Gender diverse people's psychological wellbeing and identity in the context of gender affirming speech pathology practice: A qualitative study protocol

Background: Gender diverse people may experience discomfort with the sound of their voice. Additionally, their psychological wellbeing, closely connected to a person's identity, or perspective of themselves, is often reduced. A primary goal of gender affirming healthcare is to support clients' psychological wellbeing. Speech pathology practices assist clients to alter their voice to develop authentic self-presentation. These practices have been shown to have positive outcomes related to clients' voices but have not yet been shown to improve overall client psychological wellbeing. Assisting gender diverse people to transform a negative identity perspective into a positive one could have a beneficial impact on their psychological wellbeing. Therefore, to support clients' psychological wellbeing, gender affirming speech pathology care could benefit from focusing on gender diverse clients' identity more broadly, i.e., beyond gender. For this type of care, speech pathologists would need to see themselves as responsible for supporting client psychological wellbeing and identity. However, some clinicians may be hesitant to incorporate more holistic approaches to provide such care. This study aims to explore gender diverse speech pathology clients' views on psychological wellbeing and identity and speech pathologists' perspectives and actions in supporting clients in that regard.

Methods: This qualitative study approaches the research topic through insights from gender diverse people's and speech pathologists' subjective perspectives and experiences on psychological wellbeing and identity. Gender diverse people will participate in one-on-one episodic interviews, whereas speech pathologists providing gender affirming care will participate in focus group discussions. Data will be analysed with reflexive thematic analysis. The study is supported by collaborators from the gender diverse community. Study findings will be disseminated in an accessible manner to healthcare professionals providing gender affirming care, mainly speech pathologists, and to the gender diverse community.

Implications: Study findings are anticipated to contribute to further understanding gender diverse people's psychological wellbeing and identity in a gender affirming speech pathology context to tailor practices to the unique needs of gender diverse clients.