: Smoking can negatively impact the vocal feminization process. It often leads to vocal changes, such as a decrease in fundamental frequency, which can interfere with achieving a voice that aligns with a woman's gender identity. Why Smoking Rates Are Higher
Higher smoking rates in this demographic are often tied to "minority stress"—the chronic stress faced by members of stigmatized groups: smoking mature shemale
Smoking introduces specific risks for transgender women, particularly those undergoing gender-affirming medical treatments: : Smoking can negatively impact the vocal feminization