Voice Characteristics at Presentation in Nonbinary Individuals Seeking Gender‐Affirming Voice Care

ABSTRACT Objectives Gender‐affirming voice care has primarily focused on trans women with limited research on nonbinary (NB) individuals. This study aims to describe baseline characteristics of NB individuals seeking gender‐affirming voice treatment to enhance clinicians' understanding and improve patient care. Methods A retrospective review of NB individuals seeking voice treatment at a tertiary laryngology center was conducted. Data on demographics, medical history (including hormone therapy), presenting concerns, and baseline voice‐related outcome measures were collected. Results Twenty‐five NB individuals (13 assigned male at birth (AMAB)) are described. Mean age was 32.3 years (range: 21–50) with the majority (84%) identifying as white, non‐Hispanic. 80% were on gender‐affirming hormone replacement therapy, with 56% receiving feminizing hormones. Most had previously engaged in gender‐affirming treatments, including surgery, voice therapy, and mental health services. All patients presented for gender‐related voice concerns: 92% reported dissatisfaction with voice quality, and 52% utilized gendered language when describing their voice goals. Voice‐related experiences of nonbinary individuals (VENI) survey was completed by 8 patients, mean score 45 out of 68. Mean overall grade of dysphonia was 29.4 (0, 85). No organic changes were noted on videostroboscopy. All patients were stimulable for improvement toward patient‐expressed goals based on SLP assessment, and voice therapy was recommended to all patients. Conclusion This study offers the first comprehensive description, at presentation, of NB individuals seeking gender‐affirming voice care. Understanding their voice concerns and goals is essential for providing personalized, effective care that aligns with their unique experiences and aspirations. Level of Evidence 4