NIH Award to Study How Testosterone Affects Trans Men’s Voices

BY GINA MANTICA

Although most trans men treated with testosterone are satisfied with how their voice sounds in the context of their gender identity, a sizeable proportion are not. And despite how commonly testosterone is used to masculinize speech, there is very little information on how it affects the vocal tract. Cara Stepp, a Research Fellow at the Hariri Institute and a Professor in both Speech, Language and Hearing Sciences at BU College of Health & Rehabilitation Sciences:  Sargent College and Biomedical Engineering in the BU College of Engineering, was awarded a five-year $2.8 million National Institutes of Health (NIH) Research Project Grant (R01) recently to investigate the effects of testosterone treatment on speech production in trans men.

The new study was inspired by a Boston University student who started taking testosterone to make his voice more masculine. The student approached Stepp about the lack of information on how testosterone changes speech, and wanted to better understand the hormone’s effects on vocal organs. “I took a look at the literature myself and I was stunned to see how little is known, despite how commonly testosterone is used for this purpose,” said Stepp, “Along the way I became more and more frustrated with the dearth of information for this population for any speech intervention.”

Stepp and her colleague Dr. Lauren Tracy, an Assistant Professor of Otolaryngology at Boston University School of Medicine, are building upon work they began at the Hariri Institute nearly two years ago. “Getting the pilot grant from the Hariri Institute was key – it allowed us to really dedicate resources to work on voice and speech in trans men,” said Stepp. The original project looked at how an online voice modification module could masculinize trans men’s voices using instantaneous biofeedback.

Now, the researchers will investigate how testosterone affects parts of the body that control speech to change voices. Since testosterone isn’t sufficient for nearly one-third of people that use it to change their voice, the team will examine what individual factors might affect the success of treatment. Stepp also plans to look at how testosterone treatment influences the way trans men’s voices are perceived, both by themselves and by others.

Stepp hopes that this research can shed light on how testosterone changes speech to both increase people’s understanding of the therapy and create better treatment plans that lessen the mismatch trans men experience between their gender identities and their voices. “Choosing to take testosterone without knowing whether it is likely to cause the speech changes you are hoping for is no small ask – testosterone therapy causes a large number of changes across the body,” said Stepp, “These individuals deserve to know when and how their speech is likely to be affected by testosterone therapy.”

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