Highlight
- Testosterone therapy in transmasculine adolescents and young adults produces a significant reduction in fundamental voice frequency (F0) beginning at 2 months and plateauing by 9 months.
- Voice quality as measured by cepstral peak prominence smooth (CPPs) initially decreases but shows partial recovery, remaining below baseline at 12 months.
- Patient-reported voice-related distress improves over the course of therapy, alongside reduced anxiety levels, indicating psychosocial benefits of hormonal treatment.
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For clinical reference; use professional judgment.

