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Gender-Affirming Voice Training

Our voice and communication style plays an integral role in how we perceive and express our identity. Regardless of an individual’s unique gender identity, attaining a voice that is truly congruent and aligned with their authentic self is critical for overall well-being, happiness, and confidence.

For some transgender individuals, their voice may not align with their gender identity and gender expression, causing possible feelings of discomfort or dysphoria. This can affect a person’s quality of life, self-esteem, and fear of being misgendered.

While not all transgender individuals may wish to modify their voice, gender-affirming voice training can help those that do. In this article, we’re going to answer frequently asked questions about gender-affirming voice training, and discuss how working with a speech-language pathologist, specializing in gender diverse voice can help individuals discover and develop their desired vocal qualities and communication style.


This article was authored by Heather Gross, M.S. CCC-SLP, a speech-language pathologist and voice specialist with extensive experience working with gender diverse speakers and singers.

What is Gender-Affirming Voice Training?

Gender-affirming voice training, which you may sometimes hear referred to as a type of voice therapy or transgender voice modification, is a non-surgical intervention used to modify the gendered aspects of a person’s voice. The voice specialist and client will often work together to explore the client’s identity and explore a variety of vocal characteristics to more closely align their voice and their identity.

Gender-affirming voice training consists of a series of individualized sessions geared towards helping gender diverse individuals explore their authentic voice and communication. Helping a gender diverse individual find their true voice may consist of adjusting resonance, pitch, intonation, nonverbal communication, syntactical choices, vocal quality, and more.

Individuals across the entire gender spectrum, including transfeminine, transmasculine, non-binary, gender non-conforming, genderqueer, bi-gender, agender, cisgender, and more, may elect to participate in voice training.

Training is completely dependent on each individual's needs and communication goals. Speech-language pathologists with a specialization in gender-affirming voice training can help clients explore vocal characteristics in a safe and effective way. These speech therapists, in addition to having a high level of experience and expertise, offer a unique understanding of voice physiology, vocal hygiene to safely modify the voice, and coaching to provide a whole person, holistic approach. They are lifelong learners in working to become more culturally competent in working with this population.

How Does Hormone Replacement Therapy Affect a Person’s Voice?

According to the National Center for Transgender Equality , voice treatment is the second most common intervention received by transgender individuals assigned male at birth. This is largely because testosterone and estrogen as a form of hormone replacement therapy (HRT) generally have a different effect on the pitch of someone’s voice. For transgender men who elect to use testosterone, this can have a masculizing effect on their voice. When testosterone is used over time, it can thicken the vocal cords resulting in a deepening pitch of the voice to gender-affirming levels. However, estrogen often has no significant impact on the pitch of someone’s voice. Voice and communication training has been shown to result in gains in areas important to listeners’ perception of gender (Hancock & Garabedian, 2012). Even more importantly, it has been shown to increase reported quality of life, happiness, contentment, confidence, and ability to find authenticity.

In a study on the effects of testosterone on the transgender male voice, research showed the largest drop in fundamental frequency, or pitch during the first 2-5 months of hormone replacement therapy (Irwig, Childs & Hancock). Since the onset and duration of voice deepening varies considerably, transgender males may elect to work with a voice specialist to modify their voice further to include deepening the resonance, rounding the vowels, and modifying intonation, volume, and articulation. Gender affirming voice training has been shown to help individuals across the entire gender spectrum safely modify their voice to more closely align their voice with their identity.

What are the Aspects of Communication that Can be Modified?

Gender affirming voice training can include a wide variety of vocal and communication aspects including pitch, resonance, intonation, articulation, nonverbal communication, language and vocabulary use. This does not mean that all males should speak one way, and all females should speak another. It simply means there’s a wide range of feminine and masculine vocal qualities; behavioral voice change is intended to help you find the ideal range that feels most natural to your authentic self. Each session is individualized to your unique goals. Your voice specialist will only target those areas which feel authentic to you.

Working with a speech-language therapist specializing in voice modification, there are many aspects of your verbal and non-verbal communication that can be explored to better align your voice and identity. These may include:

  • Pitch: How high or low your voice sounds, which is impacted by the number of vibrations your vocal cords produce
  • Resonance: The quality of the sound your voice makes
  • Intonation: How the voice rises and falls during speech. In other words, the melodic or rhythmic quality of your voice
  • Rate of Speech: How quickly or slowly you talk
  • Volume: How loud or soft your voice sounds
  • Nonverbal Vocalizations: Sounds you produce that aren’t speech, such as laughing or coughing

In addition to voice qualities, there are other components of your communication that you may wish to alter. These can include how clearly you articulate certain sounds or words, your vocabulary and word choice, and certain social pragmatics that you follow during conversational exchanges.

Why Professional Guidance is Recommended

It is important to seek care from a specialist in the area of gender affirming voice care as modifying your voice can be vocally fatiguing. Vocal health and hygiene is an important consideration for anyone seeking to change aspects of their voice. For many beginning their voice transformational journey, there may be a perception that simply adjusting the pitch or volume of one’s voice will help them sound more feminine or masculine. This is not necessarily true. A certified speech-language pathologist can provide techniques and warm ups to prevent vocal fatigue or strain and to help you find a voice you can use for a whole lifetime! A certified voice therapist can help you find your voice in a healthy, safe, and productive way.

What Does Gender-Affirming Vocal Training Involve and Look Like?

When working with a speech-language pathologist that specializes in gender-affirming vocal training, the first step is an intake or assessment. This assessment seeks to uncover your existing communication profile, and establish your voice and communication goals.

An assessment may include several different components including:

  • Examination of Oral-Motor Skills: Oral-motor functioning is how the muscles in your face and throat, including your lips, jaw, and tongue, coordinate movement to produce speech. Your speech therapist may begin by examining this coordination to see how these muscles work together to produce desired sounds.
  • Voice Evaluation: Your speech therapist may use a variety of tests and exercises to examine your current voice profile. This includes your voice’s existing pitch and pitch range, intonation, volume, resonance, intensity, and more. This also includes your respiration and breathing habits which affect the “power” beyond your voice.
  • Communication Skills: In addition to your voice, there are many other verbal and nonverbal communication behaviors that we exhibit during conversation. This style of communication can be adjusted to take on more feminine or masculine qualities.
  • Goals: Gender-affirming vocal training will look different for every individual. This is because your existing vocal profile, and desired outcome are all factors that will be used in developing a unique training program tailored to your needs. Your speech therapists will take the time to clearly understand your goals and the desired voice and communication style that best match your identity.

What is Expressable’s Approach to Gender Affirming Voice?

Our voice specialists use a holistic, whole-person approach to gender-affirming voice training. Our unique approach allows space for our clinical work to integrate with the human we are serving, covering many aspects of voice and communication. Your therapist will never tell you what to do or how to be, but will simply present information and help you explore aspects that may align with your identity in a safe and supportive environment. This approach encompasses traditional voice therapy to ensure vocal health and vocal hygiene, voice physiology, coaching and mindfulness to explore your unique identity and to begin to visualize your authentic self, and to help you find happiness and confidence in who you are. Gender identity refers to your internal sense of self, your internal knowledge of your gender. It’s in your heart. It must be explored with great sensitivity and care.

Talk with a certified therapist today.

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