Trans Voice Therapy

Transgender Voice Training or voice therapy is the term often used by speech language pathologists and medical professionals. It implies a mechanical, medical approach. These professionals come from a background of treating swallowing disorders, unhealthy voice habits, and voice damage.

ADVANTAGES

   You will find a few advantages to this approach that may make it the better choice for some. First, speech language pathologists are able to accept insurance in some cases for offering Trans voice therapy. Within this school of thought, gender dysphoria (with respect to the voice) is a medical condition, and can then be treated medically for insurance eligibility.

          Another advantage of a medical providers is that they record progress in an objective way. This can be helpful for measuring progress of transgender voice therapy. You will have concrete data, and can understand the progress you are making. Some objective ways of measuring the voice include:

1.   Frequency: the number of times the vocal folds vibrate in a set amount of time. Frequency is typically measured in vibrations per second, or Hertz (Hz).

2.   Harmonics: frequencies that are multiples of the frequency that your vocal folds produce. This influences what quality we perceive a person’s voice to have.

3.   Volume: how loud or quiet a voice is, measured in decibels.

In a world that’s perpetually connected via social media, cellphones, and computers, the power and significance of your voice can be tremendous. Whether you’re listening to a loved one over the phone or hearing an actor on TV, you probably hear hundreds of unique voices every day. But have you ever put much thought into your own voice?

For transgender men and women, the answer to that question is usually an unequivocal yes, constantly. Our voices can out us to strangers and inspire intense dysphoria, widening the gap between who we are and who we present to the world. For many Tran’s men, testosterone lowers the tone of their voice over time. Tran’s women aren’t as fortunate: Estrogen has no impact on a voice that’s already been affected by male puberty. However, voice therapy—conducted at home or through a professional—can lead to a more cis-comparable speaking voice. We recommend mtf voice training by a professional to help.

I’ve never had the abundance of disposable income necessary to hire a voice therapist or do voice feminization exercises, so my experiences are composed of amateur work through internet resources. Voice therapy comprises three major techniques: tone, resonance, and cadence. Once you master the three, you’ll have a strong foundation for exploring the more abstract components of your voice. Most of these guides start with the same advice: strengthen your larynx, then learn to control its position. If you aren’t sure where your larynx is, tilt your head back, place a finger in the center of your throat and swallow. Do you feel that muscle bouncing up and shooting back down? That’s your larynx, and it’s partly responsible for the unique sound of your voice. Controlling your larynx is tricky and requires you to use the muscles surrounding it to lift it and lower it.

The human voice is a powerful thing. But what if your voice didn't represent who you are?

Within the transgender community in Massachusetts and beyond, that is a reality for many people who are transitioning from one gender identity to another.

That's where gender-affirming voice therapy comes in. It's a form of speech therapy, but the goal is to help a person craft a voice that feels comfortable and authentic to themselves.

"There's no recipe for finding your voice," said Laurie Korza, a speech pathologist at Northampton Atwood Rehabilitation Services who works with Trans patients. "You have to work within what your voice can do. And we know that that can change."

Gender-affirming care like voice therapy recently became easier to access in Massachusetts. The state-funded health care program MassHealth OK'd the addition of procedures like breast reduction surgery and genital surgery to a list of covered, medically necessary care last year.

But Trans health care is under attack in other parts of the country. Last month in Texas, for instance, Gov. Greg Abbott directed state agencies to investigate families of children undergoing gender-affirming care for child abuse. Several leading medical organizations have condemned the directive, and the American Civil Liberties Union is now suing Texas over it.

Discrimination based on gender identity is against Massachusetts law. Studies suggest banning or criminalizing gender-affirming care is detrimental to Trans people's well-being. A 2020 survey found 40% of LGBTQ young people had considered suicide within the previous year, in part due to their gender identity not being affirmed by others.

Korza said her foray into gender-affirming voice therapy began when a patient came in for care for a different matter: Parkinson's disease. But that patient eventually asked if Korza could help make her "sound more feminine."

"I was honest and said, 'Well, I've never done that before, but I'm certainly willing to give it a try,' " Korza said.

Today, Korza estimates about one-third of her caseload is people seeking gender-affirming voice therapy.

"It was a big shift, because you do need to understand the safety aspects. You have to be open. And for me, I have to admit what I don't know," Korza said. "Everybody's different. You have to really tailor the program and the process to that individual and to where they are in their process. It continues to be a learning experience for me.