Goals of Voice Therapy Support Site Mission Statements

• One of the most daunting obstacles is http://www.youthpride.org achieving an acceptable voice, “YouthPride, a 501(c)3 non-profit particularly during the male to female organization, creates positive change in transition the lives of lesbian, gay, bisexual, • For the MtF population, it has been transgender, and questioning youth

demonstrated that voice alone has a through education, outreach, support services, community activities, and Transgender negative impact upon a person’s advocacy. “ perceived femininity, while physical

appearance bestows a positive impact www.thepointfoundation.org Voice Therapy

• Therapy should focus upon a variety of “Point Foundation provides financial , language, and pragmatic support, mentoring, leadership training

functioning as they relate to gender and hope to meritorious students who are marginalized due to sexual Voice Characteristics orientation, gender identity or gender expression.” • Dividing line for male versus female

voice perception is approximately 155- www.glad.org 160 Hz “Celebrating 30 years as New England's leading legal rights organization Voices pitched higher than 160 Hz • dedicated to ending discrimination based typicallyare perceived as female, and on sexual orientation, HIV status and

voices pitched less than 155 Hz usually gender identity and expression.” are perceived as male A guide to voice www.nctequality.org (American Speech Language Hearing Association, 2009; therapy for the Andrews, 1995, Case, 1996, Colton & Casper, 1990, Oates & “Dedicated to advancing the equality of Dacakis, 1993, Wiltshire, 1995: cited by King, Lindstedt, Jensen & Law, 1999; Berger, 1988; Neumann & Welzel, 2004; Sorensen transgender people through advocacy, transgender and Horii, 1983 as cited by Van Borsel, De Cuypere, Rubens & collaboration and empowerment.” Destaerke, 2000Spencer, 1988 cited by Brown, Perry, Cheesman individual & Pring, 2000; Stemple, Glaze & Klaben, 2000; Van Borsel, De Cuypere & den Berghe, 2001)

FtM Surgical Options Voice Therapy Options

• Intake of testosterone during FtM • Acoustically, voice therapy can • Surgery modulates automatic hormone therapy increases the mass of increase formant frequencies and functions, such as sneezing, coughing,

the vocal folds, and thus, results in a pitch into the female range and throat-clearing lower pitched voice • 3 goals • The effects of testosterone on the voice • SLP should ensure that the – Increase tension

may become apparent as soon as six to transgender client does not produce – Alter consistency effortful speech and place a large 12 weeks after the first injection, or as – Decrease the mass of the vocal late as several months later amount of tension upon the . folds.

• 14 out of 16 FtM transgender clients This type of speech is characteristic of • Types both adductor reported that they were satisfied with – Cricothyroid approximation, their vocal changes as a result of and vocal nodules, and has been also known as type IV

hormone therapy, while the other two observed to occur in MTF transgender thryroplasty clients participants did not report a change due – Anterior commissure to previously low-pitched and acceptable advancement • Transgender clients are generally voices – Scarification satisfied with their voice following – Injection of triamcinolone into voice therapy, although while rating MtF vocal folds their voice on the Voice Handicap – Endoscopic vocal fold • Intake of the female hormone estrogen Index (VHI), a mild voice handicap shortening does not produce any discernable effects remains • Intended to both upon the vocal folds • Gelfer (1999) designed a more rigid shorten the vocal folds and reduce their • Many MtF transgender clients seek a course of treatment for transgender combination of voice therapy and/or voice clients focusing solely upon vibrating mass

surgery. establishing an acceptable pitch level (Adler, Hirsch & Mordaunt, 2006 as cited by Pickering & across all levels of speech Kayajian, 2009; Gross, 1999 Neumann & Welzel, 2004) (King, Lindstedt, Jensen & Law, 1999; Kuiper, Asscheman & Gooren, 1992, Damsté, 1964, as cited by Van Borsel, De Cuypere, (Gorham-Rowan & Morris, 2006; McNeill, Wilson, Clark & Rubens & Destaerke, 2000; Money & Walker, 1977 as cited by Deakin, 2008;) Brown, Perry, Cheesman & Pring, 2000)