For transgender people in transition, voice is a critical part of their identities.
“That is one of the first things that people will notice when you are medically transitioning,” said Tony Clark, a senior history major who began transitioning as a transgender man in 2015. “It’s not only an adjustment period for yourself, it’s a new world.”
Transgender people may want to change their voices to sound more masculine or feminine and avoid being misgendered, said Ann Addis, a clinical instructor and supervisor in the Department of Communication Sciences & Disorders at Temple University.
Addis works with graduate students in the Speech-Language-Hearing Center’s Voice Therapy Clinic, which offers voice therapies for the transgender community and people experiencing various voice disorders.
“It’s easy to change their hair,” said Addis, who also listed facial surgery and breast augmentation as ways a transgender person can physically alter themselves while transitioning. “But nothing else helps the voice, and they need to do the therapy.”
There are currently six second-year graduate students in the clinic who work individually with 12 clients, consisting of Temple students and members of the surrounding Philadelphia area, once per week.
Eight of the 12 clients receive transgender voice therapies, Addis added.
The students administer these therapies not to correct a “disorder,” but as an “elective type of intervention” to assist transgender people in confirming their new identity, Addis said.
Finding his voice was a pivotal moment for Clark in his own transition.
“It is very cathartic,” Clark said. “You are finally coming into your own butterfly after being in the cocoon your whole life.”
To lower his voice, Clark takes testosterone, which initially required him to get a letter of approval from a gender therapist, he said. This was to make sure he was ready to make these irreversible changes to his body.
Transgender men can take testosterone to enlarge the larynx and thicken vocal cords, which will deepen their voices, according to University of California, San Francisco, Transgender Care. This process is successful for some, but not all. In some cases, testosterone may be unable to bring someone’s pitch low enough and can make the voice weak and hoarse, according to a 2017 report in the Journal of Voice.
Estrogen hormone replacements cannot raise a person’s voice, so transgender women are more likely to seek voice therapy than transgender men, Addis said.
“One a voice box is developed, you can’t shrink it,” Addis said.
In voice therapy, transgender women can practice exercises to change their intonation patterns and use techniques like breathiness, pitch upswings and blended articulation to create a more feminine sounding voice, Addis said.
“Most [transgender women] come in knowing that they want their pitch to be somewhat higher,” Addis added. “We have to educate them that there’s a limit to how high they can get their pitch. …Women use different kinds of intonation patterns. That doesn’t necessarily mean you need a higher pitch.”
Voice therapies can complement or serve as alternatives to medication to help alter the tone of one’s voice to match their gender.
Ari Cole Rubinson, a junior nursing major who is a transgender man, has been misgendered despite taking testosterone.
“It’s something that I have kind of accepted…but it doesn’t change the fact that it still hurts,” Rubinson said. “It just sucks that I was born in the wrong body.”
“Voice is the No. 1 thing I look forward to changing from taking hormones,” he added.