In this episode of BackTable ENT, Dr. Mark Courey (chief of otolaryngology at Mount Sinai) and Sarah Schneider (Speech Language Pathologist at UCSF) join host Dr. Gopi Shah to discuss voice care for transgender patients.

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SHOW NOTES

First, Mark and Sarah define terms relevant to transgender healthcare and offer tips on welcoming transgender patients to clinic. They describe how voice care fits into the overall process of transition, and why patients seek care for voice-related concerns at different points in their journey. Gopi asks about collaboration with other specialties, and Mark discusses collaboration with other clinicians in a patient-centered transgender care team.

The conversation then shifts to workup and treatment of voice-related concerns. In Sarah’s experience, trans women present with voice fatigue if they are overly reliant on pitch modulation. By addressing pitch, articulation, rate of speech, volume, and resonance, Sarah helps her patients achieve a more feminine communication style while minimizing physical strain. Mark outlines his physical exam and process of history-taking as they relate to voice concerns. They also address the role of laryngoscopy in transgender patient populations.

Finally, Sarah and Mark address the importance of duration and goals of voice therapy. Both she and Mark emphasize the need to monitor progress over sessions of voice therapy. Delving into surgical management, Mark addresses the indications for, steps in, and complications of voice-modifying surgery. To wrap up, Sarah and Mark encourage listeners to educate their fellow clinicians regarding voice care for transgender patients.

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RESOURCES

https://www.enttoday.org/article/gender-affirmation-surgery-in-california/

https://www.enttoday.org/article/analyzing-the-latest-gender-affirming-care-restrictions-in-state-laws/

Sarah’s Twitter:

https://twitter.com/scharx16

Sarah’s UCSF Profile:

https://transcare.ucsf.edu/team/sarah-schneider

Mark’s Mount Sinai Profile:

https://profiles.mountsinai.org/mark-s-courey