Transgender Voice Therapy

Voice therapy, also known as transgender speech therapy or transgender communication therapy, can be a way for transgender, non-binary, and gender-expansive people to alter the tone and pitch of their voice if their voice causes them gender dysphoria or discomfort. Among other reasons, trans and non-binary people can use voice therapy to increase confidence and self-satisfaction in their communication style. Although voice therapy is often used by binary-identifying transgender people, non-binary people can tailor voice therapy to their own specific goals based on what feels affirming and important to them. 

What is transgender voice therapy? 

Voice therapy encompasses a series of non-surgical interventions used to change key components of verbal speech that can help a trans, non-binary, or gender-expansive person be audibly affirmed in their gender. With the help of a speech-language pathologist, communication therapy can help reduce how much a trans person is misgendered by altering the gender cues that are given off in everyday speech. Voice or speech therapy sessions help trans-spectrum individuals masculinize or feminize their voice and communication style to affirm their gender identity. Approaches to treatment include working on pitch, resonance, vocal hygiene, and communication scenario role-plays.

It should be noted that testosterone as a method of hormone replacement therapy (HRT) is more likely to change the pitch of someone’s voice than estrogen. This is because the masculinizing effects of testosterone usually impact the vocal cords enough to drop the pitch of the voice to gender-affirming levels, while estrogen often does not significantly impact someone’s voice. However, the impact that hormones can have on the voice is dependent on many variables, including age that someone started HRT, the pitch of the voice to begin with, how long someone has taken HRT, and other factors. That being said, HRT does not always impact someone’s voice, and there are voice therapy techniques that can be used to masculinize and feminize the voice. 

Some information for this section was informed by The Robbins Center’s website.

Who can use transgender voice therapy?

Anyone, regardless of gender identity, may benefit from voice therapy. Voice therapy is especially useful for transgender or non-binary people who feel dysphoric or uncomfortable with their voice. 

How do I start voice therapy?

Because there are so many different options when it comes to voice therapy, we recommend contacting a provider to get started. While there are many trans folks who discuss and offer guidance for transgender voice and speech therapy on YouTube and other online platforms, everyone who has decided to undergo voice therapy starts off in a unique place and has specific desired goals and outcomes. Online platforms might be a helpful place to start, but finding a provider who can tailor voice therapy interventions to your needs is your best bet. 

To find a provider who can work with you, we recommend the WPATH provider search tool. WPATH’s provider search can also help you find a provider who specializes in many other gender-affirming medical, behavioral, educational, and mental health fields. 

What is transgender voice surgery? 

Voice fold surgery is a surgical intervention used to alter a person’s voice. Voice therapy is often required as a prerequisite to surgery. Otolaryngologists who subspecialize in laryngology may attempt vocal fold surgery techniques to achieve results that previous voice therapy could not. Typically, vocal surgeries among trans feminine individuals are more common. There are several vocal feminization techniques that surgeons may use to assist in raising vocal pitch. Voice masculinization surgeries, while less common, are also possible. Voice surgery is not for everyone and carries a considerable amount of risk. Dr. Mosser does not perform voice surgeries, so please talk with your Primary Care Provider (PCP) about whether or not you think this is the right choice for you. 

In Summary

  • Transgender voice therapy is a vastly broad topic that encompasses a range of behavioral interventions.
  • Anyone who feels gender dysphoria or discomfort associated with their voice stands to benefit from transgender speech therapy.
  • Voice fold surgery is a less common intervention for voice dissatisfaction that may be worth pursuing if voice therapy does not help you meet your goals. Dr. Mosser does not perform voice fold surgery.
  • You can search for a speech-language pathologist or vocal surgeon using the WPATH provider search tool.