I got hit with Tinnitus and constant ear ringing 2 years ago when I moved from sea level to high elevation. It’s definitely the upper mids and highs that sound shrill and distorted. In my car, music does not sound shrill and music is easy to listen too. It sounds good but it's a rolled off sound from a 2023 car.
I think both the amp and speakers play an equally important role. I am about to post am discussion to ask about warm sounding integrated amps with dacs. Then once I find one, I will start pairing speakers with them. No speaker will please you if paired with sharp DAC or analytical amp. Not all tube amps are warm.
PS: I have older B&W 804s and B&W Matrix that I used to love until Tinnitus hit me.