1739:, reading a standardized passage and producing a spontaneous speech sample. Then the therapist and the individual determine what the target pitch should be, based on the gender acceptable range for cis women (i.e. a socially acceptable pitch based on the average woman's vocal pitch range). When therapy begins, they establish a starting frequency to work on, that is slightly above the individual's SFF. The point is to choose a starting pitch that can be produced without strain or excessive vocal effort. As therapy progresses, the target SFF will gradually increase until the goal has been reached. Progression moves from using the target pitch in a sustained vowel to using it in a 2-5 minute conversation.
1943:
treatment option. Others believe it is, and still others believe it should be considered only as a "last resort" after the desired pitch change has not been seen in therapy. Critics cite variability in outcome, lack of outcome data, and reported negative effects like compromised voice quality, decreased vocal loudness, adverse impact on swallowing/breathing, sore throat, wound infection, and scarring as reasons to avoid vocal surgery. Proponents argue that surgery may protect a person's voice from damage caused by repetitive strain to elevate pitch in therapy. Ultimately, the decision to undergo surgery is up to the patient, with input from a knowledgeable physician and SLP.
1522:, they typically do nothing to alter the pitch of an adult voice or to make the voice sound more feminine, unless HRT is started immediately after puberty blockers during teenage years. The existing vocal structure can be surgically altered to raise vocal pitch by shortening the vocal folds, decreasing the whole mass of the folds, or by increasing the tension of the folds. Transgender women can undergo surgery to raise their vocal pitch as measured by fundamental frequency (F0), to increase their pitch range and to remove access to lower frequency ranges in their voice. The current pitch-raising vocal surgeries can be split-up into several categories:
1642:
there has been evidence to show that all these surgeries can be effective in increasing vocal pitch as measured by F0, results have been mixed. However, many patients do report being satisfied with the results. Negative effects from these surgeries have been noted, including reduced voice quality, reduced vocal loudness, negative effects on swallowing and/or breathing, sore throat, infections and scarring. A positive effect of surgery can be protecting the voice from damage due to the strain of constantly elevating pitch while speaking. Because of the risks, vocal surgery is often considered a last resort after vocal therapy has been pursued.
1871:
lack of knowledge, or a perceived lack of knowledge, about transgender health care. This may manifest itself in health care providers being more reluctant to treat transgender clients because of an unwillingness to find information about their specific population. Institutional erasure describes policies that do not accommodate transgender identities or bodies. For example, forms, texts, or prescriptions may refer to a person by an inappropriate name or pronoun. Issues of erasure may hinder a transgender person's ability to find speech therapy services, or may affect the person's comfort with speech therapy.
1400:, can help in that effect. Fundamental frequency, closely related to pitch, was initially thought to be the characteristic most effective in voice feminization. Raising the fundamental frequency can help towards voice feminization. However, each person might have different perspectives regarding speech and voice, and therefore the salient characteristics, and their relative impact on femininity, can vary from person to person, and many people are not satisfied with only a change in fundamental frequency.
1834:
includes posture, gesture, movement, and facial expressions. In a discussion of the differences between masculine and feminine non-verbal behaviour, Hirsch and Boonin (2012) describe feminine communication as generally more fluid and continuous. Examples of feminine non-verbal communication behaviours include more smiling, expressive and open facial expression, more side-to-side head movement, and more expressive finger movements than men.
1864:, there are psychosocial factors that can influence transgender voice therapy. For example, some clients feel that hormone therapy for transitioning changes concentration and emotional stability, which could affect receptiveness to speech therapy. Davies and Goldberg (2006) also note that an altered voice may feel inauthentic, and it may take time for the client to feel as if their new voice is an expression of their true self.
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train genderfluid voice, arguing that it decreases the opportunity for practice, and it may be difficult or even damaging to the vocal folds for the person to switch from one voice to another. However, Davies, Papp and Antoni (2015) reference the ability of actors to use different accents and dialects, and people to learn different languages as a sign that training a genderfluid voice may be a viable treatment goal.
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1707:(SFF) (the average frequency produced in a connected speech sample) because they typically perceive a feminine voice as using a higher pitch. Although pitch is not the most essential element of voice change for these individuals, it is necessary to raise the SFF to a gender-appropriate pitch to help with vocal feminization. A
1913:
Few studies have considered the potential repercussions of age on therapy. Currently, there is no consensus regarding speech therapy for adolescents. During adolescence, there is an increase of both vocal tract size and vocal fold length, especially for those assigned male at birth, which affects the
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While there is some evidence for the effectiveness of voice therapy for transgender people, it is still weak. In a 2012 review by Oates (as referenced in Davies, Papp, and Antoni, 2015) of the literature on transgender voice therapy, 83% of studies were found to be at the lowest level of the evidence
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Few studies have looked into the transition in the elderly. A survey has shown that many elderly members of the LGBT community do not disclose their LGBT status to their clinicians, including members that receive speech therapy; they choose not to disclose this information because they are afraid it
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describes systematic, individual, or organizational discrimination against transgender people. Informational erasure and institutional erasure were identified in a 2009 Canadian study of health care for transgender people as being the most prominent barriers to care. Informational erasure involves a
1847:
Within the speech therapy context, non-verbal communication may be targeted through the encouragement of focused observation, offering feedback on the client's self-defined non-verbal goals, offering information about the differences between men and women's non-verbal communication, and/or referring
1695:, and the remaining 17% were also at low levels. However, research does show that transgender people who have had voice therapy have high satisfaction with the results, and there is a strong consensus among speech-language pathologists (SLPs) as to what are strong markers of speaker gender in voice.
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As for transgender men, it is generally presumed that hormone therapy does successfully masculinize the voice and lower vocal pitch. However, this may not be the case for all transgender men. Although it is far less common, surgery to lower vocal pitch does exist and may be considered if traditional
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This surgery, instead of simply shortening the vibrating length of the vocal cords in the same manner as a glottoplasty, actually removes a portion of both the anterior true and false vocal folds by also removing the front of the voice box. The larynx is then reconstructed with surgical sutures and
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Therapy may take place in an individual or group setting. The most common focus in transgender voice therapy is pitch raising or lowering; however, other gender markers may be more important for an individual to work on. Clients and clinicians should discuss goals of therapy to ensure that they are
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Usually, transgender women consider vocal surgery when they feel dissatisfied with voice therapy results, or when they want a more authentic sounding feminine voice. However, vocal surgery alone may not produce a voice that sounds completely feminine, and voice therapy may still be needed. Although
1638:, in their voice. These include Thyrohyoid Elevation (commonly performed as part of Feminization Laryngoplasty), which raises the larynx in the neck, and Pharyngeal Narrowing, which removes a strip of tissue from the back of the mouth in order to reduce the size of the pharyngeal resonance cavity.
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may have more of an effect on a transgender person's readability than verbal factors such as pitch or resonance. Regardless of what is most effective, congruency between a person's visual and auditory gender presentation contributes greatly to their perceived authenticity. Non-verbal communication
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A lack of training on how to use their new voice may cause some transgender men to have increased muscle tension. Therefore, a speech-language pathologist can give individuals vocal exercises to help find their optimal speaking pitch and maintain overall vocal health. Adler, Hirsch, & Mordaunt
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There is also some controversy regarding the use of a genderfluid voice. A person may want to have both a masculine and a feminine voice in their vocal repertoire, possibly to fit with their own genderfluid identity, or to read as a different gender in different contexts. Some clinicians will not
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Pitch can also be altered through voice resonance modification. The length of the vocal tract affects the resonance of the vocal tract, which in turn affects the pitch. Cis men tend to have vocal tracts that are 10-20% larger than those of cis women, and therefore cis men have a lower vocal tract
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What is considered a feminine or a masculine voice varies depending on age, region, and cultural norms. The changes with the greatest effects towards feminization, based on current evidence, are fundamental frequency, vocal weight and voice resonance. Other characteristics that have been explored
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A speech-language pathologist (SLP) may be involved in aiding transmaculine people to achieve their desired voice goals, while usually prioritizing the overall health of the voice. Therapy techniques may involve finding a person's most comfortable pitch range, using breath support and relaxation
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in order to make their voices sound more typical of their gender, and therefore increase their likelihood of being perceived as that gender. Having voice and speech characteristics align with one's gender identity is often important to transgender individuals, whether their goal be feminization,
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In a review of speech literature, Davies and
Goldberg (2006) were unable to find any clear protocols for transgender men's voice therapy. Based on the protocols they found for treating transgender women's voices, they proposed the following therapeutic techniques for both voice feminization and
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Professional opinion is mixed regarding the use of vocal surgery. There is currently a lack of outcome data, particularly longitudinal data, for pitch-elevating surgery, and outcomes have not been well-monitored over time. Because of this, some SLPs do not think that phonosurgery is a viable
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LAVA and VFMR are commonly done to augment the result of the other procedures, as many doctors believe the impact of them alone, without another procedure like Femlar or a
Glottoplasty, is minimal on a typical male-to-female transgender patient. VFMR however may occasionally be done in
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Diaphragmatic breathing patterns: In order to maintain their new speaking pitch, transgender men need to establish an appropriate breathing pattern to support their speech output. Establishing a stable speaking posture is also important to optimize pitch and breath
1617:) or a weaker KTP (Potassium Titanyl Phosphate) laser that vaporizes portions of the vocal folds. When the vocal fold tissue is in the process of healing and scarring, the vocal folds decrease in mass and increase in stiffness. This results in a rise in vocal pitch.
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Adler, R. K., & van Borsel, J. (2006). Female-to-male considerations. In R. K. Adler, S. Hirsch, & M. Mordaunt (Eds.), Voice and communication therapy for the transgender/transsexual client: A comprehensive clinical guide (pp. 139–168). San Diego, CA:
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This is the most common surgery today. This surgery shortens the vibrating length of the vocal folds to raise vocal pitch. The tissue of the anterior part of the vocal folds is removed, and then this tissue is sutured together to form a nonvibrating anterior
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VFSRAC is another variation invented by Hyung-Tae Kim in Seoul, South Korea, wherein the glottic web is additionally sutured downward in the larynx during surgery to provide further tensioning of the vocal cords and to help preserve the funnel shape of the
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Chest resonance: Head resonance is more commonly used by women, and therefore transgender men must establish a pattern of chest resonance to match their lower speaking pitch. Exercises can help establish this chest resonance and help a person lower their
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This procedure is not currently as widely practiced due to being a newer surgery, and its complexity and greater risks in comparison to the other surgeries listed here, with only a few practitioners in the US, Australia, and
Thailand currently performing
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The pitch increase and general feminizing effect of this surgery is typically higher than glottoplasty, which may or may not be desirable for patients. The period of pitch instability and recovery is also typically longer as this is a more complex
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Semi-occluded vocal tract (SOVT) techniques may be used to facilitate voice production in the higher pitch range. SOVT techniques include phonating into straws, lip or tongue trilling, and producing multiple speech sounds such as nasals (e.g.,
1384:
people. Transfeminines trying to feminize their voice represent the largest group seeking speech therapy services, therefore, most studies regarding transgender voice have focused on voice feminization, as opposed to voice masculinization.
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The authors note that this is not an exhaustive list of possible psychosocial factors and that every client is different. Psychosocial factors such as these may affect a transgender client's progress and prognosis in speech therapy.
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Koçak, Ismail; Akpınar, Meltem Esen; Çakır, Zeynep Alkan; Doğan, Müzeyyen; Bengisu, Serkan; Çelikoyar, Mehmet Mazhar (2010). "Laser
Reduction Glottoplasty for Managing Androphonia After Failed Cricothyroid Approximation Surgery".
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This procedure is also typically combined with a thyrohyoid elevation to raise the larynx in the neck in order to further affect the patient's resonance as well, given doing so reduces the length of the pharynx to more feminine
1782:, where the voice goes from soft to loud to soft again. SOVT techniques have the individual prolong their voice at a higher pitch, which may help make voice production at a higher, non-habitual pitch easier and more efficient.
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The first step in therapy is determining the habitual speaking fundamental frequency of the individual using an acoustic analyzing program. This is accomplished through several tasks including sustained phonation of the vowels
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Bauer, Greta R.; Hammond, Rebecca; Travers, Robb; Kaay, Matthias; Hohenadel, Karin M.; Boyce, Michelle (2009). ""I Don't Think This Is
Theoretical; This Is Our Lives": How Erasure Impacts Health Care for Transgender People".
436:
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This surgery effectively locks the patient into falsetto, and sometimes fails over time. The patient is also likely to lose use of their cricothyroid muscle after this surgery. As such, fewer doctors are performing it
1489:
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Kelly, Rebecca J.; Robinson, Gregory C. (2011-05-01). "Disclosure of
Membership in the Lesbian, Gay, Bisexual, and Transgender Community by Individuals With Communication Impairments: A Preliminary Web-Based Survey".
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The term Laser
Reduction Glottoplasty (LRG) is also sometimes used to refer to this procedure with or without the additional creation of a glottic web as with a Wendler Glottoplasty, but this varies by context and
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Wendler
Glottoplasty (Anterior glottal web formation or anterior commissure advancement, also Laser Reduction Glottoplasty/LRG, and VFSRAC, Vocal Fold Shortening with Retrodisplacement of Anterior Commissure)
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to vaporize the anterior part of the vocal folds. Then the vocal folds are tensed with sutures, causing the pitch to increase. LRG may also include additional laser tuning at the same time (described further
1439:. Larynx length can be controlled via exercise, making lowering the larynx a useful tool for transgender men in obtaining a passing voice. Other areas that transgender men may benefit from training are
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hormone therapy did not adequately lower it. Medialization laryngoplasty (or masculinization laryngoplasty) is a procedure where the vocal fold contours are medially augmented with the injection of
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In addition to paying attention to problems of erasure, Adler and
Christianson (2012) suggest that a clinician should be sensitive to the following areas when working with a transgender client:
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Warm-up exercises: A person can do these at home to help to strengthen the voice, maintain optimal pitch and prevent vocal fatigue. Resting the voice after long periods of use is also important.
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voice and pitch. Because of these physical changes and hormonal changes, it is difficult to focus on pitch. Previous studies have shown that therapy shaped from adult therapy can be effective.
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Voice modifications for transgender men typically involve the lowering of the speaking fundamental frequency. Voice therapy is generally not required for transgender men as the effects of
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and maintaining high CQ (closed quotient, a quotient of how long the vocal folds are touching to how long the cycle of vibration lasts), responsible for "heavy" or "buzzy" voice quality.
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Mastronikolis, Nicholas S.; Remacle, Marc; Biagini, Michela; Kiagiadaki, Debora; Lawson, George (2013). "Wendler
Glottoplasty: An Effective Pitch Raising Surgery in transgender women".
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Optimal pitch: Rather than straining to achieve a lower speaking pitch, a comfortable pitch range should be sought. This range is generally approximately between 100 and 105 Hz.
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In these procedures, microlaryngoscopy (a surgical procedure that looks at the vocal folds in great detail) is done in conjunction with a laser, typically a strong carbon dioxide (CO
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change faster than larynx. Overdevelopment of vocal folds in an undescended, small larynx can result in a condition named "entrapped vocality" with permanent hoarseness, and lack of
1043:
418:
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Carew, Lisa; Dacakis, Georgia; Oates, Jennifer (2007-09-01). "The effectiveness of oral resonance therapy on the perception of femininity of voice in male-to-female transsexuals".
1775:), and high vowels (e.g., and ). There are two exercises that are often used: producing a pitch glide that goes from the middle of the pitch range to the upper pitch range; and a
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resonance, and a lower pitch, than cis women. Modifying the length of a vocal tract results in a change in resonance and in pitch, as can be shown by pronouncing a prolonged
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There are two major areas of controversy for professionals working on the voices of transgender people. The first is regarding vocal surgery, and the second is regarding
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VFMR vaporizes a larger portion of the vocal folds, including the underlying muscle, while LAVA is more superficial to the surface of the vocal cord and less invasive.
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result in a deeper pitch. However, testosterone replacement therapy does not always deepen the voice to the person's desired level, and others choose to not undergo
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while protruding and retracting the lips. Transgender women can use techniques, such as retracting the lips, to shorten the vocal tract and sound more feminine.
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Some surgeons may refer to their suite of voice feminization procedures as Feminization Laryngoplasty despite not actually performing this particular procedure.
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Relaxation Techniques: The speech-language pathologist may teach tension-releasing techniques for the jaw, tongue, shoulders, neck and overall laryngeal area.
2814:"Yeson's Minimally Invasive Natural Sound Voice Feminisation Surgery based on Yeson's Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure"
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de Vries, Annelou L. C.; Cohen-Kettenis, Peggy T. (2012-01-01). "Clinical management of gender dysphoria in children and adolescents: the Dutch approach".
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at all. Voice masculinization therapy can help to further lower the pitch of transgender men and address voice problems associated with hormone therapy.
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with sutures or metal plates. The cricoid cartilage is shifted backward and upward and the thyroid cartilage is moved forward and downward. This mimics
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Anderson, Jennifer A. (2014). "Pitch Elevation in Trangendered Patients: Anterior Glottic Web Formation Assisted by Temporary Injection Augmentation".
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Laser Tuning (including Laser assisted voice adjustment (LAVA) and Vocal Fold Muscle Reduction (VFMR), and sometimes Laser Reduction Glottoplasty)
1372:, improve the self-reported wellbeing and health of transgender people, and alleviate concerns over an individual being recognized as transgender.
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noted other factors being involved in gender perception, saying: "a minimum F0 value of 180 Hz required for a voice to be perceived as feminine".
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implants. This mimics the changes that the vocal folds non-transgender men go through during puberty, which causes a lower sounding voice.
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Vocal gender presentation can be assigned by speakers even as things like fundamental frequency stay the same, especially where we see
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Voice feminization refers to the perception of voice change from masculine to feminine. It is considered an essential part of care for
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Additionally, some other procedures are currently being employed in an attempt to provide the patient a more feminine resonance, or
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McNeill, Emma J. M.; Wilson, Janet A.; Clark, Susan; Deakin, Jayne (2008-11-01). "Perception of voice in the transgender client".
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neutralization or masculinization. Voice therapy can be seen as an act of gender- and identity-affirming care, in order to reduce
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2589:"Influences of Fundamental Frequency, Formant Frequencies, Aperiodicity, and Spectrum Level on the Perception of Voice Gender"
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Shelagh, Davies; Goldberg, Joshua M. (2006-09-01). "Clinical Aspects of Transgender Speech Feminization and Masculinization".
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Orloff, L. A.; Mann, A. P.; Damrose, J. F.; Goldman, S. N. (2006). "Laser-assisted voice adjustment (LAVA) in transsexuals".
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Therapy has been shown to be effective in voice feminization, and the modification of certain voice characteristics, such as
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1092:
936:
771:
656:
397:
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Hancock, Adrienne; Helenius, Lauren (2016-10-01). "Adolescent male-to-female transgender voice and communication therapy".
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Van Borsel, John; Eynde, Elke Van; Cuypere, Griet De; Bonte, Katrien (2008). "Feminine after cricothyroid approximation?".
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Hoffman, Matthew R.; Devine, Erin E.; Remacle, Marc; Ford, Charles N.; Wadium, Elizabeth; Jiang, Jack J. (2013-11-16).
1844:(1990), is referred to by the authors as a seminal work on the difference in men and women's non-verbal communication.
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3033:"Combined type IIIB with bilateral type I thyroplasty for pitch lowering with maintenance of vocal fold tension"
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Spiegel, Jeffrey H. (2006). "Phonosurgery for Pitch Alteration: Feminization and Masculinization of the Voice".
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Another option for transgender men who wish to further lower their speaking pitch is to undergo vocal surgery.
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frequencies changing, which is noted as important for gender presentation alongside fundamental frequency.
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exercises, introducing voice strengthening warm-ups, stabilizing posture and increasing chest resonance.
2219:"Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside"
1754:
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2840:"Feminization Laryngoplasty - A Comprehensive Approach to Reducing the Size of the Larynx and Pharynx"
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Voice and communication therapy for the transgender/transsexual client: a comprehensive clinical guide
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This procedure has the ability to provide a better reduction of the adam’s apple beyond that of a
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2635:"The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review"
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2061:"Hearing Gender: Voice-Based Gender Classification Processes and Transgender Health Inequality"
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vocal gender identification examples, key features noted to effect gender perception included
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Van Damme, Silke; Cosyns, Marjan; Deman, Sofie; Eede, Zoë Van den; Borsel, John Van (2017).
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1474:(a rough measure of harmonicity in voice with low values indicating a higher likelihood of
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Identifying and altering voice qualities when coughing, laughing, and clearing the throat.
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contraction that tenses and elongates the vocal folds which causes the pitch to increase.
2454:"On using voice source measures in automatic gender classification of children's speech"
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Modifying gender presentation of voice on a selection of vowels including a, i, e and o.
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2538:"Vocal Feminization for Transgender Women: Current Strategies and Patient Perspectives"
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will work with the individual to raise their pitch and provide therapeutic exercises.
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hardware using the remaining tissue. This has both an effect on vocal size and pitch.
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1478:) and rolloff in energy between the first and second harmonics. A 2020 study in the
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University of California, San Francisco Center of Excellence for Transgender Health
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2962:"VOICE SURGERY with Dr. James Thomas - Live Interview, Discussion, and Q&A"
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1339:" or "voice training" refers to any non-surgical technique used to improve or
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2379:"Where the Boys At? — A Rant on the Disparities of the Transmasculine Voice"
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Vocal Arts Medicine: The Care and Prevention of Professional Voice Disorders
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The most common concern for transgender women is their pitch and speaking
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patterns, loudness, speech rate, speech-sound articulation and duration.
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Abitbol; Abitbol; Abitbol (1999). "Sex Hormones and the Female Voice".
1803:(2012), describe the following therapy techniques for transgender men:
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people may frequently undertake voice training or therapy as a part of
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Vocal flexibility exercises to maintain vocal range and voice quality.
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Davies, Shelagh; Papp, Viktória G.; Antoni, Christella (2015-07-03).
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220:
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Progressively complex practice while maintaining good voice quality.
2452:
Chen, Gang; Feng, Xue; Shue, Yen-Liang; Alwan, Abeer (2010-09-26).
2218:
1562:
Laser Reduction Glottoplasty is a variation that involves using a
1486:
163:
1233:
204:
3331:
2489:"Cepstral Peak Prominence Values for Clinical Voice Evaluation"
1860:
issues faced by transgender people are often addressed through
1533:
in order to increase vocal pitch. This is done by bringing the
1659:
working together toward the voice that most fits the person's
1348:
1238:
1526:
Cricothyroid approximation (CTA) (A common legacy procedure)
2487:
Murton Olivia; Hillman Robert; Mehta Daryush (2020-08-04).
1671:
Imitation of non-transgender people observed in daily life.
2437:
Adler, Richard; Hirsch, Sandy; Mordaunt, Michelle (2012).
1590:
and to fix tracheal shave complications that impact pitch.
3326:
2587:
Skuk Verena G.; Schweinberger Stefan R. (2014-02-01).
3327:
World Professional Association for Transgender Health
1470:
as well as further source related measures including
1686:
Experimentation with a broad range of voice styles.
1923:would negatively affect their access to services.
3141:Journal of the Association of Nurses in AIDS Care
2593:Journal of Speech, Language, and Hearing Research
1518:can cause a more feminine outward appearance for
1579:(also known as Open Laryngoplasty or Femlar/FL)
173:
2372:
2370:
3282:American Journal of Speech-Language Pathology
2493:American Journal of Speech-Language Pathology
1316:
8:
2340:
2338:
3037:European Archives of Oto-Rhino-Laryngology
1323:
1309:
29:
27:Procedure undertaken by transgender people
3064:
2563:
2553:
2542:International Journal of General Medicine
2512:
2347:"The Changing Female-To-Male (FTM) Voice"
2076:
1481:International Journal of General Medicine
2998:Otolaryngologic Clinics of North America
2844:Otolaryngologic Clinics of North America
2054:
2052:
2441:. San Diego, CA: Plural Publishing Inc.
2432:
2430:
2428:
2426:
2424:
2422:
2420:
2418:
2223:International Journal of Transgenderism
2137:International Journal of Transgenderism
1998:
1909:Transition in childhood and adolescence
41:
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1529:This surgery tenses and elongates the
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1878:Gender attribution and discrimination
7:
2940:London Voice & Swallowing Clinic
1891:Spouse, partner, or family attitudes
1881:Possible feelings of shame and guilt
1848:to peer support or expert services.
1431:In testosterone replacement therapy
358:Puberty-suppressing hormone therapy
3238:Journal of Communication Disorders
2906:10.1097/01.mlg.0000205198.65797.59
2035:. Thieme Medical Publishers, Inc.
1987:List of transgender-related topics
25:
3347:Gender transitioning and medicine
1293:
1292:
1280:
1268:
419:Assisted reproductive technology
3294:10.1044/1058-0360(2011/10-0060)
2605:10.1044/1092-4388(2013/12-0314)
2345:Constansis, Alexandros (2008).
1918:Transition in aging populations
1900:Racial and cultural differences
2960:Erose, Zheanna (7 July 2022).
2010:. Cambridge University Press.
777:Cisgender / cissexual
772:Childhood gender nonconformity
398:Facial masculinization surgery
1:
3250:10.1016/j.jcomdis.2012.06.008
2536:Kim, Hyung-Tae (2020-02-12).
2466:10.21437/Interspeech.2010-251
2321:10.1016/s0892-1997(99)80048-4
2235:10.1080/15532739.2015.1075931
1426:masculinizing hormone therapy
1254:Social construction of gender
3196:10.1080/00918369.2012.653300
3102:10.1016/j.jvoice.2006.05.005
2936:"Voice Feminisation Surgery"
2792:10.1016/j.jvoice.2013.04.004
2757:10.1016/j.jvoice.2009.06.004
2721:10.1016/j.jvoice.2014.05.002
2686:10.1016/j.jvoice.2006.11.001
2651:10.1016/j.jvoice.2016.04.002
2278:10.1016/j.jvoice.2006.12.010
2065:American Sociological Review
1759:), voiced fricatives (e.g.,
826:Gender-sexuality questioning
2505:10.1044/2020_AJSLP-20-00001
2059:Lagos, Danya (2019-10-01).
2031:Benninger, Michael (1994).
1709:speech-language pathologist
1516:gender reassignment surgery
1512:hormone replacement therapy
391:Facial feminization surgery
3368:
3153:10.1016/j.jana.2009.07.004
1577:Feminization Laryngoplasty
1454:Gender perception in voice
761:Androphilia and gynephilia
461:Gender self-identification
3049:10.1007/s00405-013-2798-0
3010:10.1016/j.otc.2005.10.011
2856:10.1016/j.otc.2022.05.002
1841:You Just Don't Understand
135:Non-binary or genderqueer
3184:Journal of Homosexuality
2377:K-T, Rien (2020-04-28).
2078:10.1177/0003122419872504
1831:Non-verbal communication
1826:Non-verbal communication
1472:cepstral peak prominence
580:Parental rights movement
489:Political office-holders
368:Gender-affirming surgery
2008:Principles of Phonetics
1977:Transgender health care
1693:evidence-based practice
174:
107:Bissu, Calabai, Calalai
2838:Thomas, James (2022).
1654:Therapeutic techniques
1495:
1341:modify the human voice
1275:Transgender portal
1244:Sex–gender distinction
803:Gender detransitioning
690:Anatomical terminology
2149:10.1300/J485v09n03_08
1897:Incidence of HIV/AIDS
1705:fundamental frequency
1493:
1464:fundamental frequency
1412:Voice masculinization
1390:fundamental frequency
1343:. Because voice is a
1229:Queer heterosexuality
841:Rapid-onset dysphoria
624:Yogyakarta Principles
18:Voice masculinization
2645:(2): 244.e1–244.e5.
2555:10.2147/ijgm.s205102
2006:Laver, John (1984).
1884:Consequences of the
1856:While some specific
1852:Psychosocial factors
1564:carbon dioxide laser
1361:gender transitioning
815:Gender transitioning
767:Blanchard's typology
695:Fictional characters
641:Events and awareness
547:Anti-gender movement
2850:(4). NIH: 739–748.
1982:Language and gender
1868:Transgender erasure
1543:cricothyroid muscle
1370:gender incongruence
1209:Anti-LGBTQ rhetoric
754:Theory and concepts
636:Society and culture
617:Trans panic defense
2818:Yeson Voice Center
2351:Radical Musicology
1496:
1376:Voice feminization
1249:Sexual orientation
1088:Disenfranchisement
657:Day of Remembrance
558:trans-exclusionary
43:Transgender topics
2460:. ISCA: 673–676.
2042:978-0-86577-439-1
2017:978-0-521-45031-7
1894:Employment issues
1667:masculinization:
1539:thyroid cartilage
1535:cricoid cartilage
1520:transgender women
1491:
1468:formant frequency
1333:
1332:
1179:elected officials
809:Gender expression
662:Day of Visibility
471:Non-binary gender
437:Standards of Care
94:Gender identities
16:(Redirected from
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2499:(3): 1596–1607.
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2458:Interspeech 2010
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1967:Speech pathology
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1366:gender dysphoria
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1287:LGBTQ portal
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710:Media portrayals
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1939:voice therapy.
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1680:Motor training.
1661:gender identity
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1506:Vocal surgeries
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1458:In the case of
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1398:voice resonance
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863:Transmedicalism
831:Gender variance
821:Gender identity
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652:Beauty pageants
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479:Rights movement
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3321:External links
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2019:
2013:
2009:
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1992:
1988:
1985:
1983:
1980:
1978:
1975:
1973:
1970:
1968:
1965:
1963:
1960:
1958:
1955:
1954:
1950:
1948:
1944:
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1938:
1934:
1926:
1924:
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1890:
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1883:
1880:
1877:
1876:
1875:
1872:
1869:
1865:
1863:
1862:psychotherapy
1859:
1851:
1849:
1845:
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1837:
1832:
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1809:
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1778:messa di voce
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1699:Raising pitch
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1395:
1391:
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1383:
1382:transfeminine
1375:
1373:
1371:
1367:
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1354:
1350:
1346:
1342:
1338:
1337:Voice therapy
1326:
1321:
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1306:
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1083:United States
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1040:South Africa
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896:
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877:
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869:
868:Transmisogyny
866:
864:
861:
857:
854:
853:
852:
851:Transfeminism
849:
847:
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839:
837:
836:Postgenderism
834:
832:
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812:
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797:Gender binary
795:
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790:
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780:
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770:
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517:United States
515:
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494:
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484:Organizations
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476:
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469:
467:
464:
462:
459:
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455:
449:
448:
438:
434:
433:
432:
429:
426:
425:Voice therapy
422:
420:
417:
415:
412:
409:
405:
404:
399:
395:
392:
388:
383:
379:
376:
372:
371:
369:
365:
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359:
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350:masculinizing
348:
346:
343:
342:
340:
336:
335:
330:
326:
321:
317:
316:
314:
310:
307:
306:Gender clinic
303:
302:
298:
293:
292:
285:
282:
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277:
273:
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268:
267:
266:
263:
259:
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170:
167:
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162:
161:
160:
157:
155:
152:
150:
149:
145:
141:
138:
137:
136:
133:
131:
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126:
125:Gender bender
123:
121:
118:
116:
115:
111:
109:
108:
104:
102:
99:
98:
95:
90:
89:
83:
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75:
73:
70:
69:
67:
66:
48:
47:
44:
40:
36:
32:
31:
19:
3288:(2): 86–94.
3285:
3281:
3274:
3241:
3237:
3187:
3183:
3177:
3144:
3140:
3093:
3089:
3083:
3040:
3036:
3026:
3004:(1): 77–86.
3001:
2997:
2991:
2981:
2969:. Retrieved
2965:
2955:
2943:. Retrieved
2939:
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2897:
2893:
2887:
2875:. Retrieved
2847:
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2821:. Retrieved
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2383:Scinguistics
2382:
2358:. Retrieved
2354:
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2259:
2226:
2222:
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2032:
2026:
2007:
2001:
1945:
1941:
1930:
1921:
1912:
1903:
1873:
1866:
1858:psychosocial
1855:
1846:
1839:
1829:
1801:
1784:
1777:
1741:
1713:
1702:
1689:
1665:
1657:
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1640:
1633:
1594:proportions.
1509:
1497:
1479:
1457:
1449:
1445:
1430:
1418:testosterone
1415:
1402:
1394:vocal weight
1387:
1379:
1334:
1154:Nazi Germany
1106:
886:
727:Publications
683:
640:
466:Legal gender
454:legal status
424:
408:Hair removal
274:
255:
248:
219:
187:
159:Third gender
146:
112:
105:
3352:Human voice
1957:Chest voice
1933:genderfluid
1927:Controversy
1531:vocal folds
1433:vocal folds
1357:transgender
1118: [
1098:Transphobia
1051:South Korea
1021:New Zealand
945: [
512:South Korea
452:Rights and
320:in children
297:Health care
284:Transsexual
265:Transgender
239:Trans woman
195:Mudoko dako
176:Femminiello
3341:Categories
2388:2021-08-21
2360:2009-09-21
1993:References
1886:coming out
1624:isolation.
1514:(HRT) and
1441:embouchure
1406:intonation
1345:social cue
989:Tamil Nadu
881:By country
792:Deadnaming
742:Television
720:non-binary
705:Literature
602:Inequality
575:Non-binary
502:Healthcare
345:feminizing
215:Two-spirit
200:Mukhannath
169:Faʻafafine
3302:1058-0360
3258:1873-7994
3204:1540-3602
3110:0892-1997
3057:0937-4477
2971:26 August
2945:26 August
2877:20 August
2872:249934885
2823:26 August
2548:: 43–52.
2286:1873-4588
2243:1553-2739
2165:143007221
2157:1553-2739
2095:203444371
2087:0003-1224
1972:Vocal fry
1838:'s book,
1476:dysphonia
1189:Stonewall
1159:Singapore
1127:Australia
1115:Argentina
1076:2022 bill
1036:Singapore
1009:2017 bill
1005:Pakistan
979:2014 bill
925:2016 bill
910:Australia
893:Argentina
414:Pregnancy
299:practices
276:Akava'ine
244:Fakaleitī
234:Trans man
154:Koekchuch
120:Cisgender
114:Burrnesha
101:Androgyne
3310:21393619
3266:22796114
3220:11731779
3212:22455322
3169:12586015
3161:19732694
3118:16822646
3075:24241252
3018:16469656
2922:40744935
2914:16585875
2864:35750518
2800:23809571
2765:19900788
2729:24962228
2694:17280818
2659:27474996
2613:23882002
2574:32104050
2523:32658592
2329:10498059
2294:17400427
2251:21705607
1962:Falsetto
1951:See also
1937:bigender
1811:support.
1780:exercise
1648:silastic
1628:surgeon.
1602:surgery.
1404:include
1299:Category
1224:Intersex
1203:See also
1174:Legality
1132:Re Kevin
1093:Title IX
1071:2004 act
1059:2022 law
1044:2003 act
1029:2016 act
1014:2018 act
984:2019 act
969:2024 law
964:2018 law
959:1980 law
903:2021 law
898:2012 law
732:Religion
607:Violence
597:Genocide
528:Toilets
250:Mak nyah
227:X-gender
210:Travesti
82:Timeline
35:a series
33:Part of
3066:4013228
2986:Plural.
2966:YouTube
2565:7024865
2514:7893528
2474:1566466
1888:process
1821:larynx.
1571:larynx.
1567:below).
1500:formant
1437:passing
1420:on the
1149:Finland
1108:History
1025:Norway
1001:Ireland
954:Germany
937:Finland
846:Studies
684:Culture
612:Murders
524:Prisons
257:Rae-rae
183:Khanith
148:Kathoey
77:History
72:Outline
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3210:
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2014:
1636:timbre
1549:today.
1510:While
1422:larynx
1353:gender
1297:
1214:Gender
1139:Brazil
1055:Spain
975:India
942:France
920:Canada
915:Brazil
887:Rights
737:Sports
715:People
537:Unisex
497:Asylum
221:Winkte
62:
59:
56:
53:
50:
3216:S2CID
3165:S2CID
2918:S2CID
2868:S2CID
2470:S2CID
2247:S2CID
2161:S2CID
2091:S2CID
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1144:China
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932:China
856:views
672:March
431:WPATH
270:Youth
164:Bakla
130:Hijra
3306:PMID
3298:ISSN
3262:PMID
3254:ISSN
3208:PMID
3200:ISSN
3157:PMID
3114:PMID
3106:ISSN
3071:PMID
3053:ISSN
3014:PMID
2973:2023
2947:2023
2910:PMID
2879:2023
2860:PMID
2825:2023
2796:PMID
2761:PMID
2725:PMID
2690:PMID
2655:PMID
2609:PMID
2570:PMID
2519:PMID
2325:PMID
2290:PMID
2282:ISSN
2239:ISSN
2153:ISSN
2083:ISSN
2037:ISBN
2012:ISBN
1935:and
1767:and
1751:and
1731:and
1559:web.
1466:and
1396:and
1368:and
1351:and
1234:LGBT
996:Iran
700:Film
677:more
667:Flag
205:Muxe
189:Māhū
3290:doi
3246:doi
3192:doi
3149:doi
3098:doi
3061:PMC
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