title: Transmasculine people's vocal situations: a critical review of gender-related discourses and empirical data.
abstract: BACKGROUND
  Transmasculine people assigned female sex at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Some voice researchers and clinicians suggest that transmasculine people do not need attention because testosterone treatment leads to a satisfactory masculinization of their voice organs and voices. Others, however, argue that transmasculine people are a heterogeneous group whose members might not share the same body type, gender identity or desire for medical approaches to gender transitioning. Therefore, testosterone-induced voice changes may not necessarily meet the needs and expectations of all transmasculine people.
  
  
  OBJECTIVE
  To evaluate the gender-related discursive and empirical data about transmasculine people's vocal situations to identify gaps in the current state of knowledge and to make suggestions for future voice research and clinical practice.
  
  
  METHODS
  A comprehensive review of peer-reviewed academic and clinical literature was conducted. Publications were identified by searching seven electronic databases and bibliographies of relevant articles. Thirty-one publications met inclusion criteria. Discourses and empirical data were analysed thematically. Potential problem areas that transmasculine people may experience were identified and the quality of evidence appraised.
  
  
  RESULTS
  The extent and quality of voice research conducted with transmasculine people so far was found to be limited. There was mixed evidence to suggest that transmasculine people's vocal situations could be regarded as problematic. The diversity that characterizes the transmasculine population received little attention and the complexity of the factors that contribute to a successful or unsuccessful vocal communication of gender in this group appeared to be under-researched. While most transmasculine people treated with testosterone can expect a lowering of their pitch, it remains unclear whether the extent of the pitch change is enough to result in a voice that is recognized by others as male.
  
  
  CONCLUSIONS
  More research into the different factors affecting transmasculine people's vocal situations that takes account of the diversity within the population is needed.
authors.affiliation: La Trobe Rural Health School, Faculty of Health Sciences, La Trobe University, Bendigo, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Azul
mesh_terms: D005260:Female; D005783:Gender Identity; D020249:Hormone Replacement Therapy; D006801:Humans; D013061:Speech Acoustics; D013739:Testosterone / Q000008:administration & dosage; D063106:Transgender Persons; D014833:Voice Quality; D014834:Voice Training; D008297:Male
chemical_list: D013739:Testosterone
keywords: female-to-male transgender; female-to-male transsexual; gender diversity; voice; voice problem; voice treatment