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The study aimed to evaluate the relationship between items and persons on the Trans Woman Voice Questionnaire (TWVQ) using item-response theory and to improve the meaningfulness of TWVQ scores. The analysis resulted in a new interval scoring system that supports a unidimensional construct with four scaled score zones, which can be interpreted as minimal, low, moderate, and high voice-related life impact for trans women. This updated scoring system provides improved clinical and research utility for the TWVQ and sets the foundation for future improvements in clinical care and outcomes assessment.
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