From internal echoes to sharing experiences: transformative learning with voice apps to enhance transgender care literacy in medical students

Abstract

Introduction: Gendered voice perception is central to gender recognition and can be a major source of distress for transgender people, yet voice and voice therapy remain marginal in medical curricula. This study examined how a digital, experiential seminar using voice-feedback applications can foster medical students’ understanding of gendered voice and transgender health. Methods: We conducted a qualitative observational study within a 135-min online seminar, “Feminize Your Resonance!”, embedded in a fourth-year public health module at the Medical University of Vienna. One hundred medical students used commercially available voice apps to experiment with their own pitch and resonance and submitted app screenshots and written reflections via an online learning platform. We applied a narrative analysis, based on narrative episodes in students’ accounts, using a multi-stage coding process supported by qualitative data analysis software to map learning processes in several stages. Results: Analysis yielded three interlinked themes—implicit voice awareness, technology engagement, and sharing transgender experience—organized into a five-phase learning journey from pre-existing discomfort with one’s recorded voice to social awareness with voice challenges of transgender individuals. Students moved from internal, often negative, self-evaluation to critical appraisal of app algorithms, exploration of their own vocal plasticity, and perspective-taking on the challenges of gender-affirming voice transition. Conclusion: Technologically mediated voice exploration can catalyze transformative learning about the role of voice in gender incongruence and support the development of affective and clinical competencies in medical education. Potentially the training facilitates communicating with transgender individuals empathically, not only related to transgender-affirming care but in all healthcare settings.