VOLUME 23, ISSUE 3 The Voice

T h e V o i c e VOLUME 23, ISSUE 3 The Voice T h e V o i c e VOICE OF THE EDITOR Mary Sandage, PhD, CCC-SLP

IN THIS ISSUE: CHANGES IN VOICE AND SPEECH

THE VOICE OF 2,3 BY MARY SANDAGE, PHD, CCC-SLP T H E E D I T O R As the cicadas buzz in the singing teacher, acting voice

B Y E D I T O R late summer air, I am re- teacher, and laryngologist. MARY SANDAGE, P H D , C C C - SLP minded of the pending sea- Transgender voice goals VOICE CARE FOR 4, 5, 6,7 sonal change to fall. This T H E may span both speaking and TRANSGENDER issue of The Voice Founda- S P E A K E R singing voice. Christie Block, tion Newsletter is about B Y C H R I S T I E a well-regarded transgender BLOCK, MA, MS, changes to voice and speech CCC- SLP voice specialist in New York MARY SANDAGE, PHD, that may have a dramatic, V O I C E 8, 9, 10, City starts off the issue with CCC - SLP PEDAGOGY 11 positive influence on quality F O R a general discussion of TRANSGENDER? of life and the effectiveness TAKING THE transgender voice and pro- Assistant Professor GENDER OUT OF with which individuals can Dept. of V O I C E vides a valuable perspective CLASSIFICATION function in their world. The Communication Disorders for the careful consideration Auburn University BY LORAINE changes in voice, accent, S I M S , D M A of the individual that is be- speech, and language that ing treated – femininity does WHAT DIALECT 12, 13, will be described in this issue C O A C H I N G 14 not mean the same to each T A U G H T M E are generally conducted with ABOUT ACCENT person who identifies as fe- MODIFICATION a healthy larynx with male.

B Y K A T E maintenance of vocal health DEVORE, MA, in mind. For this issue, vocal While transgender speaking CCC- SLP voice is better described in 47TH ANNUAL 15 changes will span S Y M P O S I U M the literature and there are INFO transgender voice and accent modification. Successful vo- an increasing number of B O A R D O F 16 DIRECTORS cal and speech changes may training opportunities

CONTACT require the skill sets of the through which to learn

speech-language pathologist, (Continued on page 3)

Voice of the Editor T H E V O I C E Page 3

training singing voice in the of theatre voice and speech- (Continued from page 2) transgender population, point- language pathology. In our fi- ing out that singing voice dys- nal piece, she describes how the about transgender speaking phoria is not a given with all interprofessional nature of her voice, our knowledge and transgender singers and we career trajectory makes her skills in the area of need to reconsider our singing particularly well suited to work transgender singing voice are voice classification system to with accent modification. less well described. Loraine be more inclusive. Sims, Associate Professor and I hope you find these three con- Vocal Studies Division Chair Kate Devore, owner of Total tributions and their authors as at Louisiana State University, Voice, Inc. in Chicago, moves inspiring as I do. summarizes her experience effortlessly between the worlds T H E V O I C E Page 4 VOICE CARE FOR THE TRANSGENDER SPEAKER

BY CHRISTIE BLOCK, MA, MS, CCC-SLP fully assess and treat all aspects of gendered voice, speech, and lan- The growth of transgender guage that are troublesome to the voice is an exciting and important client. This involves pitch, reso- development for clinicians and cli- nance, intonation, vocal quality, ents alike. Voice specialists broaden loudness level, articulation, phras- their services with rewarding expe- ing, word choice, communication riences as clients gain critical access style, non-speech vocalizations, and to care. But access to what kind of non-verbal communication. Since care? Sufficient work in this area phonosurgery only addresses pitch demands a very specific set of clini- and often results in complications or cal and cultural skills. Because the insufficient outcomes, the behavior- needs of the transgender communi- al voice clinician is the primary pro- CHRISTIE BLOCK, MA, ty are complex and have historical- vider for assessment, treatment, M S , C C C - SLP ly been misunderstood by the medi- treatment coordination with a possi- cal establishment and society at ble team of providers, and rehabili- large, developing these skills re- Clinical voice specialist and owner tation if dysphonia exists or phono- New York Speech & Voice Lab quires a strong clinical background, surgery applies. This is especially New York, NY solid commitment, and heart. true for the client who understanda- Clinical competence. The bly wants a quick surgical fix and Standards of Care, Version 7, of the needs to make an informed decision. World Association for Transgender It is the behavioral clinician who Health (WPATH) (Coleman et al., can fully educate the client regard- 2011) specifies that in order to as- ing overall prognosis and the need sist a client in achieving voice and to learn how to 'play the instrument' communication patterns that are appropriately with or without congruent with their gender identi- change in anatomy.

ty, the voice clinician should care- (Continued on page 5) The Voice of the Speech-Language Pathologist VOLUME 23, ISSUE 3 Page 5

(Continued from page 4) wants voice change. Not everyone who wants voice change is feminine-identified. For example, In general, when training a client to speak some trans men need training for pitch or other in a more feminine or masculine way, I have per- voice parameters in addition to or instead of pitch sonally relied on thinking outside the box in order lowering from testosterone. Other people, who to find and facilitate the right com- identify as gender non-binary or non bination of speaking patterns for -conforming, are challenging our tra- that particular client. But teaching “She will not benefit from ditional perceptions of gender. The those technical skills is worthless being taught to always be voice clinician must be prepared to without the cultural understanding elaborative, because that's help anyone along the gender spec- it takes to help the client integrate the way women talk. trum, never assuming, and always those skills with their sense of self Instead, the question being sensitive to each person's spe- and into their daily communica- should be "how can she be cific identity, needs, goals, pronoun, tion. In fact, I have personally dis- recognized and treated re- and ways of discussing their experi- covered, particularly as a cisgender spectfully as a woman, ences. clinician, that the non-technical while meeting the Focusing explicitly on the aspect of training has been the communicative expectations needs of the individual client also most critical part of my develop- of the situation" allows the clinician to avoid blanket ment as a transgender speaking stereotyping. They apply their voice specialist in helping my clients achieve vocal knowledge of research about speech and voice satisfaction. norms of cisgender people and expected gender Cultural competence. Understanding roles in communication to the client's specific lin- where the client is coming from and what gen- guistic, social, professional, and cultural contexts. dered communication they need starts with a fun- Additional factors may also shape gender percep- damental awareness of common issues in the tion in communication, such as socioeconomic sta- transgender community. This includes knowledge tus, social role, professional role, regional dialect, about gender dysphoria (the distress that results age, ethnicity, and power differences between the from the mismatch of the body with gender iden- sexes. To illustrate, a trans woman may need a tity), voice dysphoria (the distress specific to the more direct communication style if she works in voice), gender expression (how a person shows finance but a more elaborative style if she is a gender in their looks and actions), transphobia, teacher. She will not benefit from being taught to and related problems such as lack of support. always be elaborative because that's the way women talk. Instead, the question should be "how can she Yet as soon as a few common threads are be recognized and treated respectfully as a woman recognized, a myriad of variations prove that while meeting the communicative expectations of there is no one transgender narrative. Not every- the situation?" one transitions or transitions fully. Not everyone (Continued on page 6) T H E V O I C E Page 6

(Continued from page 5) tremely useful for addressing these problems or other feelings about voice that are influenced by Only with an understanding of com- stressors, depression, anxiety, etc. Ultimately, mon transgender issues and the ability to iden- the provider's objective is to positively influence tify and teach a range of technical, context- the client's overall resilience and self- specific skills for the individual client can the determination. The question I like to leave my voice clinician then help the client embrace clients with is "now that you have a voice, what and use their skills, juggling any mental, logis- do you want to say?" tical, or societal factors that may hinder pro- On the road to understanding. It is safe gress. The client may be dissociative or hyper- to assume that many voice specialists who are sensitive to their voice and changes in their interested in this area have had very little expo- voice, evoking concerns about sounding unnat- sure to the community but have excellent clini- ural or taking a risk to use their new voice cal knowledge to bring to the table. If you fit skills with others. However, a feeling of unnat- into that category, consider meeting with a uralness is more often due to neurologic pro- trans person, taking a training for voice clini- cessing of new habits. The client may also not cians, attending a WPATH symposium or com- accept their best possible voice out of a need munity conference, or reading existing research for perfection or out of fear of not being ac- or community literature. It's that cultural cepted by others. On the contrary, the client's knowledge that will improve your already ex- modified voice is almost always more function- ceptional skill set to the level of care that trans al than they think it is. How does people deserve. the clinician bring the client's heart in line with their head? Some strategies that I have References found useful include: 1) re- Adler, R., Hirsch, S., & Picker- cordings that document ing, J. (in press). Voice and com- voice progress, 2) discussions munication therapy for the about risk-taking, neurologic transgender/gender diverse client: A processing, and acceptance, comprehensive clinical guide, 3rd 3) positive reminders, and 4) edition. San Diego, CA: Plural short interactive tasks in Publishing. and outside the office to ease the client into real communi- Azul, D. (2015). On the varied cative situations, such as and complex factors affecting asking the office receptionist gender diverse people's vocal situ- a question or saying good ations: Implications for clinical morning to their partner. practice. Perspectives on Voice and Obviously, good overall Voice Disorders, 25, 75-86. counseling skills are ex- Block, C. (2014). Finding our

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voices, literally. In Erickson-Schroth, L. (Ed.) Trans Bodies Trans Selves. New York, NY: Ox- ford University Press.

Coleman, E., Bockting, W., Botzer, M., Cohen- Kettenis, P., DeCuypere, G., Feldman, J . Zucker, K. (2011). Standards of care for the health of transsexual, transgender, and gender nonconforming people, version 7. International Journal of Transgenderism, 13, 165-232.

Davies, S., Papp, V., & Antoni, C. (2015). Voice and communication for gender non- conforming individuals: Giving voice to the person inside. International Journal of Transgenderism, 16(3), 117-159.

Christie Block, MA, MS, CCC-SLP is a clinical voice pathologist and specialty. Some include: Trans Bodies Trans Selves, SIG3 Perspec- owner of New York Speech & Voice Lab in New York City. She has tives, Speech-Language Pathology Casebook, Voice and Communica- over 25 years of professional experience in linguistics, ESL, and tion Therapy for the Transgender/Gender Diverse Client, ASHA, Phila- speech pathology. Her practice is primarily devoted to voice and com- delphia Trans Wellness Conference, Voice Foundation Symposium, munication training and rehabilitation for transgender and gender Working Group on Gender, and the World Professional Association non-conforming speakers. She is a contributing writer and active for Transgender Health. speaker of transgender voice, and she trains other clinicians in the VOLUME 23, ISSUE 3 Page 8

BY LORAINE SIMS, DMA

After writing several articles and has a successful career in Germa- presenting many times about ny as a heldenbariton. She said: teaching transgender singers, I “…it’s not like you have… have come to the conclusion that soprano and mezzo soprano (while some singing teachers are still hesi- holding up one hand) and then tant to believe that they are quali- you have tenor and bass (while fied to work with this population. holding up the other hand) and Certainly, sensitivity training and then you have this third category learning a transgender vocabulary (smiling and gesturing with both that is positive and affirming will hands in the middle) that all these help you and your student com- voices fit into…no, not at all!” municate. You need to learn the Lucia suggested a simplification terms, use the correct pronouns and for voice teachers to consider is LORAINE SIMS, DMA names, and come to terms with that there are voices that have your own lack of comfort with all been lowered by testosterone and things transgender. You are teach- those that have not. Some voices Associate Professor ing people, not voices. There are Vocal Studies Division Chair have been changed after puberty Louisiana State University transgender and non-binary peo- and are individuals that were as- in Baton Rouge. ple, but is there a transgender signed female at birth (AFAB). voice? Well, certainly not just one! Teaching these individuals means There are as many kinds of learning what happens to the transgender voices as there are singing and speaking voice of kinds of voices in any population. I these individuals. There are now recently interviewed Lucia Lucas, several resources for teachers to a trans feminine opera singer who (Continued on page 9)

The Voice of the Vocal Pedagogue VOLUME 23, ISSUE 3 Page 9

TAKING THE GENDER OUT, CONTINUED

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come to an understanding of the voice changes that occur. However, once the voice has stabilized, teaching this type of singer is not really different than teaching any tenor or baritone. I interviewed Hold- en Madagame, an assigned female at birth (AFAB) trans masculine opera singer making a career in Germany as a tenor potential. after testosterone therapy who contralto range is the goal, there confirmed this. He is proving are vocal exercises that can help When considering a transgender that a voice dropped with tes- these individuals develop their woman who continues to sing tosterone in adulthood can be voices in those ranges. Descend- with her natural baritone or tenor a viable professional instru- ing, sliding “oo” exercises from voice, do we really need the label ment. the most comfortable high note female baritone or female tenor? If a in a head voice (Mode 2) produc- transgender man is still singing There are other voices that tion can be successful. Lucia Lu- with his natural mezzo soprano have been lowered by testos- cas suggested that we should use voice because he has chosen not to terone that belong to individu- the term head voice instead of take testosterone, do we need to als who were assigned male at falsetto for this type of voice label him male mezzo soprano? I birth (AMAB) but who now production for a transgender say no. Lucia Lucas is making an present as feminine. These woman because they are general- unconventional choice to continue transgender women may ly not seeking a tone that is as- to sing with her baritone voice, choose to continue to sing sociated with falsetto if they but it is the same voice that she with their natural tenor or want the label of mezzo soprano has been singing with for many baritone voices but some may or contralto, for example. Re- years. Since the estrogen therapy wish to feminize the voice for member that some transitions to that she is currently taking has no singing and speech. As a sing- this voice production are more effect on her voice that was ing teacher, you have the task successful than others, and your changed at puberty by testos- of seeing if there is a path to job as the teacher may mean terone, she remains a baritone. whatever the individual has as giving a gentle dose of reality to Training and working in her ca- a singing goal. If singing in the the singer and helping them to reer have allowed her to be suc- soprano, mezzo soprano, or define their goals within their (Continued on page 10) VOLUME 23, ISSUE 3 Page 10

TAKING THE GENDER OUT, CONTINUED

cessful. We cannot give credit for that success to tertenors without a gender designation. We do not her being transgender or having anything to do call them male countertenors. However, there with the medical journey she has been taking for a might be transgender women or a non-binary per- while now. son who was AFAB and has taken testosterone I have been making the case for taking the who now wants to sound like a countertenor and gender out of voice classification at several confer- choose that label rather than mezzo soprano. I ences recently, because we are making it too com- think we can assume that classifying voices by plicated for competitions and auditions. When timbre and range without gender would be less considering non-binary individuals, a binary gen- cumbersome and certainly more inclusive. We are der designation is impossible for them. There are also limiting our ideas about what voices can do. also cisgender individuals who sing outside the If we begin by assuming these limitations, our expected ranges for their gender. We all know of expectations may not be serving all our students those cisgender women who sing tenor in their well. choirs for example. We have long accepted coun- VOLUME 23, ISSUE 3 Page 11

TAKING THE GENDER OUT, CONTINUED

We should keep in mind that there is no LORAINE SIMS, DMA, is Associate Professor/Vocal Studies right or wrong way to be cisgender, transgenderr, Division Chair at Louisiana State University in Baton Rouge. or non-binary. Your gender identity has nothing Recent performances include “Comedy in Song: Humorous Art Songs in English” for the 2016 National NATS Conference to do with how you present yourself to the world, and for the 2017 ICVT in Stockholm, Sweden. Professional or your sexual orientation. Then there can be no activities include a pre-conference workshop, “Teaching Out- right or wrong way to decide with what voice you side the Gender Binary: Working with Transgender and Non- Binary Singers” for the 2018 National NATS Conference in would like to sing. Removing the binary gender Las Vegas and a workshop, “What the Fach? Voice Dysphoria designation in voice classifications will allow all in the Transgender and Genderqueer Singer” for the Voice voices to be categorized regardless of gender iden- Foundation’s 2018 Annual Symposium: Care of the Profes- sional Voice in Philadelphia. Other presentations include tity or gender presentation. As voice teachers, “Training Transgender Singers for Opera Performance: Gen- when presented with any voice, we find solutions der Bending Beyond the Pants Role” for the 2017 NOA Con- ference, “Teaching Lucas: A Transgender Student’s Vocal to make the voice production free and easy and Journey from Soprano to Tenor” at the 2017 ICVT, the 2016 use all we know about respiration, phonation, res- National NOA/NATS conference, the 2016 National MTNA onation, articulation, cognition, and perception to Conference, and the 2016 National NATS Convention, and “Training the Terrible Tongue!” for the 2014 Chicago NATS guide our students. However, we still have work Chapter, and the 2012 National NATS Conference. Upcoming to do to make this singing world all-inclusive. presentations include a session at the national ACDA Confer- ence in Kansas City in 2019, “Honoring and Validating Transgender Singers in a Choral Context II: Healthy Vocal Pedagogy for Transgender Singers.” Dr. Sims is a past South- ern Region Governor of NATS as well as a member of NOA The interview with Lucia Lucas and Loraine Sims can be and MTNA. She enjoys giving master classes and her stu- seen at: https://youtu.be/YcDsVGXtnl8 dents have been winners in national and regional competi- Ibid. tions. There are several resources now available in addition to Voice and Communication Therapy for the Transgender/ Transsexual Client: A Comprehensive Clinical Guide by Adler, Hirsch, and Mordaunt. Loraine Sims’s article in the March/April 2017 NATS Journal, “Teaching Lucas: A Transgender Student’s Vocal Journey from Soprano to Tenor”, the Key of T website, https://keyoft.com/, man- aged by Ari Agha, a transgender amateur singer and re- search lead, and the book by Liz Jackson Hearn and Brian Kremer, The Singing Teacher's Guide to Transgender Voices are a few examples. The interview with Holden Madagame and Loraine Sims can be seen at: https://youtu.be/uja29wsuq-c . VOLUME 23, ISSUE 3 Page 12

WHAT DIALECT COACHING TAUGHT

ME ABOUT ACCENT MODIFICATION

BY KATE DEVORE, MA, CCC-SLP differences. I became a compe- I am both a theatre voice/speech/ tent but inexperienced voice, dialect coach and a speech- speech, and dialect coach. language pathologist specializing in voice and professional speak- Through a strange twist of fate, I ers. I started my training as an ended up going to grad school for actor. In my undergrad voice and speech pathology, with the sole speech classes I learned basic intention of enhancing my anatomy and physiology of toolbox for working with actors speech production. I learned and other professional voice us- about the articulators and how ers. In the middle of my first they moved. I learned narrow year, I was offered the oppor- transcription and used diacritics tunity to work with a private to notate dialects and accents. I client in need of accent modifica- KATE DEVORE, MA, CCC-SLP learned how each phoneme is cre- tion work.

ated and the terminology to de- Theatre voice, speech, dialect trainer scribe it. My training was largely I had learned literally nothing in SLP specializing in professional voice based on Edith Skinner’s phonet- my first semester of intro SLP Author Total Voice Inc. ic system, which differs slightly classes that was in any way ap- (www.TotalVoice.net) from IPA, but has the same plicable to accent modification. I Teacher School at Steppenwolf bones. I learned to listen to many also wanted the job so I thought, Columbia College Chicago accents and dialects, and analyze well, what CAN I do? I can ana- the myriad of ways they differ lyze his speech to determine from a Neutral American accent. what phonemes, placement, and Then I had the privilege of be- prosodic elements differ from a Voice of coming my mentor’s teaching as- Neutral American accent. That’s sistant, and I got to teach all those just like analyzing native speak- the things, thus deepening my ers of other accents or dialects to knowledge and understanding. I teach those dialects to actors. learned to teach people to under- Next, I can demonstrate and ex- Speech stand the differences between plain to him how to use his artic- their own speech and the target ulators differently to more close- Coach

dialect, and how to create those (Continued on page 13) T H E V O I C E Page 13

TALKING ABOUT BREATH ING… (CONTINUED)

I’m pleased to report that it went ry behaviors of various speakers. (Continued from page 12) well. It stands to reason that analyz- ing and practicing 50 other ac- ly approximate Neutral Ameri- There are some additional skills cents is helpful to my ear, my can. Just like teaching an Eng- possessed by dialect coaches that mouth, and my ability to under- lish speaker to produce the are also applicable to practicing stand the pathway from one to challenging phonemes of, say, a accent modification: the other. The more familiar I French accent. I can teach him am with how your mouth moves principles of intonation, stress, We are trained to listen to sound like you’re from Lon- and rhythm through reading, for nuance. Dialect coaches are don, the easier it is for me to re- various listening and repeating used to analyzing minutia of verse-engineer those movements tasks, and conversation. Much many dialects and accents in or- when someone from London like cementing an accent for a der to learn them well enough to wants to sound American. character in a play. And I can teach them. Quickly. globally help him speak with While most dialect more clarity and confidence, as Familiarity with teaching coaches do not have formal we do for actors. other accents gives us flexibility (Continued on page 14)

and understanding of articulato- T H E V O I C E Page 14

TALKING ABOUT BREATH ING… (CONTINUED)

(Continued from page 13)

training in motor learning theo- ry or Skinnerian approaches, we are well versed in behavior and its modifications. We come from the world of theatre, which holds advanced knowledge of experiential train- ing and manipulation of human behavior. That said, there is a definite uptick in speech and dialect teachers pursuing ad- vanced education and training in the more scientific aspects of goer is more likely to believe an ence) are able to sound 100% speech and learning. actor’s Brooklyn dialect than an American, most business clients Indian person’s Neutral Ameri- do not need or want that level of Finally, dialect coaches can - the bar is simply different work. possess the fundamental on-stage and off. It is also the knowledge that learning a new case that, for the most part, intel- In both fields the common goal accent is possible, and doesn’t ligibility trumps authenticity for remains: for people to listen to involve “losing” your own. stage dialects, so we might cheat what you are saying rather than a little bit. Therefore, for most how you are saying it. Just as we Of course, it’s much harder to accent modification clients the don’t want a manager’s accent to “fool a native” than an audi- goal is usually for the accent to interfere with content delivery in ence listening to an unfamiliar be a non-issue in terms of com- meetings, a performance that is dialect. Most speakers of dia- munication; few feel called to aim all about an accent, or calls at- lects of English find their theat- for a “perfect” version of Neutral tention to a dialect, is not the end rical portrayal to be sub-par. American. While some people goal. Likewise, the average theatre- (typically actors, in my experi-

Kate DeVore, MA, CCC-SLP, is a theatre voice, speech, and Columbia College Chicago, and lectures nationally and abroad. dialect trainer, an SLP specializing in professional voice, and She created the self-study iBook, “Accent Modification: Neutral author. She operates Total Voice Inc. in Chicago American Dialect”, is co-author of “The Voice Book: Caring For, (www.TotalVoice.net), where she coaches professional voice Protecting, and Improving Your Voice”, and co-creator of users ranging from actors to executives. She also coaches downloadable self-study materials for learning stage accent/ professionally, teaches at the School at Steppenwolf and dialects available through AccentHelp.com. VOLUME 23, ISSUE 3 Page 15

VOICE FOUNDATION NEWS 48TH ANNUAL SYMPOSIUM: CARE OF THE PROFESSI ONAL VOICE CHAIRMAN, ROBERT T. SATALOFF, MD, DMA,FACS M A Y 2 9 — JUNE 2, 2019 PHILADELPHIA PENNSYL VANIA

Wednesday, May 29 Saturday, June 1

Basic Science Tutorials Medical, SLP Session

Presentation Coaching Panels Accent Modification Coaching G. Paul Moore Lecture:

Vocal Master Class Thursday, May 30

Science Sessions Quintana Award Lecture Sing Along Keynote Speech - Peter Q. Pfordresher, PhD, Professor of Psychology with University at Buffalo, SUNY Grant Uhle Poster Session

Friday, May 31 Special Session: Moderator: Nancy P. Solomon, PhD Sunday, June 2 Young Laryngologists Study Group Vocal Workshops Medical Session

Panels

*Voices of Summer Gala* Voice Pedagogy Session

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THE VOICE FOUNDATION CHAIRMAN DIRECTORS Robert Thayer Sataloff, MD, Jean Abitbol, MD THE VOICE FOUNDATION DMA, FACS Martina Arroyo STAFF 219 N. Broad St. 10FL Mara Behlau PRESIDENT Harolyn Blackwell EXECUTIVE DIRECTOR, Philadelphia, PA 19107 Stuart Orsher, MD Claudia Catania THE VOICE FOUNDATION Simon Estes Maria Russo, MM (215) 735-7999 VICE-PRESIDENT Abdul-Latif Hamdan, MD Michael S. Benninger, MD Walt Hunter EXECUTIVE COORDINATOR fax: (215) 762-5572 Gwen S. Korovin, MD MANAGING EDITOR, SECRETARY Justice Sandra Newman JOURNAL OF VOICE voicefoundation.org Mary Hawkshaw Renata Scotto Katie Erikson, MM Michael Sheehan [email protected] TREASURER AND George Shirley [email protected] GENERAL COUNSEL Brian P. Flaherty, Esq. [email protected] [email protected] ADVISORY BOARD CHAIRMAN Michael M. Johns III, MD