An ICF Perspective on Voice-related Quality of Life of American Transgender Women

SummaryPurposeThe factors and correlates of voice-related quality of life (vQOL) in American transgender women (ie, male-to-female) were examined using two questionnaires and were reviewed in the context of the International Classification of Functioning, Disability, and Health (ICF) model. This information will assist clinicians to be culturally and clinically competent providers of voice and communication feminization services.MethodsA diverse group of 81 transgender women completed a survey to report relevant demographic information, as well as the Voice Handicap Index and the Transgender Self-evaluation Questionnaire (TSEQ). Descriptive statistics for the overall levels of vQOL were calculated. Items from the TSEQ were sorted to correspond to the ICF components to allow for description and ranking of factors impacting health function. Spearman correlations were used to examine the relationships between questionnaire scores and to select demographic and gender transition characteristics (ie, personal factors in the ICF).ResultsThese transgender women reported a wide range of vQOL; some are severely restricted by their voice and communication, whereas others are not. The most common concerns are emotional reactions to activity limitations and participation restrictions. Personal factors related to demographics and gender transition generally were not significant contributors to the vQOL scores.ConclusionsIn addition to addressing the physiological functions of the voice, speech language pathologists should cultivate cultural competence and consider transgender clients' emotional reactions to voice function impairments and related life participation restrictions.