The Laryngoscope
August 7, 2026 · via Europe PMC
Evaluation of the Effects of Testosterone on Voice in Transmasculine Adolescents and Young Adults.
Ma Y, Arora N, Kohli M, +7 more, Schneider SL.
AI summary — for doctors, generated from the abstract only
Testosterone in transmasculine adolescents and young adults progressively lowered speaking pitch over about 9 months and improved voice-gender congruence and anxiety.
What was studied
Prospective cohort of 15 transmasculine adolescents and young adults starting testosterone (14 analyzed), with monthly acoustic measures and patient-reported voice, anxiety and depression scores over 12 months.
Key findings
- Speaking fundamental frequency fell by about 33 Hz at 3 months and plateaued by about 9 months.
- Cepstral peak prominence in connected speech dropped and stayed below baseline at 12 months, while pitch range did not change.
- VHI-10 worsened transiently at 3 months then returned to baseline; Transgender Voice Questionnaire improved (51.3 to 26.5) and anxiety decreased, but depression did not.
Clinical relevance
It gives realistic expectations and timing for voice change in young patients on testosterone, which helps counseling and decisions about voice therapy referral.
Who should care
Limitations
Very small single-cohort sample without a control group, so the findings are descriptive and may not generalize.
Counsel patients that pitch drops over roughly 9 months with a temporary voice-handicap dip, and consider early voice-care support.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Prospectively evaluate longitudinal voice changes in transmasculine adolescents and young adults (AYAs) initiating testosterone therapy.
Methods
AYAs assigned female sex at birth and naïve to testosterone and voice therapy were prospectively enrolled prior to hormone initiation and followed for 12 months. Fundamental frequency (F 0) during sustained vowel and connected speech, pitch range, and cepstral peak prominence smooth (CPPs) were measured monthly. Patient-reported outcome measures analyzed include VHI-10, Transgender Voice Questionnaire (TVQ), and PROMIS Anxiety and Depression scales.
Results
Fifteen individuals enrolled; 14 (mean age [SD] = 18.43 years [4.31]) completed 12-month follow-up for analysis. Speaking F 0 decreased at 3 months (mean -32.9 Hz, p = 0.033) and plateaued by 9 months (p 0 decreased earlier at 2 months (p = 0.036). Semi-tone pitch range showed no significant change across 12 months (p = 0.47). CPPs in connected speech decreased significantly from baseline at 3 months (p = 0.047) and improved but remained significantly lower than baseline at nine (p = 0.010) and 12 months (p = 0.003). VHI-10 transiently worsened at 3 months (+3.14, p = 0.033) but returned to baseline by 9 months (p = 0.42). TVQ improved significantly from baseline (51.3) to 12 months (26.5; p = 0.002). PROMIS Anxiety decreased (p = 0.018), while Depression did not (p = 0.56).
Conclusion
Testosterone therapy in transmasculine AYAs results in progressive lowering of F 0 beginning at Month 2 and stabilizing by Month 9, with improved voice-gender congruence and anxiety. This is the first prospective study with a substantial adolescent cohort, providing critical data that strengthens understanding of testosterone-related voice changes and informs best practices in gender-affirming voice care.
Level of evidence: 4
DOI
10.1002/lary.70729
PMID
42567716
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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