Purpose: The aim of the present study was to develop and validate a patient-reported outcome measure for gender incongruence specific to voice and communication parameters, including pitch, intonation, resonance, loudness, speech smoothness, speech clarity, word choice, facial expression, gesture, and posture.
Method: The Utah Gender Presentation Scale for Communication (U-GPS) includes 10 items, each on a 10-point scale from masculine to feminine. Items were selected based on literature review and patient focus groups. During test administration, respondents provide their current rating and goal rating for each item. The difference between these scores is used to calculate an overall incongruence score. Prospective data from transgender and gender-diverse (n = 155) and cisgender (n = 69) individuals were then used for a multiparametric psychometric evaluation of the measure.
Results: Findings demonstrate excellent levels of internal consistency (Cronbach's alpha for current scores: α = .943; Cronbach's alpha for goal scores: α = .970), test-retest reliability (intraclass correlation coefficient = .905), longitudinal validity (improvement in therapy for trans women: F = 293.0, p < .001; nonbinary folx: F = 80.9, p < .001), concurrent validity (correlation with the Trans Woman Voice Questionnaire: r = .51, p < .001), and known-group expectations (differences among five gender groups: F = 82.7, p < .001).
Conclusion: The U-GPS is a meaningful measure of voice-related gender incongruence, which is clinically relevant for assessing goals in gender-affirming voice and communication therapy for individuals across the gender spectrum.