Date of Award

Spring 3-24-2023

Degree Type


Degree Name

Master of Science


Communication Sciences and Disorders

First Advisor

Shannon Salley

Second Advisor

Erin Wallace

Third Advisor

Alison King


Emerging adulthood, occurring between the ages of 18 to 25, is a time of significant identity exploration. This age group has the highest prevalence of individuals who are transgender or nonbinary; however, there is minimal current research on access to gender-affirming voice services among this demographic. This study utilized a healthcare access framework by Levesque et al. (2013) to analyze organizational barriers to care including approachability, acceptability, availability, affordability, and appropriateness for this population.

The researchers collected data from 104 participants with an electronic survey. Survey data showed most participants (64%) are aware of and desire gender-affirming voice services. Of the participants who indicated desire for gender-affirming voice services, 93% reported that they never received services from a voice professional. Affordability, approachability, and acceptability were the most significant organizational barriers to access with affordability (68%) being the most significant. Awareness of services was a barrier to access with 46% reporting either a lack of awareness of gender-affirming voice services or a lack of awareness of these services provided by speech-language pathologists. The most used sources for information on gender-affirming voice services included friends; national, state, and local LGBTQ+ websites; LGBTQ+ community centers, and various social media outlets. This health-seeking information may be useful in providing better outreach to gender-expansive emerging adults.



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