Psychological factors influencing voice outcomes: Impacts in gender minority patients

ABSTRACT Voice disorders are common and can cause significant functional, occupational, and social impairment. Voice-related handicap is highest in cisgender patients with low perceived control, which is the extent to which one can control events or one?s reactions to events. Perceived control is associated with greater likelihood of following treatment recommendations and participating in communication. In gender diverse patients (including transgender and nonbinary patients), voice concerns are also frequent, but distinct from those identified by cisgender patients. Thus findings on the relationships between voice-related perceived control and voice outcomes in cisgender patients cannot be assumed to be representative of the experience of gender diverse patients. Gender diverse patients have identified as important several key themes related to perceived control. The proposed research aims will clarify the relationships between perceived control and voice outcomes among gender diverse patients, facilitating strategic adaptation of an existing perceived control intervention for testing in gender diverse patients with voice concerns. The research aims are to (1) measure relationships between perceived control and voice handicap in transgender patients with voice concerns, (2) characterize the role of perceived control in the vocal experience of transgender patients using a qualitative approach, and (3) determine priority focus areas for measuring voice outcomes in nonbinary patients with voice concerns. These aims will also support the primary career development goal to acquire expertise at the interface between modern psychology and voice research. This work is innovative as it will lead to an understanding of voice-related perceived control and voice outcomes among gender diverse patients, who are an understudied and underserved population. Completion of these aims will help position the PI to contribute new information about how psychological factors influence voice outcomes. These aims will also pave the way toward a new addition to the treatment armamentarium for voice disorders, which currently includes voice therapy, medications, and surgery, but no systematic approach to addressing contributory psychological factors. The overall goal of the investigator is to contribute to integrated care that leads to the best possible voice and quality of life outcomes for patients with voice disorders.