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
Extending previous research on the characteristics associated with adolescents’ general tendency to be a moral rebel (Sonnentag & Barnett, 2016), the present study examined the roles of moral identity and (general and situation-specific) moral courage characteristics on 3 (i.e., caring, just, and brave) expressions of the tendency to stand up for one’s beliefs and values despite social pressure not to do so. Results revealed that general and situation-specific moral courage characteristics are important motivators of individuals’ caring, just, and brave expressions of the tendency to be a moral rebel, especially when they possess a relatively strong moral identity. 相似文献
Positive psychology interventions (PPIs) are effective in increasing well-being across the population. Whilst educators are recognising the importance of well-being in the classroom and of its long-term impact on life trajectory, the transformative potential of PPIs in educational settings is yet to be fully realised. This study investigates, for the first time, the effects of a PPI in school children by means of a daily dairy. Self-report questionnaires were used to measure well-being in school children aged 8–11 years. Across two studies, children kept a positive events diary, recording three experiences every day for a week. The intervention led to an increase in happiness and a decrease in depressive symptoms immediately following the intervention and at a three-month follow-up. Children who had unhappier baseline scores benefitted more from the intervention. This study demonstrates significant scope, in school settings, for targeted light-touch interventions to promote well-being in those with the greatest need. 相似文献
We offer a new theoretical angle for cognitive arithmetic, which is that evidence accumulation may play a role in problem plausibility decisions. We build upon previous studies that have considered such a hypothesis, and here formally evaluate the paradigm. We develop the finding that performance differences, due to variations in strategy use and aging effects, can indeed be reasonably explained through these accumulation-to-bound cognitive models. Results suggest that these models may be effectively used to learn more about the underlying cognitive processes. In this study, we modelled young (18–24) and older (68–82) adults’ solution times in performing arithmetic verification (e.g. whether 8?×?5?=?41 is true/false). The domain-relevant factors in strategy use (problem-verification heuristics) and aging differences (older/younger adult groups) were analyzed by a response process model of the latency data, that is fit by participant and item. Lower thresholds accounted for the faster response times (RTs) for problems solved with heuristics (arithmetic rule-violation checking strategies), as opposed to problems solved by calculation approaches. A more rapid accumulation accounted for faster RTs on problems in which two arithmetic rules were violated (strategy combination) rather than one. Third, higher thresholds (i.e. preferring to have greater certainty before responding) accounted for older adults’ slower speed. These findings are in support of accumulation models being relevant for more complex cognitive tasks, as well as to account for the age-related differences therein. 相似文献
Early defenders of the Universal Declaration of Human Rights invoked species hierarchy: human beings are owed rights because of our discontinuity with and superiority to animals. Subsequent defenders avoided species supremacism, appealing instead to conditions of embodied subjectivity and corporeal vulnerability we share with animals. In the past decade, however, supremacism has returned in work of the new ‘dignitarians’ who argue that human rights are grounded in dignity, and that human dignity requires according humans a higher status than animals. Against the dignitarians, I argue that defending human rights on the backs of animals is philosophically suspect and politically self-defeating. 相似文献