the Content Validity Index (CVI). Target population participants completed the TWVQ three times: initially, after 2-14 days, and following a voice intervention from a speech-language-hearing pathologist.
The overall CVI in the content validation phase was 0.89. For the Item CVI (I-CVI), 13 out of 30 items scored below the expected threshold (<0.8) and were revised by the authors. The full protocol was administered to 20 participants from the target population, and 14 items required adjustments. Following item revision, the protocol was readministered to the target population, and all items were deemed adequate. The second validation phase involved 65 transgender women, administering the instrument at three moments: initial application (test), reapplication after 7-14 days (retest), and a third application after the voice intervention (responsiveness). For the final TWVQ version, items 1 ("People have trouble hearing me when I speak in noisy places") and 26 ("People who don't know me find my voice unusual") were excluded due to low communality. Confirmatory Factor Analysis validated the three-factor, 28-item TWVQ-Br model: Factor 1 with 15 items (voice-gender congruence), Factor 2 with 11 items (voice production and impact), and Factor 3 with 2 items (vocal restriction). Reliability was found for the internal consistency of the TWVQ-Br and test-retest reliability. Responsiveness indicated a significant change in construct scores following the voice intervention, with lower TWVQ-Br scores postintervention. The TWVQ-Br distinguished transgender and cisgender women across all factors and total scores (P < 0.001 for all).
The TWVQ's validation in Brazilian Portuguese led to significant adjustments to enhance alignment with the experiences of Brazilian transgender women. Certain items that did not contribute to the instrument's objectives were removed, and three factors were extracted. The final instrument had high reliability in test-retest analysis, high sensitivity with score changes postintervention, and the capacity to differentiate between transgender and cisgender women based on protocol scores, indicating that it specifically meets transgender women's needs.
验证巴西葡萄牙语版跨性别女性声音问卷（TWVQ），用于测量跨性别女性的声音自我认知。
这是一项定量的方法学研究。验证过程包括评估效度、信度和反应度的步骤。样本包括五名声音专家、85名跨性别女性和40名顺性别女性。声音专家使用内容效度指数（CVI）评估TWVQ项目。目标人群参与者完成TWVQ三次：最初、2 - 14天后以及在接受言语语言听力病理学家的声音干预后。
内容验证阶段的总体CVI为0.89。对于项目CVI（I - CVI），30个项目中有13个得分低于预期阈值（<0.8），作者对其进行了修订。完整方案应用于20名目标人群参与者，14个项目需要调整。项目修订后，该方案再次应用于目标人群，所有项目均被认为合适。第二阶段验证涉及65名跨性别女性，在三个时间点应用该工具：初始应用（测试）、7 - 14天后重新应用（重测）以及声音干预后的第三次应用（反应度）。对于最终的TWVQ版本，项目1（“当我在嘈杂的地方说话时，人们很难听清我的声音”）和项目26（“不认识我的人觉得我的声音很特别”）因共同性较低而被排除。验证性因素分析验证了三因素、28项的TWVQ - Br模型：因素1有15项（声音 - 性别一致性），因素2有11项（声音产生和影响），因素3有2项（声音限制）。发现TWVQ - Br的内部一致性和重测信度具有可靠性。反应度表明声音干预后结构得分有显著变化，干预后TWVQ - Br得分较低。TWVQ - Br在所有因素和总分上区分了跨性别女性和顺性别女性（所有P < 0.001）。
巴西葡萄牙语版TWVQ的验证导致了显著调整，以增强与巴西跨性别女性经历的一致性。去除了一些对工具目标无贡献的项目，并提取了三个因素。最终工具在重测分析中具有高信度，对干预后得分变化具有高敏感性，并且能够根据方案得分区分跨性别女性和顺性别女性，表明它特别满足跨性别女性的需求。
