Voice-related challenges experienced by transgender and gender diverse individuals in Belgium

gender perception; gender-affirming care; non-binary experiences; transgender voice; voice and communication services; Gender Studies; Health (social science); Medicine (miscellaneous); Health Policy

Abstract :

[en] Introduction: Transgender (trans) and gender diverse (TGD) individuals often face challenges related to voice and communication, prompting many to seek professional support. However, barriers to accessing voice and communication training (VCT) persist, and research on diverse needs of TGD individuals remains incomplete. Further, research on the voice and communication needs of TGD individuals across the broad spectrum of gender identities is also incomplete. This study investigates the voice-related needs, experiences with voice and communication services, and access barriers faced by TGD individuals in Belgium. Methods: Using a community-based participatory approach, a questionnaire was co-developed with TGD individuals, assessing voice satisfaction, social impacts, and access to voice services. Results: The questionnaire was completed by 197 TGD individuals with different gender identities, including feminine and transfeminine (n = 108), masculine and transmasculine (n = 29), non-binary presumed male at birth (PMAB) (n = 11), non-binary presumed female at birth (PFAB) (n = 40), and ‘other or questioning’ (n = 4). Half of the participants (48.2%, 95/197) expressed dissatisfaction with their voices and felt their voices did not align with their gender expression. Misattributions and voice-related judgments negatively affected well-being and social lives. More than half (57.4%; 113/197) had engaged in VCT, reporting positive outcomes, particularly (trans)feminine individuals. All participants using masculinizing hormone therapy (21.8%; 43/197) experienced voice changes. Ten participants (0.05%; 10/197) underwent gender-affirming pitch changing surgery with mixed results. Non-binary participants, especially those PFAB, faced more barriers accessing VCT. Conclusion: This study underscores the importance of voice in gender expression and well-being, offering new insights into voice-related needs of TGD individuals across gender identities. The study highlights the benefits of VCT and GAHT in reducing misattribution and increasing voice satisfaction, while identifying significant barriers to care in Belgium, especially for non-binary PFAB individuals. These findings fill a crucial gap, providing context-specific insights to improve gender-affirming voice services.

Disciplines :

Speech and language therapy

Author, co-author :

Papeleu, Tine ; Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium

Oates, Jennifer ; School of Allied Health, Human Services, and Sport, La Trobe University, Melbourne, Australia

Motmans, Joz ; Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium

Morsomme, Dominique ; Université de Liège - ULiège > Département de Logopédie > Logopédie des troubles de la voix

T’Sjoen, Guy ; Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium ; Department of Endocrinology, Ghent University Hospital, Ghent, Belgium

D’haeseleer, Evelien ; Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium ; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium ; Musical Department, Royal Conservatory Brussels, Brussels, Belgium

Language :

English

Title :

Voice-related challenges experienced by transgender and gender diverse individuals in Belgium

Publication date :

2025

Journal title :

International Journal of Transgender Health

ISSN :

2689-5269

eISSN :

2689-5277

Publisher :

Routledge

Pages :

1-28

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.tandfonline.com/doi/pdf/10.1080/26895269.2025.2520958

Funders :

FWO - Research Foundation Flanders

Available on ORBi :

since 24 April 2026

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