Abstract :
[en] Background
Many Trans and Gender-Diverse Individuals (TGDI) seek Gender-Affirming Vocal Care (GAVC). The effectiveness of GAVC is well-documented (Leyns et al., 2021). However, discrimination against TGDI can severely impact mental health and quality of life, contributing to anxiety and depression through the minority stress process (Meyer, 2015). This stigma often leads to social isolation, limiting the use of feminized or masculinized Vocal Motor Behaviour (VMB) in daily life and hindering its generalization, as described in motor learning theories (Remacle & Morsomme, 2021).
Methods
This case study explored the efficacy of GAVC combined with virtual reality (VR). A multiple-baseline Single-Case Experimental Design (SCED) (Krasny-Pacini & Evans, 2018) was used, including pre-intervention (T0), post-intervention (T1), follow-up evaluations (T2), and five VR-based assessments. Vocal, psychological, and VR sensitivity parameters were measured. The measures were collected through acoustic voice analysis of the participant and both standardized and non-standardized questionnaires.
Results and Conclusions
Significant improvements were observed in vocal measures, including pitch (ƒo), pitch variation (sd_ƒo), and fourth formant resonance frequency (fR4), with these changes perceived as more feminine. TWVQ scores reduction further confirmed an increase in vocal congruence. Psychological benefits were also noted, with enhanced self-efficacy and decreases in anxiety and depressive symptoms, demonstrating a positive interaction between GAVC and overall well-being. Additionally, the participant exhibited positive adaptation to virtual reality (VR) exposure. These findings underscore the effectiveness of GAVC when complemented by VR. By providing immersive and secure environments, VR facilitates VMB generalization, reduces psychological and social barriers, and addresses the need for its automation, as emphasized in motor learning theories. Moreover, VR enables exposure therapy, improving the use of proximal resources from the minority stress model in communicative contexts. In conclusion, VR offers unique opportunities to enhance psychological well-being and support the transfer of therapeutic gains to everyday life.
• Vocal measures: Significant improvements were observed in pitch (ƒo), pitch variation (sd_ƒo), and fourth formant resonance frequency (fR4), with changes perceived as more feminine. TWVQ scores confirmed increased vocal congruence.
• Psychological improvements: Enhanced self-efficacy and reduced anxiety and depressive symptoms demonstrated the positive interaction between vocal changes and overall well-being.
• Virtual Reality Response: The participant showed positive adaptation to VR exposure.
These findings highlight the effectiveness of GAVC when enhanced by VR. VR offers immersive and secure environments that promote vocal skill generalization while reducing psychological and social barriers. It addresses the need for vocal motor behavior automation, as outlined in motor learning theories, and enables exposure therapy to improve the use of proximal resources from the minority stress model in communicative contexts.
In conclusion, VR presents unique opportunities to enhance psychological well-being and facilitate the transfer of therapeutic gains to daily life in GAVC.
