Background: Testosterone therapy is the predominant treatment for voice masculinization in transgender patients. Although lowering of voice fundamental frequency (f0) occurs with testosterone therapy, evidence suggests voice and gender identity may not fully align—i.e., voice-gender congruence may not be achieved—with its use.
Aim: This meta-analytic review evaluates the effectiveness of testosterone therapy to masculinize voice in transgender patients.
Methods: Multiple electronic databases were queried (inclusion dates: from database inception up to October 27, 2017) to identify original research on voice masculinization using testosterone therapy. Nineteen articles were included in this meta-analytic review, which followed PRISMA guidelines. In addition to qualitative analyses, random effects proportion meta-analyses were performed on data related to f0, voice-gender congruence, voice problems, and satisfaction with voice.
Results: A meta-analysis on f0 data showed after 1 year of testosterone therapy a combined estimate of 21% of participants (95% confidence interval [CI]: 5%–43%; I2: 59.9%) did not achieve cisgender male normative frequencies (f0 ≤ 131 Hz). Meta-analyses on incomplete voice-gender congruence and voice problems indicated combined estimates of 21% (95% CI: 10%–34%; I2: 0.0%) and 46% (95% CI: 14%–79%; I2: 90.2%), respectively. Regarding incomplete satisfaction with voice, a meta-analysis showed a combined estimate of 16% (95% CI: 7%–28%; I2: 0.0%).
Discussion: We found that not all transgender patients using testosterone therapy to masculinize voice should expect f0 lowering to cisgender male normative frequencies after 1 year. The vocal transition may involve voice problems for many patients, and some might not achieve voice-gender congruence without additional, voice-specific intervention. Given these findings, a voice evaluation should occur prior to initiating testosterone therapy and involve counseling on expectations for voice. Transgender patients who pursue voice masculinization may need management from laryngology and speech and language therapy to improve voice-gender congruence, mitigate voice problems, and increase satisfaction with voice. 相似文献
Interrelations of two measurement methods (cognitive versus behavioral ratings) for executive function (EF) were examined and related to reading comprehension and math calculations in fourth and fifth grade students (n = 93) in the context of a diverse urban student population. Relations among measures within four EF processes (working memory, planning, inhibition and shifting) were modest; relations to academics were stronger. EF measures contributed to both academic outcomes even in the context of relevant covariates (age, language and educational program). Working memory was particularly important for reading comprehension across measurement type. Cognitive measures from all EF processes, particularly inhibition and planning, and behavioral ratings of working memory were important for math. 相似文献
Working memory allows complex information to be remembered and manipulated over short periods of time. Correlations between working memory and mathematics achievement have been shown across the lifespan. However, only a few studies have examined the potentially distinct contributions of domain-specific visuospatial and verbal working memory resources in mental arithmetic computation. Here we aimed to fill this gap in a series of six experiments pairing addition and subtraction tasks with verbal and visuospatial working memory and interference tasks. In general, we found higher levels of interference between mental arithmetic and visuospatial working memory tasks than between mental arithmetic and verbal working memory tasks. Additionally, we found that interference that matched the working memory domain of the task (e.g., verbal task with verbal interference) lowered working memory performance more than mismatched interference (verbal task with visuospatial interference). Findings suggest that mental arithmetic relies on domain-specific working memory resources. 相似文献
Many everyday actions are implicit gambles because imprecisions in our visuomotor systems place probabilities on our success or failure. Choosing optimal action strategies involves weighting the costs and gains of potential outcomes by their corresponding probabilities, and requires stable representations of one's own imprecisions. How this ability is acquired during development in childhood when visuomotor skills change drastically is unknown. In a rewarded rapid reaching task, 6‐ to 11‐year‐old children followed ‘risk‐seeking’ strategies leading to overly high point‐loss. Adults' performance, in contrast, was close to optimal. Children's errors were not explained by distorted estimates of value or probability, but may reflect different action selection criteria or immature integration of value and probability information while planning movements. These findings provide a starting point for understanding children's risk‐taking in everyday visuomotor situations when suboptimal choices can be dangerous. Moreover, children's risky visuomotor decisions mirror those reported for non‐motor gambles, raising the possibility that common processes underlie development across decision‐making domains. 相似文献
This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed. 相似文献
The study investigated whether differences between contrasting groups reflect significant differences in psychological well-being scores. Membership of hazardous vs. less hazardous occupations in the same profession served as proxy measures of well-being. Antonovsky's Sense of Coherence (SOC), Block & Kremen's Ego-resiliency, and Goldberg's Emotional Stability scales were validated. Study 1 compared mine rescue team members and ordinary miners (n = 34, 41) and Study 2 police special task force members and regular officers (n = 43, 41). In Study 1, SOC and job satisfaction predicted group membership. In Study 2, satisfaction with life and extraversion scales predicted group membership, as did SOC in a secondary analysis. The SOC scale could predict psychological well-being in hazardous work settings. 相似文献
AbstractTemperament styles of 400 Nigerian children are described in reference to possible gender and age differences and compared with those of 3200 U.S. children in light of Jung's theory of temperament as modified by Myers and Briggs, one that highlights four bipolar qualities: extroversion-introversion, practical-imaginative, thinking-feeling, and organized-flexible styles. Nigerian children generally prefer introverted to extroverted styles, practical to imaginative styles, feeling to thinking styles, and organized to flexible styles. In contrast to males, females are more likely to prefer feeling and organized styles. Age differences are seen only on organized-flexible styles, with a preference for flexible styles increasing with age. In contrast to U.S. children, Nigerian children tend to express higher preferences for introversion, practical, feeling, and organized styles. 相似文献
