Factors Associated With Vocal Fatigue In Transfeminine And Transmasculine Individuals Who Have Not Undergone Voice Harmonization

Objective To investigate the presence of vocal fatigue in transmasculine and transfeminine individuals, compare these groups, and identify associated factors. Methods This cross-sectional, observational study was conducted online in Brazil with convenience sampling. Transmasculine and transfeminine individuals participated by completing a characterization questionnaire including questions on age, gender, hormone therapy, implementation of vocal adjustments in communication, and the number of contexts in which these adjustments are performed, as well as the Vocal Fatigue Index (VFI) and the global self-assessment item of the Trans Woman Voice Questionnaire (TWVQ). Variables were analyzed descriptively, and the transmasculine (TMG) and transfeminine (TFG) groups were analyzed comparatively. Associations between variables were investigated using linear regression, with the total VFI score as the outcome measure. Results The study sample comprised 34 individuals in the TMG and 24 in the TFG. Mean VFI scores were outside the reference values for Brazilian Portuguese. The TMG presented a significantly higher total VFI score than TFG. Linear regression analysis revealed a significant association between the total VFI score and the number of contexts in which individuals make vocal adjustments: for every 1-unit increase in the number of contexts, the total VFI score increased by an average of 4.11 points. Conclusion Transgender individuals presented symptoms of vocal fatigue, which were more pronounced in transmasculine compared to transfeminine individuals. Additionally, the number of contexts in which vocal adjustments are made to express gender identity was associated with increased vocal fatigue symptoms.