Professional Documents
Culture Documents
Transgender Voice Presentation
Transgender Voice Presentation
Christopher Donoso
GMSL 6525
November 2017
ASHA Code of Ethics
(Sataloff, 2017)
Trans Female :Voice
Feminization
Thyrohyoid Approximation
Suspends the thyroid cartilage
to the hyoid bone and narrows
the resonance tube
Alters resonance
No known changes in pitch
LeJeune Anterior Commissure
Advancement
Pulls the vocal fold forward
Results a in a prominence on
the thyroid cartilage
Scar Formation
Use to be done
Not Recommended
Causes stiffness & hoarsness
Can result in additional
problems
(Sataloff, 2017)
Trans Female :Voice
Feminization Cont.
Abitbol Thyroarytenoid
Myectomy
Removal of muscle mass
Reduced VF mass
Increased pitch
Breathy but clear vocal quality
VF Web Formation
Shortening of the vibratory
length
Reduced mass during vibration
Increased stiffness
Increased pitch
(Sataloff, 2017)
Trans Female: Therapy
Physical exam from the
doctor or ENT should always
be done prior to therapy
Ensure the vocal tract is intact
before doing anything
If something is found during
therapy (i.e., scaring, nodules,
etc.), fingers may get pointed
towards you.
Outing when baritone
voicing emerges during
moments of surprise, sleep
talking, high emotions, etc.
(Sataloff, 2017).
(Dacakis, 2017)
Trans Male: Transition
Hormone: Testosterone
Dosage and frequency vary on
drug type, individual, and
prescription site.
Results in altered resonance
May or may not result in a
lowered F0
In some cases, testosterone
lowers the voice on its own,
but this is NOT the case for
every patient (Hancock, 2017).
Some pathologies aid in
lowering pitch
Polyps (good)
Scarring (bad)
Trans Male: Therapy
Physical exam from the
doctor or ENT should
always be done prior to
therapy
Bindings around chest to
make the breast more
discreet but negatively
effect respiration.
Hunched
posturer/rounding of
shoulders
Restricted chest movement
(Ziengler, 2017)
Gender Fluid or Gender
Nonconforming
Gender Fluid/Gender
Nonconforming
A person who does not
associate themselves with a
specific gender.
May jump between
presenting with more male
qualities to showing more
female qualities.
Voice Goals should target
what the patient wishes to
sound like.
Typically desire a wider
pitch range.
Speech-Language Pathologist
and Transgender Patients
Consultation prior to transitioning is ideal
What does the patient want their voice to sound like?
Have they started transitioning/When do they plan on transitioning?
What levels of hormonal drugs are they taking/want to take?
High dosage = faster changes = less vocal control
Lower dosage = slower changes = more vocal control
What is their voice typically used for?
Do they require their voice to work?
May be best to utilize a lower dosage for reduced chances of vocal
misuse/abuse.
Age effects the voice
Ossification of laryngeal cartilage
Better to transition at a younger age
Less chance of complications
Ossification begins after 40 yr. and increases by 60 yrs. (Sataloff, 2017)
(Ziengler, 2017)
Transgender Speech Therapy
Client centered goals
Referral source
Patients gender identity
Preferred name and pronoun
Phonetogram
Dynamic range of patients voice
Perceptual measures
How do you think you sound?
When you think, do you hear a male/female voice?
Support for transition process
Family/Friends/Employer
(Dacakis, 2017)
Transgender Speech Therapy
Evaluation & Goals
Voice Sample (Decakis, 2017)
Sustained /a/ and /i/
Reading standardized passage
Rainbow Passage / Caterpillar Passage
Read in your best male/female voice.
Targets (Oates, 2017; Sataloff, 2017)
Pitch
Prosody
Resonance
Pragmatics
Articulation
Vocabulary
Gender Congruence Scale
Strongly agree Somewhat Agree Somewhat Disagree
Strongly Agree Neither Agree nor Disagree
Please Indicate the response that best describes our experience
over the past two weeks.
1. My outward appearance represents my gender identity.
2. I experience a sense of unity between my gender identity
and my body.
3. I do not feel that my appearance reflects my gender
identity.
4. I am generally comfortable with how others perceive my
gender identity when they look at me.
(Dacakis, 2017)
References
American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from
www.asha.org/ policy
Bodoin, E. M., Byrd, C. T., & Adler, R. K. (2014). The Clinical Profile of the Male-to-Female Transgender
Person of the 21st Century. Contemporary Issues In Communication Science & Disorders, 4139-54.
Dacakis, Georgia. Evaluating Transgender Voice and Communication. 30th Annual Voice Foundation
Annual Symposium, 2 June 2017, The Westin Hotel, 99 South 17th St., IN. Keynote Address.
Hancock, Adrienne. Current Perspective and Future Directions for Transgender Voice Care. 30th Annual
Voice Foundation Annual Symposium, 2 June 2017, The Westin Hotel, 99 South 17th St., IN. Keynote
Address.
Hembree, Wylie. Managing Gender Dysphoria: From Childhood to Old Age. 30th Annual Voice
Foundation Annual Symposium, 2 June 2017, The Westin Hotel, 99 South 17th St., IN. Keynote Address.
Oates, Jennifer. Selecting Targets for Transgender Voice and Communication Training. 30th Annual Voice
Foundation Annual Symposium, 2 June 2017, The Westin Hotel, 99 South 17th St., IN. Keynote Address.
Sataloff, Robert. Surgical Considerations for Voice Feminization. 30th Annual Voice Foundation Annual
Symposium, 2 June 2017, The Westin Hotel, 99 South 17th St., IN. Keynote Address.
Soloman P., Nancy. Care of the Transgender Voice: Historical Context. 30th Annual Voice Foundation
Annual Symposium, 2 June 2017, The Westin Hotel, 99 South 17th St., IN. Keynote Address.
Wylie, K., Barrett, J., Besser, M., Bouman, W. P., Bridgman, M., Clayton, A., & ... Thornton, J. (2014). Good
Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria. Sexual &
Relationship Therapy, 29(2), 154-214. doi:10.1080/14681994.2014.883353
Wylie, K., Knudson, G., Khan, S. I., Bonierbale, M., Watanyusakul, S., & Baral, S. (2016). Series: Serving
transgender people: clinical care considerations and service delivery models in transgender health. The
Lancet, 388401-411. doi:10.1016/S0140-6736(16)00682-6
Ziegler, Aaron. Voice Training in Trans Men: How to Facilitate the Transition of a Changing Voice. 30th
Annual Voice Foundation Annual Symposium, 2 June 2017, The Academy of Vocal Arts, 19200 Spruce St.,
IN. Keynote Address.