{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:37:32Z","timestamp":1773041852933,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gendered voice perception is central to gender recognition and can be a major source of distress for transgender people, yet voice and voice therapy remain marginal in medical curricula. This study examined how a digital, experiential seminar using voice-feedback applications can foster medical students\u2019 understanding of gendered voice and transgender health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a qualitative observational study within a 135-min online seminar, \u201cFeminize Your Resonance!\u201d, embedded in a fourth-year public health module at the Medical University of Vienna. One hundred medical students used commercially available voice apps to experiment with their own pitch and resonance and submitted app screenshots and written reflections via an online learning platform. We applied a narrative analysis, based on narrative episodes in students\u2019 accounts, using a multi-stage coding process supported by qualitative data analysis software to map learning processes in several stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Analysis yielded three interlinked themes\u2014implicit voice awareness, technology engagement, and sharing transgender experience\u2014organized into a five-phase learning journey from pre-existing discomfort with one\u2019s recorded voice to social awareness with voice challenges of transgender individuals. Students moved from internal, often negative, self-evaluation to critical appraisal of app algorithms, exploration of their own vocal plasticity, and perspective-taking on the challenges of gender-affirming voice transition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Technologically mediated voice exploration can catalyze transformative learning about the role of voice in gender incongruence and support the development of affective and clinical competencies in medical education. Potentially the training facilitates communicating with transgender individuals empathically, not only related to transgender-affirming care but in all healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1767576","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:47:13Z","timestamp":1773038833000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From internal echoes to sharing experiences: transformative learning with voice apps to enhance transgender care literacy in medical students"],"prefix":"10.3389","volume":"14","author":[{"given":"Susanne","family":"Gahbauer","sequence":"first","affiliation":[{"name":"Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna","place":["Vienna, Austria"]},{"name":"Department of Science and Technology Studies, University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamim","family":"Sherafat","sequence":"additional","affiliation":[{"name":"Vienna Institute of Demography, Austrian Academy of Sciences","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Wagner-Menghin","sequence":"additional","affiliation":[{"name":"Clinical Division for Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna","place":["Vienna, Austria"]},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/15532739.2015.1075931","article-title":"Voice and communication change for gender nonconforming individuals: giving voice to the person inside","volume":"16","author":"Davies","year":"2015","journal-title":"Int J Transgend Health"},{"key":"ref2","volume-title":"The gender of sound","author":"Carson","year":"2025"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1300\/J485v09n03_08","article-title":"Clinical aspects of transgender speech feminization and masculinization","volume":"9","author":"Davies","year":"2006","journal-title":"Int J Transgend Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.jvoice.2013.08.009","article-title":"Intonation and gender perception: applications for transgender speakers","volume":"28","author":"Hancock","year":"2014","journal-title":"J Voice"},{"key":"ref5","doi-asserted-by":"crossref","DOI":"10.1145\/3405755.3406123","volume-title":"Gender ambiguous, not genderless: Designing gender in voice user interfaces (VUIs) with sensitivity. proceedings of the 2nd conference on conversational user interfaces","author":"Sutton","year":"2020"},{"key":"ref6","volume-title":"LGBTIQ+ Gesundheitsbericht 2022","author":"Gaiswinkler","year":"2023"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1080\/26895269.2020.1753136","article-title":"Epidemiological considerations in transgender health: a systematic review with focus on higher quality data","volume":"21","author":"Zhang","year":"2020","journal-title":"Int J Transgend Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1002\/ohn.1207","article-title":"Physical features contributing to gender dysphoria: the role of voice","volume":"172","author":"Pu","year":"2025","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.jvoice.2010.07.013","article-title":"Voice perceptions and quality of life of transgender people","volume":"25","author":"Hancock","year":"2011","journal-title":"J Voice"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1080\/17549507.2019.1709544","article-title":"Who or what has the capacity to influence voice production? 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