# Assessing Gender Bias in Auditory-Perceptual Ratings of Tracheoesophageal Speakers
## 2 Methods
### Auditory-Perceptual Rating Task  
For ratings of the auditory-perceptual feature SA, listeners were asked to rate a voice based on \"The pitch, rate, understandability, and voice quality. In other words, is the voice pleasing to listen to or does it cause...some discomfort as a listener?\" [29]. Alternatively, ratings of the auditory-perceptual feature LC required the listener to rate samples based on \"How comfortable would you feel listening to the person's speech in a social situation?\" [30]. Each audio file was individually labeled as \"Sample 1\", \"Sample 2\"...\"Sample 16\", etc., and, accordingly, each rating scale provided was labeled with the same sample number. Upon listening to each consecutive sample, the listener bisected the line of the visual analog rating scale at the point that they believed best represented their judgment of that sample for each dimension; this procedure was followed identically for each of the randomized set of samples presented. Listeners could play each individual sample as many times as desired before making their judgment using the rating scale, but they were instructed that once a rating was made, it could not be altered later, nor could they return to past samples.  
Regardless of whether SA or LC was being evaluated, each rating scale was comprised of a solid line measuring 100 mm and listeners were shown examples of how the scale was to be used. The appearance of the rating scales used were consistent with those of the Consensus Auditory-Perceptual Evaluation--Voice (CAPE-V) that is used in clinical studies and research associated with laryngeal-based voice disorders [31]. Below each scale, descriptive indicators of \"mild\", \"moderate\", and \"profound\" were provided at approximately 25 mm, 55 mm, and 85 mm, respectively. Thus, as scores moved from left-to-right on the scale (increased) for both SA and LC, listener judgments became increasingly more favorable for either dimension; that is, higher scores indicated a more positive judgment by a listener.  
Once the first auditory-perceptual dimension was rated, listeners were provided with a short break of approximately 15-20 min and then were asked to complete a second rating session, which addressed the second dimension that they had not yet completed (either SA or LC). During the rating task for the second dimension, listeners were provided with the same samples in a new randomized order. The delegation of these scales (SA and LC) was counterbalanced so that 8 of the 16 listeners rated SA first, followed by LC; conversely, the other 8 listeners rated LC first, followed by SA. Thus, controls for potential order effects related to the auditory-perceptual dimensions were considered. Once ratings of both SA and LC were completed in this session, listeners were dismissed and scheduled to return for a follow-up listening session in 7 to 14 days.  
In the second experimental listening session, which occurred between 7 and 14 days after completion of the first, listeners were presented stimuli and asked to assess either SA or LC in the reverse order of that completed in the first listening session. In this follow-up listening session, however, the true gender of each speaker sample was now indicated in the margin of the rating form. For the purposes of data analysis, this second session was identified as \"Gender Known\". However, it should be noted that, regardless of the session (i.e., Gender Opposite or Gender Known), listeners were led to believe that the gender indicated on the rating form was accurate. The purpose of using deception in the first listening condition (Gender Opposite) was to ascertain whether listeners would rate speaker samples differently based on a prescribed gender. In both conditions, only the examiners were aware of the true gender of the voice sample being presented.