Conceptual, Practical Equivalence and Lingüistic Acceptability of the Trans Women Voice Questionnaire’s Argentine Version Compared with the Original Australian-Canadian Version

Abstract

In trans women, physiological aspects associated with their voices may arise feelings of inadequacy, limiting social participation and impacting on their Health Related Quality of Life (HRQoL). The Trans Women Voice Questionnaire (TWVQ) was developed in Australia and Canada to assess self-perception of voice and its impact on HRQoL of trans women. The aim of this study was to determine face validity, content validity, the conceptual, practical equivalence and linguistic acceptability of the Argentine version in comparison with the original Australian-Canadian version.

This study followed the World Health Organization guidelines for cross-cultural adaptations which underwent five stages: two forward semantic and independent translations, consensus of a single version, two back translations, expert panel revision and pre-testing and cognitive interviewing to 9 trans women. The study variables were the conceptual and practical equivalences and the linguistic acceptability which were defined as the adaptation of the concepts measured in each item to the worldview, experiences, identity and lingüistic acceptance of the target population. These variables were  appraised through interviews in which the trans women contributed with their knowledge about their day-to-day lingüistic uses as well as the feelings and experiences they face when they use their voices. Content validity was measured collating that each item was reciprocal to their corresponding theoretical definition given in the 6 dimensions of the original questionnaire; face validity was verified checking that the resulting questionnaire measured voice self-perception in trans women.

As a result, 9 items required major changes to reach conceptual accuracy (5 of these measured self-perception of pitch, which was interpreted by the trans women as intensity rather than frequency of the voice); 6 were adapted to keep practical equivalence and 5 to assure linguistic acceptance of the target population.

The Argentine version results equivalent to the Australian-Canadian; conceptually, practically and linguistically  appropriate for the trans women of Argentina and adequate in face and content validity. It is, hence, introduced as a useful tool for clinical interviews, in the wake of promoting dialogue and exchange about the impact voice has on the HRQoL of trans women. Future studies should examine its metric properties.