Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside

TLDR

WPATH’s Standards of Care affirm that gender identity is unique to each person, and aligning external expression with internal identity can enhance comfort, confidence, and daily functioning for transgender individuals. This document aims to equip speech‑language clinicians and researchers with guidance to help transgender people develop voice and communication that reflects their unique gender identity. It reviews evidence‑based literature and discusses clinical topics including assessment, voice‑feminization protocols and surgeries, and the under‑researched area of speech and voice masculinization. Given the absence of established minimal standards, the paper offers recommendations for high‑quality clinical care.

Abstract

In the seventh version of their Standards of Care, WPATH recognizes that, as each person is unique, so is the person's gender identity. The goal of speech-language therapists/pathologists is to help transgender people develop voice and communication that reflects their unique sense of gender. When outer expression is congruent with an inner sense of self, transgender people may find increased comfort, confidence, and improved function in everyday life. Transgender voice and communication is a relatively new area of practice within speech-language pathology/therapy and this document is intended to support clinicians and researchers working in this field. It begins with a review of the evidence-based literature in transgender voice and communication. The paper then discusses these clinical topics: trans-specific voice-and-communication assessment, voice feminization protocols and voice feminizing surgeries. There is also a section on speech and voice masculinization—an area that has received little previous attention. As minimal standards have yet to be established in this field the paper concludes with recommendations for good clinical care.