Trans Kadınların Ses Özelliklerinin Algısal ve Enstrümantal Değerlendirme Yöntemleri ile İncelenmesi

Abstract

Voice, which is a secondary gender characteristic, is an important factor in the development of people and plays a key role in social, cultural and family aspects of their life. Features such as pitch of the voice, pitch variations, resonance, intonation, stress, and voice quality are the features that are thought to be important in terms of listener's judgement of the gender identity in communication. The ideal concept of 'voice and communication features' is still unclear for trans women. The American Speech-Language-Hearing Association (ASHA) recommends a comprehensive assessment which includes perceptual and instrumental evaluations to establish a personalized therapy program for trans women. In the literature, there are studies on the perceptual and instrumental features of the voices of trans women, however these studies have a wide heterogeneity in terms of the inclusion criteria of individuals, which can directly affect the perception of femininity and voice quality, in addition to that their sample size’s are low. Therefore, in present study, it was aimed to investigate the voice characteristics of trans women with healthy vocal folds using perceptual and instrumental methods. At the same time, the cepstral analysis evaluation, which has not been studied in the literature before, was made and it was investigated whether these analyzes have superiority over time-based measurements in predicting the perceptual voice characteristics of trans women. In the present study, 40 trans women aged between 18 and 53 were included. After the psychiatrist completed his evaluation, the individuals who are suitable as for the transitional period, videolaringoscopy records were gathered by the laryngologist and individuals with no vocal fold pathology were included in the study. In perceptual evaluations; participants were asked to fill out Transsexual Voice Questionnaire/Turkish (TVQ), Self- Perception of Voice Femininity Scale (SKAS), World Health Organization Quality of Life Scale Short Form, Depression Anxiety Stress Scale. Furthermore, voice recordings of trans women were listened by two experienced raters (Speech and Language Therapist, Otolaryngologist) and scored according to the Auditory-Perceptual Evaluation of Voice Consensus protocol. In the instrumental voice evaluation, Computerized Speech Laboratory, Kaypentax with Multi Dimensional Voice Profile, Voice Range Profile, Analysis of Dysphonia in Speech and Voice softwares were used. For aerodynamic evaluations, KAY Pentax Phonatoary Aerodynamic System was used. In the study, a moderate positive correlation was obtained between SKAS and F0 and also between SKAS and jitter. Additionally a weak negative relationship was seen between TVQ and fundamental frequency. Moreover a moderate negative relationship was seen between TVQ and jitter (%). It has been confirmed that cepstral analysis is more sensitive than the time-based measurements in estimating the impact of the quality of life associated with the voices of trans women.