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  • Writer's pictureJanet Savva

What is Gender Affirming Voice Therapy?

Updated: Mar 27




Gender Affirming Voice Therapy for transgender clients is a specialist area of speech and language therapy.  We ensure that finding your authentic voice is achieved safely to avoid vocal strain whilst maintaining optimum vocal health.

 

Our voice (or voice identity) sounds like our own because of several different factors combined.  These include pitch, resonance, intonation, rhythm, intensity, rate, and articulation. 

 

  • Pitch: How high or low we can move our voice. It is the perceptual correlate of the frequency of vocal fold vibration (measured in Hertz/Hz).

 

  • Resonance: The voice quality (how rich a voice may sound). Generally, masculine voices are perceived to resonate mostly from the chest area, whereas feminine voices are perceived to resonate mostly from the head area.

 

  • Intonation: The upward and downward movement of the voice or the inflection of the voice. Generally feminine voices are perceived to have more inflections than masculine voices.

 

  • Volume: The loudness or intensity of our voice. It is the perceptual correlate of amplitude (measured in decibels, dB). Generally, masculine voices are perceived to be louder than feminine voices.

 

  • Rhythm: The patterning of syllables in speech. Rhythm is measured in terms of vowel duration. Generally, a more legato rhythm (smooth and connected with longer vowels) may be more stereotypical for feminine voices, whereas a more staccato rhythm (choppy with shorter vowels) may be more stereotypical of masculine voices.

 

  • Articulation: The shaping of sounds by the tongue, lip, jaw, soft/hard palate, teeth and alveolar ridge to produce speech. Generally, feminine voices are perceived to be clearer in terms of articulation and more precise.

 

In therapy you will explore these factors to help you find the voice.

 

Is Gender Affirming Voice Therapy available on the NHS?

 

Yes. Your GP can refer you to your local service for this. If you are under a Gender Identity Clinic (GIC), there may be an in-house speech and language therapist. 

 

Unfortunately, not all areas of the UK have a service for transgender individuals. Gender Affirming Voice Therapy has traditionally been very niche and specialist not least due to the small numbers of clients within the population as a whole. However, as the rates of referral have increased so have the number of treating therapists. So do check with your GP first to see if you can access an NHS speech and language therapy service.

 

Can I access private Gender Affirming Voice Therapy? 

 

Yes. You can do this at any time if you do not have a local NHS speech and language therapy service that offers Gender Affirming Voice Therapy, or whilst waiting to be seen by an NHS therapist.  It is also possible to continue with private therapy whilst having NHS speech and language therapy.  However, the private and NHS therapist can not be the same person.  If your private therapist also works for your local NHS voice service, you should be discharged from their private caseload and transferred to their NHS caseload.  

 

I work for Somerset NHS Foundation Trust.  Therefore, if you live within this catchment area you should contact your GP and ask to be referred to the Adult Speech and Language Therapy service based at Bracken House, Crewkerne Road, Chard, Somerset TA20 1YA.  Referral can also be referred to AdultSLTreferrals@somersetft.nhs.uk     

 

When can I begin voice feminisation?

 

You can start therapy whenever you like! There is no need to wait until you have transitioned fully.  We all have different voices we use with different people and in different situations.  Voice therapy will give you the freedom of voice choice.

All I ask is that you are motivate as therapy requires daily practice. 

 

What effect will hormone therapy have on my voice?

 

Unfortunately, oestrogen has no significant impact on the voice as once a person born male has gone through puberty, the larynx will have lowered in the body, and increased in size. In addition, the testosterone that influences other bodily changes during puberty also thickens the vocal cords which makes the voice sound deeper. This cannot be reversed with oestrogen after a person has gone through puberty.

 

How many sessions will I need?

 

This varies from individual to individual.  People learn at their own pace. In addition, many factors can influence progress such as their ability to commit to therapy, their motivation to improve and their personal circumstances. 

 

Typically, you will need 6-12 sessions spread over 6-12 months.  Sessions that are designed to help with voice change in a step-by-step process. Depending on your ability, we individualise each session to fit your needs.

 

Your Initial Assessment Consultation

 

Your first appointment will last an hour. At this appointment I will take a detailed case history from you. This will include your medical history, transgender history and lifestyle.

 

I will ask you to make a voice recording using free software that can be downloaded onto a tablet or smart phone.  I will teach you how your voice is produced and will give you voice exercises to start you on the process of feminising your voice. None of this is physically invasive.

 

You may be asked to consult your GP about health issues that could be affecting your voice. If your voice is hoarse I will ask that you be referred to the Ear Nose and Throat consultant before we can commence therapy.


Your Therapy Appointments

 

Therapy appointments will usually 45 minutes and will include a review of previous advice and exercises practice between sessions.

Therapy sessions can involve quite a lot of voice exploration to work out how to make the subtle changes needed to feminise your voice.

Sometimes therapy can be quite challenging for people as they explore their voice identity. We will work at a pace that suits you and I will support you through this process.

 

How much does private Gender Affirming Voice Therapy cost?

 

I am a highly qualified and skilled voice therapist.  However, I have only been working with Trans and Gender Diverse clients providing Gender Affirming Voice Therapy in the past few years within the NHS setting.  I access regular supervision and am a member of the National Trans and Gender Diverse Voice and Communication Clinical Excellence Network. For this reason, I offer discounted rates to those quoted on my Costs and Payments page.  So, please contact me to discuss my fees. 

 

 

Contact me for a free 15 minute telephone consultation to see if I can help you.


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