Examining the voice of Israeli transgender women: Acoustic measures, voice femininity and voice-related quality-of-life

Background: Transgender women may experience gender-dysphoria associated with their voice and the way it is perceived. Previous studies have shown that specific acoustic measures are associated with the perception of voice-femininity and with voice-related quality-of-life, yet results are inconsistent. Aims: This study aimed to examine the associations between specific voice measures of transgender women, voice-related quality-of-life, and the perception of voice-femininity by listeners and by the speakers themselves. Methods: Thirty Hebrew speaking transgender women were recorded. They had also rated their voice-femininity and completed the Hebrew version of the TVQ^MtF questionnaire. Recordings were analyzed to extract mean fundamental frequency (F0), formant frequencies (F1, F2, F3), and vocal-range (calculated in Hz. and in semitones). Recordings were also rated on a voice-gender 7-point scale, by 20 naïve cisgender listeners. Results: Significant correlations were found between both F0 and F1 and listeners’ as well as speakers’ evaluation of voice-femininity. TVQ^MtF scores were significantly correlated with F0 and with the lower and upper boundaries of the vocal-range. Voice-femininity ratings were strongly correlated with vocal-range, when calculated in Hz, but not when defined in semitones. Listeners’ evaluation and speakers’ self-evaluation of voice-femininity were significantly correlated. However, TVQ^MtF scores were significantly correlated only with the speakers’ voice-femininity ratings, but not with those of the listeners. Conclusion: Higher F0 and F1, which are perceived as more feminine, jointly improved speakers’ satisfaction with their voice. Speakers’ self-evaluation of voice-femininity does not mirror listeners’ judgment, as it is affected by additional factors, related to self-satisfaction and personal experience. Combining listeners’ and speakers’ voice evaluation with acoustic analysis is valuable by providing a more holistic view on how transgender women feel about their voice and how it is perceived by listeners.