Speech therapy for transgender women: an updated systematic review and meta-analysis

Systematic Reviews

Systematic Review Update

Bruna Costa Gomes¹  Maiko Abel Schneider²  Anna Paula Villas-Boas³  Maria Inês Rodrigues Lobato³  Dhiordan Cardoso da Silva³  Karine Schwarz⁴  Poli Mara Spritzer⁵  Anna Martha Vaitses Fontanari⁶  Carla Aparecida Cielo⁷  Angelo Brandelli Costa⁸ 

[1] Clinical Speech Therapist, Osório, Rio Grande Do Sul, Brazil;Department of Psychiatry and Behavior Neuroscience, McMaster University, Ontario, Canadá;Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre and Federal University of Rio Grande Do Sul, 90035-003, Porto Alegre, Brazil;Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre and Federal University of Rio Grande Do Sul, 90035-003, Porto Alegre, Brazil;Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil;Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre and Federal University of Rio Grande Do Sul, 90035-003, Porto Alegre, Brazil;Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil;Department of Physiology, Federal University of Rio Grande Do Sul, Porto Alegre, Rio Grande Do Sul, Brazil;Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre and Federal University of Rio Grande Do Sul, 90035-003, Porto Alegre, Brazil;Psychology Graduate Program, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Rio Grande Do Sul, Brazil;Department of Speech Therapy, Voice Laboratory, Federal University of Santa Maria, Santa Maria, Rio Grande Do Sul, Brazil;Psychology Graduate Program, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Rio Grande Do Sul, Brazil;

关键词: Gender dysphoria;    Transgender;    Gender identity;    Clinical care;    Voice;   

DOI  :  10.1186/s13643-023-02267-5

 received in 2022-07-22, accepted in 2023-06-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the fundamental frequency gain of the voice, regarding the type of vocal sample collected, and we compared the effectiveness of the treatments. In addition, the study design, year, country, types of techniques used, total therapy time, and vocal assessment protocols were analyzed.MethodsWe searched the PubMed, Lilacs, and SciELO databases for observational studies and clinical trials, published in English, Portuguese, or Spanish, between January 2010 and January 2023. The selection of studies was carried out according to Prisma 2020. The quality of selected studies was assessed using the Newcastle–Ottawa scale.ResultsOf 493 studies, 31 were deemed potentially eligible and retrieved for full-text review and 16 were included in the systematic review and meta-analysis. Six studies performed speech therapy and ten studies phonosurgery. The speech therapy time did not influence the post-treatment gain in voice fundamental frequency (p = 0.6254). The type of sample collected significantly influenced the post-treatment voice frequency gain (p < 0.01). When the vocal sample was collected through vowel (p < 0.01) and reading (p < 0.01), the gain was significantly more heterogeneous between the different types of treatment. Phonosurgery is significantly more effective in terms of fundamental frequency gain compared to speech therapy alone, regardless of the type of sample collected (p < 0.01). The average gain of fundamental frequency after speech therapy, in the /a/ vowel sample, was 27 Hz, 39.05 Hz in reading, and 25.42 Hz in spontaneous speech. In phonosurgery, there was a gain of 71.68 Hz for the vowel /a/, 41.07 Hz in reading, and 39.09 Hz in spontaneous speech. The study with the highest gain (110 Hz) collected vowels, and the study with the lowest gain (15 Hz), spontaneous speech. The major of the included studies received a score between 4 and 8 on the Newcastle–Ottawa Scale.ConclusionThe type of vocal sample collected influences the gain result of the fundamental frequency after treatment. Speech therapy and phonosurgery increased the fundamental frequency and improved female voice perception and vocal satisfaction. However, phonosurgery yielded a greater fundamental frequency gain in the different samples collected. The study protocol was registered at Prospero (CRD42017078446).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023. corrected publication 2023

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