Terminated Clinical Trial of TruVox: A Web-Based Intervention to Train Vocal Pitch and Resonance in Transfeminine People

Transgender people often want to modify their voice to better match their gender identity and expression. Gender-affirming voice training can significantly improve their voice satisfaction, mental health, and quality of life, but is often inaccessible. In an NIDCD-funded grant, we therefore developed a novel website (TruVox) that is currently intended for transfeminine people and combines visual-acoustic biofeedback about vocal pitch and resonance with structured exercises. A clinical trial of TruVox was initiated but terminated by NIDCD before completion, and the current paper describes the methods and results with six transfeminine people. Participants attended four weekly sessions of voice training with a speech-language pathologist via Zoom, with TruVox used in the sessions. Between sessions, they also used TruVox for unsupervised training at home. Results showed positive experiences and improvements on multiple scales of voice-gender incongruence (e.g., Gender Voice Index, Utah Gender Presentation Scale) and voice satisfaction. Additionally, participants exhibited increases in vocal pitch and resonance, reported high motivation, and rated TruVox as having acceptable usability. While pitch and resonance improvements were lower than those seen in other clinical trials, this was likely due to the much shorter duration compared to the 8-15 sessions seen in literature. Though the study had no control group due to the premature project termination, it suggests that TruVox and similar software could eventually become well-established platforms that could enhance gender-affirming voice training. More broadly, such software could potentially benefit anybody who wishes to change the sound of their voice.