10 things to know about Gender Affirming & Gender nonconforming Voice Training

updated June 22, 2024

Have you heard of the terms gender affirming (GA) voice services (sometimes the term "therapy" may be used instead of training or service depending on the speech language therapist or training), gender nonconforming voice training, transgender voice training, feminizing voice training, or masculine voice training? This is a type of voice service to work on people's voice to reduce gender dysphoria. I like to call this as a type of service that a skilled and experienced speech language pathologist can provide to alleviate the discomfort or even mental and/or physical pain people endure due to a mismatch of their biological sex and gender identity.

During my decade long professional practice in speech-language pathology, I have been having the honor working with many people who found and are finding their voice that represent their true-self through gender affirming voice training. We collaborate in our meetings to reach my clients' voice goals and ultimately increase their life-participation and quality of life. We visit topics more than just voice in our gender affirming voice meetings because many other aspects besides vocal pitch change can alter how people present themselves.

This is a long over-due post that I have been wanting to share because I want to reach more people who may benefit from this voice training service speech and language pathologists can provide. I have been so honored and have had so much joy working with my clients finding their voice through gender affirming voice visits and here are 10 things I would love to share with you.

1. Vocal hygiene - To simply put, it is how we care for our voice. Drinking enough water to make sure your voice box is hydrated for you to comfortably use your voice is crucial. Using your voice constantly without warming up or cooling down can be difficult for your voice to function well. Speaking loudly or in noisy environment can also add stress to your voice box and eventually cause voice problems. Voice exercises are like any other physical exercises, we must make sure we are overall healthy to be able to perform in those exercises.

2. Pain - Pain when speaking is never normal. With our current technology, it is easy to find videos and articles on social media and web for whatever it is you are looking for. However, whether the resources or contents are reliable and safe isn't always clear. So, it is highly recommended that you reach out to a voice specialist to work on your voice to make sure you are using your voice safely and you can use your voice the way you prefer in the long run. When in pain, abort whatever it is you are learning and reach out to a voice specialist (i.e., voice speech therapist, laryngologist, head and neck surgeon) for support.

3. Pitch - We work on changing the pitch range in our voice training as all of you can imagine. However, as I mentioned above, it is not the only goal we target. There are various aspects about our voice that make us sound different including our pitch, resonance/tone, loudness, how we breathe, how we phrase our sentences, what our facial expressions are, and so on. So working with a speech language pathologist who specializes in gender affirming voice services can help you identify those areas and reach your goals in voice training.

4. Movement - Use a mirror when practicing your voice exercises and techniques can also be beneficial. We look at and work on our postures, the way we walk, how we eat/drink, even how we adjust our glasses and touch our hair, and many more. We have fun in our meetings working on finding ourselves through our overall presentation. It is always amazing to see my clients leaving our meetings feeling more confident. Dress up to your training visits can help your voice training progress. For example, wear a piece of jewelry/accessory that remind you of your voice goals and make you feel more YOU whether more feminine or masculine.

5. Idol - Finding an idol who you would like to speak like can be helpful. I often ask my clients to find someone or a few people whose voices they like. We listen to and watch these idols, and we discuss why and how they are great voices. We work on imitating to start and then modifying to fit their own vocal instrument (their own voice box) and their needs. Again, we have fun while practicing vocal exercises safely.

6. Pharmaceutical and surgical options - For some people, their voice change toward their goals with hormone therapy, especially for the female to male voice goals and when they start their treatment earlier in life. Others have questions on the surgical options available out there to help them change their voice, especially for voice feminization. It is crucial that people are able to make informed decisions after they learn all the pros and cons of the procedures. As all other procedures, there are risks such as bleeding and infections. People are usually recommended to work with a voice speech language pathologist prior to the procedure for a period of time, and they may need to continue with voice training after the procedure.

7. Duration - "How long does it take?" is a very commonly asked question I get in my practice. It is typically hard to predict how long a person may need to reach their voice training goals because of many reasons. For example, people have different physical structures for their voice, they learn differently, they have different voice goals and environments for them to practice what they learn from voice training. However, we are usually able to make progress in different areas we work on within 6-8 weeks. Most people continue for months, and some people return after awhile to refresh their practice and improve their voice. Ultimately, it is a behavioral change we work on. The more we practice, the better we become just like everything else.

8. Mental health - I just can't stress this enough with everyone I work with. Our voice is impacted by many things that people don't typically think of. Our emotions, stress, and sleep can too affect how we sound. Our pitch, tone, and quality of voice can all change because we do not sleep enough, we feel stressed, or are depressed. Our body can be more tense, and the muscles in our voice box can be tighter or even in pain, and that can all lead to voice change or problems. So, even though it is hard to see it, taking care of your mental health is just as important as your physical health. There are many resources available out there and many people, such as your speech-language pathologist, will be more than happy to help you find resources.

9. Support network - Having a support network that includes people who support your can help you reach your voice training goals in many ways. For example, you can practice your voice exercises with people you are comfortable with, or you can ask people you trust to give you feedback when you use your voice. However, I understand that not everyone has the luxury of the ideal environment or support. So we brainstorm ideas where my clients can practice their "new voice" and techniques in our voice training visits. Some of the situations my clients have enjoyed trying their "new voice" in are drive-through windows or placing phone orders. I also often tell my clients to give me a call outside of our voice training visits as a practice if they like and are comfortable doing it. I tell them, "I am part of their support system." So, don't forget your speech therapist can also be part of your support system if you would like.

10. Make changes as needed - Find the voice speech therapist who works for you. Whether you are working with a private speech therapist or a speech therapist through your insurance, speaking up about what works and what doesn't in your voice training can lead to a more successful outcome. Furthermore, it is not always guaranteed that you will find the perfect match from the first try. AND it is OKAY to find another voice speech therapist if the first one does not work out. Our voice is a huge part of our identity and it often feels very intimate to share and show our goals and concerns in voice training. You want to feel comfortable changing your vocal behavior - using a new voice - so you can reach your goals, and we, as speech language pathologists, want that for you as well. Our utmost priorities are for you to reach your voice goals and find your voice in life - be you.

If you want to learn about how to care for your voice, check out this other blog of ours.

If you are interested in learning more about your voice through singing? You may consider working with a vocal coach who is formally trained in teaching singing. I personally had great gain from working with Kevin DeLisa at Breaking Down the Music. You can also take a self-study vocal health course to take care of your one and only personal instrument (aka your voice) with me on Breaking Down the Music - Finding your voice.

I hope this is a start of your voice journey to reduce the discomfort or pain gender dysphoria has caused. I hope by starting your gender affirming voice journey, you are steps closer to be the amazing you.

If you are curious about how to find a voice speech therapist who may work for you and your support network, you may find this discussion helpful.

If you would like to learn more about gender affirming voice training and our setting, you can call/text us at 818.823.8022 or email us at hello@thechatroomtherapy.com.

We provide virtual speech therapy visits/telehealth visits in California, and in home services in Montrose, La Crescenta, La Canada, and Pasadena, CA areas.

We also provide speech therapy in Mandarin Chinese. 中文/國語語言治療

Vicki Chia Hui Lin, M.S., CCC-SLP

Founder, The Chat Room Therapy

Vicki is a California licensed and American Speech Language and Hearing Association certified speech language pathologist. She has extensive experience with both adults and children, with particular specialties in gender affirming voice therapy, adult voice disorders, post stroke or head and neck cancer related voice, communication, cognitive, and swallow difficulties. 

Resources:

ASHA UCSF