A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice.

Objectives/Hypothesis: An artificial intelligence (AI) tool was developed using audio clips of cis‐male and cis‐female voices based on spectral analysis to assess %probability of a voice being perceived as female (%Prob♀). This program was validated with 92% accuracy in cisgender speakers. The aim of the study was to assess the relationship of fo on %Prob♀ by a validated AI tool in a cohort of trans females who underwent intervention to feminize their voice with behavioral modification and/or surgery. Study Design: Cohort study. Methods: Fundamental frequency (fo) from prolonged vowel sounds (fo/a/) and fo from spontaneous speech (fo‐sp) were measured using the Kay Pentax Computerized Speech Lab (Montvale, NJ) in trans females postintervention. The same voice samples were analyzed by the AI tool for %Prob♀. Chi‐square analysis and regression models were performed accepting >50% Prob♀ as female voice. Results: Forty‐two patients were available for analysis after intervention. fo‐sp post‐treatment was positively correlated with %Prob♀ (R = 0.645 [P <.001]). Chi‐square analysis showed a significant association between AI %Prob♀ >50% for the speech samples and fo‐sp >160 Hz (P <.01). Sixteen of 42 patients reached an fo‐sp >160 Hz. Of these, the AI program only perceived nine patients as female (>50 %Prob♀). Conclusion: Patients with fo‐sp >160 Hz after feminization treatments are not necessarily perceived as having a high probability of being female by a validated AI tool. AI may represent a useful outcome measurement tool for patients undergoing gender affirming voice care. Level of Evidence: 3 Laryngoscope, 131:2567–2571, 2021 [ABSTRACT FROM AUTHOR]