Voice changes over time in a female-to-male transsexual receiving hormone therapy

Abstract

Objective: To characterize voice changes over a period of 143 days in a female-to- male transsexual subject receiving hormone therapy. Patients and Methods: The subject was a 24-year-old female-to-male transsexual. Vocal assessment consisted of examination of the mean fundamental frequency (MF0), vocal range, the subject's impression concerning her own voice, and self-evaluation using the VHI scale. Results: MF0 started to decline after 48 days of therapy, and by 143 days it had descended from 187 Hz to 108 Hz. Vocal range widened from 138-1046 Hz to 97-1174 Hz after 48 days, and then narrowed to 82-392 Hz. Regarding subjective impression, at 48 days the subject complained of her voice breaking during conversation, and at 143 days difficulty of producing a falsetto voice while singing and feeling tense during conversations. VHI score improved for the emotional subscale, but deteriorated for the physical subscale. Conclusion: In the present subject, hormone therapy had the effects of decreasing the MF0 and temporarily widening the vocal range. However, the subject complained about voice symptoms as noted above. In this subject these symptoms seemed to be functional dysphonia derived from organic changes in laryngeal muscles. In order to prevent such symptoms, reconsideration of hormone quantity and the injection term may be necessary while observing voice changes.