Research Article Outcomes of Gender Affirming Voice Training: A Comparison of Hybrid and Individual Training Modules

Purpose: Gender affirming voice training supports individuals as they explore and develop a healthy voice that feels congruent with their gender and sense of self. Although gender affirming voice training is increasingly available, there is no research comparing individual versus hybrid training outcomes in the existing literature. Method: A retrospective chart review was performed on trans women and/or nonbinary individuals who attended either individual or hybrid (group and individual training) gender affirming voice and communication training at St. Michael's Hospital in Toronto between 2012 and 2019. Participant demographics, selfreported goal achievement, attendance, pre/post-Trans Woman Voice Questionnaire (TWVQ) scores, and pre/postspeaking fundamental frequency (SFF) were compared between individual and hybrid training participants. Multiple logistic regression analysis was performed to determine factors that could predict self-reported goal achievement. Results: Sixty-two trans women and/or nonbinary individuals who attended either individual (n = 43) or hybrid (n = 19) gender affirming voice and communication training were included in the study. Hybrid participants had a significantly higher goal achievement rate and therapy adherence rate compared with individual participants (74% vs. 21%; 84% vs. 28%, respectively). Both training models resulted in significant elevation of SFF and reduction of TWVQ scores. Inflection range did not change significantly for either training formats. Multiple logistic regression showed that hybrid training was a positive predictor for goal achievement (odds ratio = 2.2, 95% confidence interval [0.3, 4.1]). Conclusions: Although clients in individual and hybrid gender affirming voice and communication training achieved significant pitch elevation and lower TWVQ scores, hybrid participants demonstrated significantly higher goal achievement and therapy adherence. This study suggests that hybrid training may provide a valuable support system that improves therapy success in this client population.