Gender affirming voice therapy is an elective service which aims to educate the client in how to safely modify their voice to create a sound which better aligns with their gender. Some transgender and nonbinary patients report that the sound of their own voice can cause feelings of stress, anxiety and/or gender dysphoria. It is not uncommon for a mental health professional or primary care physician, to refer to a certified speech language pathologist who specializes in voice to offer treatment for this. Having the strategies to safely alter acoustic aspects of their voice and speech that convey gender, gives the client not only a sense of control over an aspect of their communication that once felt uncontrollable, but gives them confidence that they can sound true to themselves in any setting.
The first step is to complete a voice and communication evaluation, so the voice therapist can gather information on current vocal demands, personal voice goals and any other communication concerns. Baseline recordings are made to allow for acoustic analysis of the voice, in addition to creation of perceptual voice profile and aerodynamic measures. Evaluation of current nonverbal and spoken language preferences in also taken at this time. The therapist then creates a personalized plan to address all aspects of voice and communication that the client wishes to focus on. During initial training, the client will learn how to establish good vocal hygiene habits (for a healthy voice!) and how to practice exercises for establishing correct vocal production. It is important that the client understands what it feels like in their body when they are using their voice correctly, in order to avoid modifications that could be potentially cause vocal harm or strain. It is for this reason, that the World Professional Association for Transgender Health states in their standards of care, that the guidance of a certified speech pathologist who has specialized training in voice and additional education in transgender health, is crucial to allowing the individual to not only modify their voice safely but create a strong, authentic voice that can last a full work day, and social activities once work is done! Furthermore, should a someone present with vocal issues that need to be addressed, such as an undiagnosed voice disorder, the voice therapist will know the necessary steps to evaluate and treat this first, to ensure best possible outcome. Many clients also benefit from coaching on nonverbal behaviors such as learning how their stance, walk, gestures, and facial expressions play a role in gender expression along with vocal behaviors other than words (laughing, coughing, sneezing). Learning spoken language traits, and how they impact others perception of our identity, can also be beneficial when navigating communication.
What goals might some achieve with this? Some clients wish to establish a lighter, brighter, more feminine perceived voice. Some clients may request a lower, richer, more masculine perceived voice. Others may desire a more androgynous sound, or request guidance in how to discover their goal voice. Once the client gains mastery over how to shift their resonance, pitch, intonation patterns, etc in the direction of their goal voice, they practice on a daily basis, until the new voice begins to feel more natural. The client may start with shorter, easier tasks, such as reciting words or phrases in their goal voice before graduating to more challenging tasks such as reading a passage aloud or role playing daily conversation tasks, like ordering food in a restaurant. The benefits of training include increased confidence in both work and social settings, decrease in social anxiety, relief from gender dysphoria and overall improved quality of life.
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