Effectiveness of testosterone therapy for masculinizing voice in transgender patients: A meta-analytic review

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.     

In den Bogenmaßen des Seins. Zum Transzendentalen bei Husserl und Deleuze

Although both Husserl and Deleuze declare themselves to be committed to the idea of transcendental philosophy, it is not clear how a constructive discussion between these two approaches to the transcendental question might begin. In this paper, the basis for such a productive confrontation will be sought in the concept of multiplicity as developed by nineteenth century mathematics. This concept serves as a crucial operational concept both in Husserl and in Deleuze. The following critical analysis clarifies the idea and the task of phenomenology as a philosophy of pure immanence whose fundamental metaphysical dimension can thus be no other than time.     

Two sets of twins with selective mutism: neuropsychological findings.

Neuropsychological data are reviewed from two sets of dizygotic twins presenting with selective mutism characterized by situation specific anxiety, extreme passive behavior, lack of responsivity, lack of peer interaction, and a chronic course of selective mutism. Both sets of twins had a history of prematurity and delayed speech development. One set of twins presented with normal intelligence and normal receptive language skills but with expressive language and oral motor sequencing difficulties. The second set of twins presented with Verbal IQ deficits and significant receptive and expressive language deficits. A summary of current conceptualizations regarding etiology and treatment of selective mutism is provided.     

Is politician A or politician B more persuasive? recipients' source preference and the direction of biased message processing

Participants' preference for one of two politicians running for the post of Chancellor in Germany was measured. Under conditions conducive to effortful processing, participants were then presented with a persuasive message ascribed to one of these two sources. The message was either unambiguous strong, unambiguous weak, or ambiguous. Different from previous research on the role of message ambiguity for attitude change, the ambiguous message consisted of arguments rated as moderately convincing in a pretest rather than of a mixture of strong and weak arguments. The results were in line with predictions derived from the heuristic‐systematic model (HSM). Indicating unbiased systematic processing, an unambiguous strong message led to more agreement than an unambiguous weak message. In the case of an ambiguous message, in line with the HSM's bias hypothesis, more agreement was found among participants preferring the source politician as compared to participants preferring the other politician. Copyright © 2003 John Wiley & Sons, Ltd.     

Orthography shapes the perception of speech: The consistency effect in auditory word recognition

Inconsistency in the spelling-to-sound mapping hurts visual word perception and reading aloud (i.e., the traditional consistency effect). In the present experiment, we found a consistency effect in auditory word perception: Words with phonological rimes that could be spelled in multiple ways produced longer auditory lexical decision latencies and more errors than did words with rimes that could be spelled only one way. This finding adds strong support to the claim that orthography affects the perception of spoken words. This effect was predicted by a model that assumes a coupling between orthography and phonology that is functional in both visual and auditory word perception.     

A note on item analysis with an electronic computer

An electronic computer with large capacity memory, and employing binary numbers, is ideally suited for large-scale item analysis. The adaptation and use of one computer, SWAC, is described. A research project of the American Council on Education and The Grant Foundation.     

Getting a Grasp on Children’s Representational Capacities in Pantomime of Object Use

This study examined how 5- and 9-year-old children (N = 40) produce pantomimes of object use on verbal request. The task required participants to enact an action with an imagined object. Results showed that with age, children (a) proceeded from body part as object to imaginary object and (b) incorporated into their pantomimes more distinctive features of the object and its use. While the first result replicated previous findings with more items and a more sophisticated coding procedure, the latter result revealed new insights. Children’s selection of distinctive features in pantomime was related to their performance on a semantic odd-one-out task that requires the abstraction of specific features without situational support. The discussion focuses on the cognitive requirements of the task and the potential of pantomime being a reflection of children’s representational development. We suggest an explanation of the findings within the more general developmental model of Karmiloff-Smith.     

Predicting academic success with the Big 5 rated from different points of view: Self‐rated,other rated and faked

Self‐ratings of personality predict academic success above general intelligence. The present study replicated these findings and investigated the increment of other‐ratings or intentionally distorted self‐ratings. Participants (N = 145) had to compile a personality questionnaire twice. First they were given neutral instructions. The second time they were asked to imagine a specific applicant setting. Furthermore, two peers rated each participant. Additionally, verbal, numerical and figural reasoning scores were obtained. Grades on a statistics exam obtained 2 months later served as the criterion. Results replicated prior findings and showed incremental validity for self‐ and other‐rated personality, which was stable after controlling for intelligence. Faking had no impact on the domain‐score level, but results on the facet‐score level were less encouraging. Copyright © 2010 John Wiley & Sons, Ltd.