Week Twelve

Question 1

What is intersectionality?

Answer 1

The idea that there are other factors that make up a person

For example, a trans person also might be religious, occupation, mental health…

Question 2

Considerations when working with trans people

Answer 2

• Correct use of names and pronouns
• Body part discussions unnecessary unless part of their care
• Don’t disclose persons identity to others
• Care, not curiosity

Question 3

Where may referrals come from?

Answer 3

• GP
• Psychologist
• Endocrinologist
• Self referral

Question 4

What is involved in the assessment protocol for trans clients?

Answer 4

SES-VMTW
- self-efficacy scale for voice modification in trans women

Case History
- Similar to normal voice history, but with more information about their transition
- Where they are at, how they feel, goals
- Where they would like to go

Voice Assessment
- Name, date
- 1-20
- /a/, /i/ hold as long as possible
- Scale up and down
- 0-5 whisper to shout
- Rainbow passage

Question 5

What are some typical goals for trans clients?

Answer 5

Feminize: Lighter forward tone
Masculinize: deeper rich tone, access chest voice
Nutralize: somewhere inbetween

Question 6

What is involved in a session?

Answer 6

• Baseline discussion
• introduction of voice exercises
• finding good sound and playing around with this
• voice exercise hierarchy
• Home practice 4x daily

Question 7

What is involved in the feminization process?

Answer 7

• Air pops
• Lip trills
• Mid-pitch trill
• Giggle
• Hum
• Move through the heirarchy

There are other factors such as body statue/size that can effect outcomes

Question 8

What is involved in the masculinization process?

Answer 8

• airpops
• Low-pitch trill
• sob
• move through hierarchy

Question 9

What is the voice exercise hierarchy?

Answer 9

Initial exericse- air pop, trill, giggle or sob

Single hum word
Two hum words
short hum phrases
automatics
role play
passages
conversation
everyday life

Question 10

Why might we need to provide post surgery voice therapy?

Answer 10

• nodules, papilloma and polyps need to be removed surgically
• nodules that have formed hard calluses

Question 11

What are the phases of wound healing

Answer 11

• more rest doesn’t mean better outcomes. Sometimse too much rest can make things worse
• Inflammatory phase: 3 days
• Proliferative phase: 1 month, granulation tissue forms, wound begins to contract
• Remodelling phase: up to 12 months
• Aim not to stress the vocal folds
• non-performers start exercises day 5 (glottal strokes, lip trill, giggle release, straw breathing)
• exercises 4 times per day

Question 12

What are some considerations for post surgery?

Answer 12

• Nature and extent of injury or lesion
• Type of treatment

If performer:
- timing of performance
- nature and demands of performance (understudy)
- Importance of the performance and implications of cancellation
- person’s understanding of vocal technique

Question 13

What are some exercises for puberphonia?

Answer 13

Effects males aged

• Laryngeal massage
• Sob
• Yawn sigh

Question 14

Presbyphonia

Answer 14

• dysphonia in 12-35% of people over 65 years
• reduced QOL

The aging voice:
- increased jitter and shimmer
- Breathiness and reduced range
- Increased fundamental frequency in males and decrease in females

Other things to consider:
- respiratory status
- nutrition and weight
- medications (blood pressure medication can cause cough)
- co morbidities
- Reflux

Exercises:
- air pops
- Lip trill
- giggle
- Straw breathing
Max phonation times

Question 15

conversion disorder

Answer 15

• gargle
• cough

Question 16

Inducible laryngeal obstruction/PVFM

Answer 16

• When the vocal fold close on inhalation
• common in young, female athletes

exercises:
- yawn/yawn postures
- thrust out jaw
- clean back teeth with tongue