Logopécare : Philosophical-ethical contribution to gender-affirming vocal care.

Background
Research paradigms significantly shape scientific outcomes (Kuhn, 1962). In voice studies, Azul and Hancock (2020) emphasized the need to discuss paradigms. Azul et al. (2021) explored how hyper-medicalizing biologistic paradigm affect gender-affirming vocal care (GAVC) for Assigned-Female-At-Birth (AFAB) individuals. This presentation encourages care practitioners to integrate insights from the medical humanities to counter these representations and their effects on GAVC.
Methods
Three theoretical sources are explored and combined to develop a new problematization, from which clinical and epistemological insights are derived : 1. Speech-language pathology ethics (Kerlan, 2018), which frames the discipline as interdisciplinary, grounded in relationships between language, norms, narrative ethics, and therapeutic interactions ; 2. Care theory, from its origins (Gilligan, 2019 [1982]) to its politicization (Tronto, 2009 [1993]) and contemporary perspectives (Molinier, 2020 [2013]). Care evolves from a moral disposition to a practice that redefines the affective and aesthetic dimensions of caregiving ; 3. Queer theory (Butler, 2019 [1990]), a polysemic concept offering a theoretical framework and critical tools to analyze and strategically challenge norms, with a focus on sexuality and gender. Normative matrices are critiqued to foster sensitivity and reparative practices.
Aesthetics of care (Salamanca González, 2023), queer normativity (Niedergang, 2023), and ethical SLP approaches (Kerlan, 2018) converge to offer reflexive, practical tools for care. This synthesis, termed logopécare, examines norms, relationality, and language as potent political, scientific, and clinical levers.
Results and Conclusions
Theoretical and clinical implications are discussed for their relevance to GAVC. These implications include, for example, the ability to alternate between feminized and masculinized vocal motor behaviors, the potential to approach GAVC from an aesthetic rather than a normative perspective, and the distribution of agency involved in communicative acts. These contributions are examined through the Evidence-Based Practice (EBP) model and enriched by perspectives highlighting the importance of patient well-being (Azul et al., 2022).