{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:15:41Z","timestamp":1787318141949,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the needs of transgender and nonbinary (TNB) adults for gender\u2010affirming face, neck, and voice procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Online, February to May 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Primary outcomes included utilization of otolaryngologists and speech\u2010language pathologists; gender dysphoria felt from the face, neck, and voice self\u2010reported on a 0 to 10 numeric rating scale (0\u2009=\u2009no dysphoria, 10\u2009=\u2009unbearable); and desire for various gender\u2010affirming face, neck, and voice procedures. We used ordinal logistic and linear regression to assess relationships between site\u2010specific dysphoria and the desire for relevant procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TNB participants (N\u2009=\u2009234) infrequently sought gender\u2010affirming care with speech\u2010language pathologists (23%), facial plastic surgeons (8%), or laryngologists (3%). Participants experienced the strongest dysphoria from the voice (median 7\/10), jawline\/chin (4\/10), and neck (3.5\/10). Transmasculine and nonbinary participants typically seeking masculinization (n\u2009=\u200983) frequently desired voice therapy (want\u2009=\u200935%, had\u2009=\u20098%). Transfeminine and nonbinary participants typically seeking feminization (n\u2009=\u2009145) frequently desired voice therapy (want\u2009=\u200952%, had\u2009=\u200923%), chondrolaryngoplasty (want\u2009=\u200945%, had\u2009=\u20095%), and hair removal\/electrolysis (want\u2009=\u200943%, had\u2009=\u200944%). Many desired at least 1 facial feminization surgery procedure (65%), especially mandible reduction (want\u2009=\u200942%, had\u2009=\u20093%), rhinoplasty (want\u2009=\u200941%, had\u2009=\u20091%), and forehead reduction (want\u2009=\u200937%, had\u2009=\u20094%). Dysphoria ratings were associated with desiring relevant procedures (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05 for all), notably voice therapy (odds ratio [OR]\u2009=\u20091.50), chondrolaryngoplasty (OR\u2009=\u20091.46), mandible reduction (OR\u2009=\u20091.38), rhinoplasty (OR\u2009=\u20091.59), and forehead reduction (OR\u2009=\u20091.82).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gender dysphoria from the face, neck, and voice can be severe for TNB people and is associated with the desire for gender\u2010affirming procedures. The high demand yet low reported access to these procedures highlights the need for providers of gender\u2010affirming face, neck, and voice care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.329","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T08:14:10Z","timestamp":1679386450000},"page":"906-916","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Needs Assessment of Gender\u2010Affirming Face, Neck, and Voice Procedures and the Role of Gender Dysphoria"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1952-0626","authenticated-orcid":false,"given":"Ryan S.","family":"Ziltzer","sequence":"first","affiliation":[{"name":"Keck School of Medicine of University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6590-7821","authenticated-orcid":false,"given":"Elle","family":"Lett","sequence":"additional","affiliation":[{"name":"Center for Applied Transgender Studies Chicago Illinois USA"},{"name":"Computational Health Informatics Program Boston Children's Hospital Boston Massachusetts USA"},{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4821-8722","authenticated-orcid":false,"given":"Peiyi","family":"Su\u2010Genyk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6934-9740","authenticated-orcid":false,"given":"Tamara","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6164-9792","authenticated-orcid":false,"given":"Roxana","family":"Moayer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"JonesJM. 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