Perceptions, knowledge, and perceived competencies of South African speech-language therapists to render transgender voice and communication training

Abstract

Background: Speech-language therapists (SLTs) receive extensive education and training on voice and voice disorders in general. Therefore, they are ideally situated to render transgender voice and communication training (TVCT), and it forms part of their scope of practice. Research has, however, identified a lack of confidence in SLTs to render this service due to a perceived lack of education, training, knowledge, and clinical exposure in high income countries. Limited research exists in middle-income countries. Aim: To determine the perceptions, knowledge, and perceived competencies of South African SLTs to work with transgender clients and provide TVCT. Methods: A cross-sectional open online survey design using non-probability purposive and convenience sampling was used. Fully qualified and practising South African SLTs were asked to volunteer on social media platforms. Results: Most participants agreed that TVCT falls within their scope of practice (n=42, 84%), viewing it as their ethical responsibility (n=40, 80%) as well as a medical or educational necessity (n=34, 68%). However, most participants reported feeling inadequately prepared to provide TVCT (n=34, 68%) due to insufficient education and training in this field, with 23 participants (45.1%) reporting that they had not received any education or training on the topic. Most participants also reported knowing how to use pronouns that reflect all genders (n=29, 64.4%). However, most also reported not asking their clients what their preferred pronouns are before engaging in assessment or treatment (n=27, 44.5%) indicating a knowledge-practice gap. Conclusions: Participants held positive attitudes towards TVCT yet felt unprepared to render the service due to insufficient education, training, and exposure, revealing a crucial professional development need. Participants presented with appropriate cultural competence towards the LGBTQ+ community, however, further research is required to obtain more in-depth knowledge of the possible underlying causes of the knowledge-practice gap noted.