American Speech-Language-Hearing Association

Voice and Communication Therapy for Transgender/Transsexual Clients

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What is voice and communication therapy for transgender/transsexual clients?

In general, men and women communicate differently. For example, most men tend to speak with lower pitched voices, while women use higher pitched voices. Women often use more gestures when they speak. Men may use shorter sentences that get more to the point. Individuals who are transgender/transsexual often elect to have voice and communication therapy to help them use their voice in a safe way and communicate more like the opposite gender of that in which they were born.

The Harry Benjamin International Gender Dysphoria Association (HBIGDA) has established standards of care within the area of transsexual medicine for individuals wishing to have genital reconstructive surgery (GRS). GRS is a surgical procedure that transforms the body to the gender opposite of that in which the person was born. An individual who chooses to have GRS must see a psychologist for 2 years and live full-time in the new gender role. Voice and communication therapy services are recommended during this time.

What does the speech-language pathologist do when working with transgender/transsexual clients?

The speech-language pathologist (SLP) provides voice and communication training for male-to-female (MtF) clients and for female-to-male (FtM) clients. The SLP will look at a variety of aspects of communication, including vocal pitch, intonation and resonance, and nonverbal communication.

Assessment will involve the collection of a case history and medical history, and assessment of voice and language. It is also important for the SLP to eliminate any vocal abusive behaviors resulting from changes in pitch and intensity. For example, an MtF client may try to speak in a higher pitched voice; if not done correctly, this can lead to vocal nodules or other voice problems.

The following are some of the things that the SLP may choose to work on:

  • pitch
  • resonance
  • intonation (the rhythm of speech)
  • rate (how fast or slow the person speaks)
  • volume/intensity
  • language
  • speech sound production (articulation)
  • pragmatics (social rules of communication)

What other organizations have information about transgender/transsexual clients?

World Professional Association for Transgender Health (WPATH)

Voice and Speech Trainers of America (VASTA)

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