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This gap has implications for gender\u2010affirming voice care, as coughs are harder to modulate. We aimed to explore how cough acoustics differ by gender using a transformer model with self\u2010attention to identify salient cough features for gender classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed 327 cough recordings (154 male, 173 female) from the Coswara dataset, using a 70\/15\/15 split for model training, validation, and testing. Preprocessing included resampling, silence removal, normalization, and trimming to uniform length. The\n                      <jats:styled-content style=\"fixed-case\">HuBERT<\/jats:styled-content>\n                      transformer model was used for its ability to handle unstructured audio. Gender balance was verified through\n                      <jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content>\n                      (standardized mean difference) screening across seven variables, all of which showed negligible imbalance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On the held\u2010out test set, the model achieved an accuracy of 84.0% with an\n                      <jats:styled-content style=\"fixed-case\">F1<\/jats:styled-content>\n                      score of 0.8462 when classifying gender from cough series, compared to 71.4% accuracy and an\n                      <jats:styled-content style=\"fixed-case\">F1<\/jats:styled-content>\n                      score of 0.7308 when using single\u2010cough\/first\u2010cough samples. Attention\u2010aligned cough visualization revealed the highest attention on the explosive phases of the cough, suggesting that these segments encapsulate the most salient gender\u2010distinct acoustic cues.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cough sounds contain gender\u2010discriminative features detectable by transformer models. Attention to specific cough phases reveals physiologically meaningful segments in cough sounds supporting gender classification. These insights may inform gender\u2010affirming interventions, particularly for non\u2010speech sound production. Future research should explore further socio\u2010demographic factors shaping cough acoustics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70393","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T06:05:41Z","timestamp":1769493941000},"page":"2519-2527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Decoding Gender in Cough Sounds: A Transformer\u2010Based Analysis"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4304-1278","authenticated-orcid":false,"given":"Linh","family":"He","sequence":"first","affiliation":[{"name":"Sean Parker Institute for the Voice, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haomiao","family":"Li","sequence":"additional","affiliation":[{"name":"Cornell Tech  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Cornell Tech  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Baik","sequence":"additional","affiliation":[{"name":"SUNY Upstate Medical University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6969-4504","authenticated-orcid":false,"given":"Sarah","family":"Kervin","sequence":"additional","affiliation":[{"name":"Sean Parker Institute for the Voice, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0345-2756","authenticated-orcid":false,"given":"Robin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Sean Parker Institute for the Voice, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Sean Parker Institute for the Voice, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Bridge2AI\u2010Voice Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Colonel","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2634","authenticated-orcid":false,"given":"Ana\u00efs","family":"Rameau","sequence":"additional","affiliation":[{"name":"Sean Parker Institute for the Voice, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"477","article-title":"Cough, a Vital Reflex. 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