Developing a mobile application for gender‐affirming voice training: A community‐engaged approach

• Published in: Laryngoscope investigative otolaryngology 2024-12, Vol.9 (6), p.e70043-n/a
• Main Authors: Alter, Isaac L., Chadwick, Keith A., Andreadis, Katerina, Coleman, Rachel, Pitti, Mary, Ezell, Jerel M., Rameau, Anaïs
• Format: Article
• Language: English
• Subjects: Cisgender; Collaboration; communication modification; community‐based participatory research; Design; Femininity; Gender-affirming care; gender‐affirming voice; Intervention; LGBTQ community; Mental disorders; Minority & ethnic groups; mobile application development; Mobile communications networks; Original Research; Otolaryngology; Research methodology; Sexually transmitted diseases; speech language pathology; Speech therapy; STD; Telemedicine; Transgender persons; transgender voice
• ISSN: 2378-8038; 2378-8038
• DOI: 10.1002/lio2.70043

Objectives To date, there has yet to be a rigorous exploration of voice and communication modification training (VCMT) among transgender and gender‐nonconforming (TGNC) individuals using digital technology. We sought to evaluate and describe the iterative process of app development using a community‐based approach. Methods An interprofessional team of voice health care professionals, application developers, designers, and TGNC community members was assembled to conceive the functionality, content, and design of a mobile app to support VCMT for TGNC people. Six TGNC individuals, identified primarily by word of mouth, joined the development team as a Community Advisory Board (CAB). The CAB provided input on app content development, design choices, and user experience, with collaboration across disciplines and integration of TGNC community members throughout app development; the applicability of CBPR principles was evaluated throughout the development process. Results Iterative cycles of content creation and feedback produced multiple substantial changes during the app's development, including added functionality, improved inclusivity and accessibility, and design and branding enhancements. Several successful outcomes from our approach were identified, including the recruitment of dedicated CAB members and interprofessional collaboration that included community members. Challenges included integration of multiple different approaches and levels of expertise, navigating TGNC individuals' participation without exploitation, and creating high‐quality content on a limited budget. Conclusions Our process demonstrates the value of including a CAB in the design of a digital VCMT platform, and suggests a potential for community‐based participatory research (CBPR) in laryngology and speech language pathology, where uptake of this framework has remained limited. Level of Evidence Level 5. There is a substantial unmet need for gender‐affirming voice and communication modification training (VCMT), one of which could potentially be met by utilizing community‐based participatory research (CBPR), which remains minimally used within our field of laryngology and speech language pathology. In this article, we summarize our development of a free, evidence‐based app for gender‐affirming VCMT using a community‐engaged framework.