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In The Laryngoscope ; h5-index 55.0

BACKGROUND : As the main objective outcome measure used in gender-affirming voice care (GAVC), fundamental frequency (f0 ) often fails to accurately reflect patient perceptions of their voice. Our team developed an artificial intelligence (AI) program that provides an alternative objective outcome measure that has the potential to more accurately align with patient perceptions.

OBJECTIVE : To gauge stakeholder receptivity to the use of AI in GAVC before employing a novel outcome measure in transgender and nonbinary communities.

METHODS : This prospective qualitative study used online focus groups composed of speech-language pathologists (SLPs), transgender men (TGM), transgender women (TGW), and nonbinary (NB) individuals. Participant age, race, gender, and geographic location were recorded. Each cohort participated in a series of two focus group sessions. The first session focused on participant experiences in GAVC, whereas the second ascertained participant perspectives on the use of AI in GAVC. Transcripts of each discussion were coded using Nvivo to perform inductive thematic analysis.

RESULTS : Seven SLPs, seven TGW, three TGM, and two NB individuals (mean [range] age, 35.5 [26-48] years) participated. Transgender and nonbinary participants were generally amenable to the technology, whereas SLPs were more hesitant about its use. Positive findings included appreciation for AI as an objective outcome measure and enthusiasm for its potential to longitudinally track progress. Hesitations concerned the actionability of using the AI and unease about the black box nature of the AI's analysis.

CONCLUSION : Transgender and NB individuals were receptive to the use of AI technology in GAVC, whereas SLPs were more apprehensive about using AI.

LEVEL OF EVIDENCE : NA Laryngoscope, 2022.

Millman Noah, Timmons Sund Lauren, Johns Michael, Elliott Ayana, Silverstein Einav, Bensoussan Yael


artificial intelligence, gender-affirming voice care, nonbinary individuals, speech-language pathologists, transgender