title: The multidimensional impact of total laryngectomy on women.
abstract: Based on society's expectations of what defines the norms for what is deemed "masculine" and "feminine", and a propensity for society's members to adhere to these expectations, women may face a unique set of circumstances and pressures following surgical treatment for laryngeal cancer. This is primarily due to the changes that occur to women's physical, psychological, and social functioning when dealing with cancer diagnosis and treatment outcomes. Because of concerns related to physical disfigurement, acoustic and perceptual changes to one's voice, and threat of the psychological sequelae associated with total laryngectomy (TL) (or, the surgical removal of one's voicebox and surrounding structures), there is an increased potential for violation of social expectations that cross these areas of functioning. As such, efforts that seek to better understand the potentially differential impact of TL on women and identify the specific needs they may have leading up to and after such treatment pursuant to contemporary societal expectations are warranted. Thus, this paper provides an examination of the potentially differential impact of TL on women. In addressing this position, this paper examines the unique challenges women may face postlaryngectomy through the framework of the International Classification of Functioning, Disability, and Health (ICF). Through the use of the ICF, this paper will provide an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as facilitators or barriers to women's societal reintegration secondary to TL.
  
  
  OBJECTIVE
  Readers will be able to describe the multiple factors that may contribute to the differential impact of total laryngectomy (TL) on women. More specifically, readers will gain an understanding about women's physical, psychological, and social functioning secondary to TL. This paper also provides readers with exposure to the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework. This framework provides readers with an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as either facilitators or barriers to the societal reintegration of women secondary to TL.
authors.affiliation: Voice Production and Perception Laboratory, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada. Electronic address: scox47@uwo.ca.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cox
authors.affiliation: Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Theurer
authors.affiliation: Rehabilitation Sciences, University of Western Ontario, London, ON, Canada; School of Occupational Therapy, University of Western Ontario, London, ON, Canada.
authors.forename: Sandi J
authors.initials: SJ
authors.lastname: Spaulding
authors.affiliation: Voice Production and Perception Laboratory, University of Western Ontario, London, ON, Canada; Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Doyle
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects* / Q000523:psychology
keywords: Gender; ICF; Laryngeal cancer; Stigma; Total laryngectomy