Medical Moment: Gender-affirming voice therapy for transgender people

Published: Mar. 7, 2023 at 5:40 PM EST
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(WNDU) - The term transgender describes people whose gender identity, or their internal sense of being male, female, or something else, does not match the sex they were assigned at birth.

According to the National Center for Transgender Equality, there are about 1.4 million transgender people in the United States.

Some transgender people don’t identify with either gender exclusively. Their gender identity may combine both female and male elements, or they may not feel like either gender. Trans people are often described as being non-binary. The term transgender, or trans for short, does not describe a person’s romantic and sexual preferences. That’s because gender identity is not the same as sexual orientation. Trans people are straight, gay, lesbian, bisexual, and everything in between.

Many people go through a process of coming to know, accept, and express their gender identity, which is called gender affirmation. There are several ways to affirm gender through medical and non-medical options.

Some medical options can include hormone therapy or taking medicine such as testosterone or estrogen to help increase or decrease sex characteristics; puberty blockers, or medicines that block the hormones that cause body changes during puberty; and surgery.

There are different surgeries that can change the look and function of the body that help match the gender identity.

Some non-medical options are living as your gender identity through clothing, hairstyle, voice therapy, or even hair removal and name change; professional guidance through counseling to help a person, family, or group of people; and getting support through a doctor, school counselor, or online organizations.

Transgender people often struggle with discrimination and harassment, which can lead to mental health issues like anxiety and depression.

Some programs are helping people in transition to communicate in a way that is both comfortable and gender-affirming.

SeAnna grew up in rural West Virginia, a small town where she buried her true feelings about her gender for years.

“I’ve been a fish out of water my entire life,” SeAnna recalled.

Five years ago, she lost a close friend, and was hospitalized for depression.

“That was when, that was the first time that I had admitted to anyone that I was trans,” SeAnna said. “This is why I’ve never felt, you know, connected to the male experience. This is why when someone calls me sir, I’ve always cringed inside.”

Two years ago, during COVID-19 isolation, SeAnna started medically transitioning from male to female, starting with hormones. But she still wasn’t happy with how she sounded. That’s when she sought out gender-affirming voice coaching.

“Most of the patients that we see here can achieve their goals or close to their goals with voice therapy alone, which is a significantly less invasive option,” said Anna Lichtenstein, a speech therapist at the Ohio State Wexner Medical Center.

Lichtenstein works with patients on pitch, resonance, speech patterns and breathing. Men and women approach each differently.

“We start at a sound level, playing around with weird sounds and coordinating them,” Lichtenstein explained.

Then they practice sentences and conversation. Just listen to the difference in SeAnna’s voice between May 2022 and now.

Lichtenstein says the majority of her patients are trans women. She says the hormones taken during medical transition, like estrogen and progesterone, have no effect on the vocal tract. She also works with nonbinary and agender individuals who want a more androgynous sound when they communicate. Lichtenstein usually suggests patients see her for an hour every week for a minimum of ten weeks, and patients are encouraged to do vocal exercises at home every day.