Stigma and voice-related life impact among transgender and gender diverse adults

Introduction: Experiences of stigma negatively affect the mental and physical health of transgender and gender diverse (TGD) adults, but less is known about how it may impact voice, an important aspect of gender embodiment. This study investigated the relation between gender minority stressors and voice-related life impact and examined potential moderating effects of identity pride, community connection, resilient coping, and perceived control. Methods: TGD adults (N = 313) completed an online survey between June and November 2022. Participants completed gender-specific voice questionnaire(s), the Gender Minority Stress and Resilience (GMSR) measure, the Brief Resilient Coping Scale, and the voice-related Present Perceived Control Scale. Simple linear regressions were conducted between gender minority stressors and voice-related life impact questionnaires, and multiple linear regressions with an interaction term were used for moderation analyses. Results: Experiences of gender minority stress were associated with voice-related life impact, most consistently for non-affirmation and internalized transphobia. Identity pride was protective against non-affirmation on voice-related life impact for trans women and trans men. Resilient coping was protective against internalized transphobia on voice-related life impact for trans men and exacerbated the association between non-affirmation and voice-related life impact for trans women. Community connectedness and perceived control were not moderators. Conclusion: Experiences of stigma were associated with how TGD adults perceived their voice functioning and how their voices impacted their life. Experiences of oppression should be explored in the context of gender-affirming voice care as an important factor in voice functioning and voice-related goals.