Voice therapy can help transgender individuals modify their vocal quality in ways that match their gender identity. Several factors contribute to how a person sounds, including pitch, resonance and breath support.
Individuals who wish to sound more feminine or masculine can meet with a voice specialist (speech-language pathologist). Gender-affirming voice treatment can include training on how to safely change the way one sounds.
1. Pitch
In many cases, people seek gender-affirming voice care because their voice and communication style aren’t aligned with their gender identity. A gender-nonconforming voice can be a source of embarrassment and discomfort, and it may also signal to others that the person is male or female. This can lead to negative societal reaction, as well as a lack of confidence in social and professional environments. Gender-affirming voice training helps people feel confident in their own voices and empowers them to speak from their authentic selves.
Gender-affirming voice training can include speech therapy to help a person’s voice and speech sound more feminine, gender neutral or masculine. It can also teach how to change the way a person speaks and communicates, including the rhythm of words, vocal emphasis and melody.
A person’s pitch can be changed by altering the length and tension of the vocal cords, how much air is used, and the shape of the voice box. In addition, it is important to understand how the resonance and timbre of a person’s voice can be altered, and that voice changers are popular among gamers and streamers. These changes can have a significant impact on how a person sounds.
Typically, voice-specialized speech-language pathologists (SLPs) will work with patients to create a plan that meets their voice goals. They will assess a person’s baseline voice pitch and identify how much their voice needs to be altered to meet the desired goal. They will then teach how to make these changes in a safe and healthy manner, preventing vocal fatigue or permanent damage.
For example, a transgender man assigned male at birth who is transitioning to a woman will need to learn how to speak with a high pitched voice, which is often described as a “mezzo-soprano” or a “singer’s voice.” This requires an understanding of the vocal tract shaping and resonance. It will also require learning how to breathe in a way that prevents straining and vocal fatigue.
For someone who has been assigned male at birth, the physical changes to their voice that occur during puberty can be reversed through hormone replacement therapy and a reduction in the amount of testosterone that is produced. This can take time, however, as the process is dependent on the amount of testosterone that is being suppressed by the estrogen being consumed through hormone replacement therapy.
2. Resonance
Many people who are transgender, genderfluid or non-binary want to play with their voices and may not want to sound particularly feminine or masculine. Gender expression is an additional layer of identity that is malleable and powerful-all you need is a voice that feels like your own.
While pitch is the first sound characteristic that determines a person’s gender, there are also several other characteristics of the voice that can be modified to create a more feminine or masculine tone. These include: resonance, prosody (the rhythmic quality of your speech), articulation, intonation and loudness level. Additionally, varying word choice, phrasing, facial expression and nonverbal communication are all part of gender affirmation.
Voice training focuses on improving the quality of the voice by teaching you how to control its various aspects. A skilled therapist can help you develop a style of speaking that is authentic and consistent with your gender identity. This can be done in a variety of ways including exercises, feedback and recording. It is important to remember that changing your voice takes time and effort and that results are not linear. A good therapist will ask about your goals for the voice and set measurable, functional and realistic goals.
Researchers at the University of Cincinnati have developed an app called TruVox that helps transgender people alter their voice to be more feminine or masculine. The app allows users to practice vocal exercises while displaying a chart that changes to show their voice pitch and how it relates to the gender-specific scales of a male or female voice.
Using the chart, the user can experiment with different pitches and adjust their volume to see how these changes affect their perceived gender. This type of gender-affirming voice training can be helpful for transgender people who want to avoid being misgendered by strangers and help them stay safe in public spaces where violence against people who identify as gender non-conforming is still a risk.
Speech-language pathologists specializing in gender-affirming voice and communication training can help transgender individuals modify their voice to match their personal gender identity. In addition to helping people modulate their voice, these professionals can also teach how to use nonsurgical methods to address gender dysphoria.
3. Breath
A big part of changing your voice is learning how to breathe. Taking deep breaths causes your body to expand, which creates more chest resonance and lower pitches in the voice. This is why transgender people who want a masculine voice often work on breathing techniques. Getting more air into your lungs and expanding your vocal cords helps you make your voice deeper, which sounds more masculine.
Your vocal cords, which are the muscles that control how you speak, work best when they have the space to move freely. When you’re tense, your vocal cords tighten up and the muscles become less flexible. This can prevent you from reaching the pitches you need to sound feminine or masculine.
During gender affirmation therapy, your healthcare provider may teach you breathing exercises to help loosen the muscles around your vocal cords and allow them to stretch more easily. They’ll also instruct you in communication skills that match your gender identity. They’ll focus on rhythm, the way words are stressed and the melody and emotion of your speech.
A study of a clinical gender-affirming voice training program found that all participants improved their voices. Their satisfaction with their voice increased and negative impacts of their voices on their participation in daily life decreased. They also maintained their improvements 3 months after the end of the voice training.
Participants and clinicians jointly established long-term goals based on their own self-identified gender, and weekly short-term goals that were specific and targeted to their own voice-related situations. They also agreed on the training criterion for speaking fo (the acoustic correlate of pitch), which was set at a level close to cisgender female norms.
At each timepoint, participants were asked to rate how satisfied they were with their voice on a visual analog scale that ranged from very satisfied to very unsatisfied. However, the participant-rated voice satisfaction task did not accurately reflect day-to-day communication exchanges in which participants use a wide variety of contextual factors beyond a voice’s acoustic characteristics to attribute gender. This is why researchers have proposed using a wider range of outcome measures to assess the effectiveness of gender-affirming voice change (Azul and Hancock, 2020).
4. Volume
The quality of an individual’s voice can be a sign of their gender identity. A voice that is not in congruence with an individual’s gender may cause them distress, draw unwanted attention or even threaten their safety. Speech language pathologists who specialize in gender affirming voice and communication training can teach transgender individuals safe ways to alter their vocal and communication skills so that their voices align with their identities.
The process of transforming one’s voice to reflect one’s gender requires consideration of a number of factors. Pitch, resonance and intonation all affect perceptions of speaker gender. For example, a longer vowel duration, more frequent rising and falling intonation and greater breathiness have been identified as cues of femaleness in male-to-female transsexual women.
Gender affirmation is a personal journey. Whether or not an individual chooses to have surgery, or simply wants to learn how to use their current physical characteristics to their advantage, all paths are valid and worthy of exploration. In addition to learning how to manipulate pitch and resonance, other tools that can be used include lowering vocal intensity, eliminating vocal fry and increasing vocal clarity. The most important thing is to find a way to express your authentic self.