title: Voice in female-to-male transsexual persons after long-term androgen therapy.
abstract: OBJECTIVE
  The aim of the present study was to 1) document voice in a large sample of female-to-male transsexual persons (FMT), 2) compare their vocal characteristics with those of heterosexual biological males, and 3) determine hormonal factors with impact on their fundamental frequency.
  
  
  METHODS
  This was a controlled cross-sectional study. It is the largest study to date on voice and voice change in FMT, and the first to include a control group and FMT who were under long-term androgen administration.
  
  
  METHODS
  Thirty-eight FMT, ranging in age between 22 and 54 years, and 38 controls, frequency matched by age and smoking behavior, underwent a voice assessment that comprised the determination of pitch, intonation, and perturbation parameters measured during sustained vowel production, counting, and reading. Hormonal factors explored were hematocrit, total testosterone level, luteinizing hormone level, and biallelic mean length of the cytosine-adenine-guanine (CAG) trinucleotide repeat sequence in the androgen receptor gene.
  
  
  RESULTS
  It was found that the FMT as a group did not differ significantly from controls for any of the acoustic voice variables studied. However, in about 10% pitch lowering was not totally unproblematic. The lowest-pitched (i.e., more male) voices were observed in FMT with higher hematocrit and longer CAG repeats.
  
  
  CONCLUSIONS
  After long-term androgen therapy, FMT generally demonstrate an acceptable male voice. Pitch-lowering difficulties can be expected in about 10% of cases and appear, at least in part, to be associated with diminished androgen sensitivity.
  
  
  METHODS
  3b.
authors.affiliation: Department of Speech, Language, and Hearing Sciences, Ghent University, Ghent University Hospital, Ghent, Belgium.
authors.forename: Marjan
authors.initials: M
authors.lastname: Cosyns
authors.forename: John
authors.initials: J
authors.lastname: Van Borsel
authors.forename: Katrien
authors.initials: K
authors.lastname: Wierckx
authors.forename: David
authors.initials: D
authors.lastname: Dedecker
authors.forename: Fleur
authors.initials: F
authors.lastname: Van de Peer
authors.forename: Tine
authors.initials: T
authors.lastname: Daelman
authors.forename: Sofie
authors.initials: S
authors.lastname: Laenen
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
mesh_terms: D000328:Adult; D000728:Androgens / Q000008:administration & dosage*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000008:administration & dosage; D063106:Transgender Persons / Q000706:statistics & numerical data*; D014833:Voice Quality / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: Transsexualism; female-to-male; hormonal factors; voice