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Scientific Oral Presentation

Laryngology/Broncho-Esophagology

Contributors to Voice-related Functional Impairment in Trans Women

Monday, October 19, 2026
11:30 AM - 11:36 AM PT
Location: 406B

    Presenting Author(s)

  • Eve P. Champaloux, MD, PhD

    Assistant Professor
    SUNY Upstate Medical University
    Syracuse, NY, United States

    • Co-Author(s)

  • Tanya K. Meyer, MD

    Professor, Otolaryngology
    Univ of Washington School of Medicine
    Seattle, Washington, United States

  • Katherine C. Yung, MD

    Director of Laryngology
    Sutter Health
    San Francisco, California, United States

    • Senior Author(s)

  • Joseph Chang, MD

    Assistant Professor
    University of Washington
    Seattle, WA, United States

Disclosure(s):
Eve P. Champaloux, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Joseph Chang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Voice-related work productivity impairment has recently been identified as a functional impairment associated with gender dysphoria. The mechanism for this is unclear, as gender dysphoria is not associated with anatomic or neurologic vocal pathology. This study aims to identify specific symptoms that contribute to voice-related work productivity impairment in trans women.

Methods: Age-matched cisgender individuals and trans women without pre-existing vocal pathology were recruited for this multi-institutional, cross-sectional study. WorkHoarse, a measure of voice-related work productivity impairment, and VHI-10 were collected. WorkHoarse questions ask about frequency of specific symptoms and are scored from 0, never, to 4, very often. Scores above 2 were considered elevated, indicating impairment.

Results: 33 age-matched participants were recruited to each group. VHI-10 and WorkHoarse scores were higher in the trans woman group than the cisgender group (2.6 vs 18.1, and 2.3 vs 17.6, p = < 0.0001 and < 0.0001 for the cisgender and trans woman groups respectively). Voice-related work productivity impairment was elevated in 3.0% of cis participants and 84.8% of trans participants. A subanalysis of the individual WorkHoarse questions showed significantly higher symptom burden in the trans woman group in every subdomain (p < 0.001). Subdomains with the greatest difference in percent of participants reporting impairment included the emotional (64-70%) and physical (48%) subdomains.

Conclusions: Emotional and physical attributes of voice use, including increased vocal fatigue and discomfort, are leading contributors to voice related work productivity impairment in trans women. Gender affirming voice care that reduces the severity of these symptoms may meet criteria as medical necessary and reconstructive interventions.