Longitudinal Case Study of Transgender Voice Changes Under Testosterone Hormone Therapy.
Gabriel J Cler, Victoria S McKenna, Kimberly L Dahl and 1 others
PMID 30987859WHAT IT FOUND
In one transmasculine speaker, testosterone lowered pitch but preserved singing range in semitones.
Listeners perceived the voice as male after 37 weeks. Voice quality remained healthy despite some acoustic changes. This single case suggests pitch range loss is not inevitable, but findings cannot be generalized.
Key findings
01Speaking fundamental frequency dropped significantly, moving from a typical cisgender female range to a typical cisgender male range.
02Singing pitch range shifted down by approximately 6 semitones but remained stable in width, contradicting fears of range loss.
03Listeners consistently perceived the speaker as male after 37 weeks of testosterone therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a single case report, so findings cannot be generalized to other transmasculine individuals. The participant was a voice researcher and heavy voice user who contributed to the study design, which may bias results or make his experience atypical. The participant did not undergo voice therapy, so the effects of combined medical and speech-language intervention are not shown. The participant was 30 years old, which is older than many individuals starting testosterone; laryngeal cartilage ossification may affect outcomes in younger speakers. Acoustic measures of voice quality (shimmer, HNR) worsened, but this was not perceptually apparent to experts or the participant. Listener perceptions were based on cisgender adults, whose gender attribution norms may differ from those of transgender or non-binary listeners.
Declared interests
The participant worked as a researcher and actively contributed to the study design and data collection schedule, representing a participatory action research model. No other specific funding or conflict disclosures were detailed in the provided text.
The easy way to misread this
Do not assume this outcome applies to other transmasculine clients. This is a single case of a voice researcher and singer who did not receive voice therapy. The acoustic measures of voice stability worsened, even if perceptual ratings remained normal, so clinicians should monitor for potential voice quality changes that may not be immediately obvious.