Why is voice therapy important for transgender people?

Have you ever been on a sports team...

...that didn’t have a coach?

Some teams are self-governing, but having a coach can help you score more goals!

But what does this have to do with transgender people?

Vocal coaching — or voice therapy — for transgender people can help them achieve speaking goals.

When someone’s voice doesn’t fit with their gender identity, they may have a lower quality of life — and face unwanted attention or even threats to their safety.

With gender-affirming voice therapy, trans people can align the way they communicate with the way they want to be understood.

The goal of gender-affirming treatment is to help you gain peace of mind, which means different things to different people.

— Cleveland Clinic

Voice therapy is just one of many social, medical, and practical steps along a gender transition journey. It involves working over time with a professional provider on several areas of communication.

On its own, voice therapy for transgender people does not include medication, hormone treatment, or surgery, though these may be other parts of their transition plan.

What does voice therapy focus on?

Voice characteristics:

• Pitch (how high or low your voice sounds)

• Resonance (how your voice projects)

• Voice quality (enunciation, pace, tone, etc)

Nonverbal characteristics:

• Eye contact

• Hand gestures

• Facial expressions

Who provides voice therapy?

• Certified speech-language pathologists

• Voice performance specialists with a theater or singing background

Voice therapists have extensive training in supporting the physical production of the voice. They guide changes that are sustainable in the long term and won’t damage someone's voice.

Voice therapy can take place in person or virtually. It may be offered by an independent office or a larger clinic for speech-language or trans care. 

So why do trans people seek voice therapy?

Below are four specific reasons.

Have you ever noticed that women tend to speak at a higher pitch, and men at a lower pitch?

If someone is transitioning, their speaking pitch may not fit with their gender presentation.

Photo by Uday Mittal on Unsplash

Many trans people experience gender dysphoria, which is “a sense of unease regarding the mismatch between assigned gender and gender identity.” Gender dysphoria can include feelings of anxiety, depression, shame, and being misunderstood or incomplete.

By changing pitch, resonance, and other communication characteristics, voice therapy can help trans people adjust their speaking characteristics to affirm their gender and alleviate gender dysphoria.

Example

In the video below, voice therapist Claire Michelle introduces a clip of her client, Kris Tyson.

Kris went through voice therapy to make her speaking fit with all the other parts of her gender identity.

Gender nonconforming children, adolescents, and adults often face discrimination and verbal harassment. One in 4 are physically attacked, and more than 1 in 10 are victims of sexual assault.

— Cleveland Clinic

It is not the fault of trans people that others want to hurt them. No one should have to change their outward expression to stay safe.

Still, voice therapy for transgender people can be like safety equipment. It can help them "pass"—fit with others’ ideas of normal gender expression—which allows them safer experiences in many arenas, such as jobs, housing, and entertainment.

Examples

River (they/them) identifies as gender fluid or non-binary but is often perceived as a man. They're seeking voice therapy to help them blend in with men when visiting different cities, as they often do for work. They want to be trusted and not seen as an outsider.

Rachel (she/her) is a trans woman. She initially had a deep voice and has been working with a voice therapist to help her achieve a higher pitch, along with several other more traditionally feminine speaking characteristics. She wants her trans status to stand out less so that she can feel safe in public, everywhere from grocery stores to dance clubs.

Voice therapy retrains muscles, especially in the neck, face, and abdomen.

Many people find voice therapy less invasive than hormone treatment or surgery, so someone may seek voice therapy by itself. Gender-affirming care often includes voice therapy with other interventions, depending on how they affect the voice.

For example, voice feminization surgery directly targets the voice, and masculinizing hormone treatment tends to cause lower voice pitch among other changes. On the other hand, feminizing hormones don't generally affect the voice.

Examples

Photo by Eye for Ebony on Unsplash

Tina (she/her) is a trans woman. She recently had voice feminization surgery, which raised the pitch of her voice, but now she is undergoing voice therapy to help her find rhythms and expression patterns that fit her gender identity.

Photo by Shane on Unsplash

August (he/they) is a trans man. His doctor has told him that masculinizing hormone treatment will probably lower his voice pitch, but his current health insurance doesn’t cover this treatment. Until he can get hormone treatment, he is seeking voice therapy to change his communication sounds and patterns to fit his identity.

Voice therapy for transgender people is a specialized field, and everyone's voice is different.

Although someone can change their voice on their own, voice therapists tailor their work to each person's goals and starting point. Like good sports coaches, they provide appropriate exercises, practice schedules, and feedback so that someone can safely train their body.

Every person has their own gender expression and identity, as well as their own local and personal circumstances, so trans care plans must be individualized.

Example

Watch Sienna (she/her) in session with voice therapist Anna in the video below:

Photo by Andre Hunter on Unsplash

Zander (he/him) has been dealing with gender dysphoria since he was about 10 years old. He is now 25. About a year ago, he started using his new name, he/him pronouns, and different clothes, and he’s looking at voice therapy for the next step in his transition. 

What can he expect from voice therapy?

A. Working with a throat surgeon

B. Practicing facial expressions

C. Speaking sentences and dialogues

D. Continuing appointments for many years

Keep learning, and keep looking at trans perspectives!