For transgender people, a voice can be more than just speech, and it can shape how they are heard, seen, and understood by the world.
In this episode of Translucent, Lee Wade talks with a local speech therapist about the importance of voice in transgender lives.
This transcript has been lightly edited for length and clarity.
Wade: Today we're talking about something many of us use every day: our voice. I'm a trans man and I've been on testosterone for about six years now, and my voice hasn't really dropped. I still deal with voice dysphoria. And I still get misgendered just from how I sound. So I know firsthand how complicated and emotional this can be. For a lot of transgender, non-binary, and even gender non-conforming people, finding a voice that actually feels like you can be one of the hardest parts of gender expression and one of biggest sources of dysphoria.
To help us understand how voice therapy fits into gender-affirming care, I'm joined by Marissa Nguyen. She's a speech-language pathologist based in Dayton who specializes in voice and swallowing rehabilitation, including gender-affirming voice therapy. She sees every day how important voice can be in someone's transition.
Nguyen: It can be very debilitating for people to not have the voice that they are looking for that matches with who they are as a person. With the vocal exercises we are doing, we are physically changing the way that the muscles are working. So think of it like physical therapy, for example. That's considered health care because we are rehabilitating the muscles. We are helping train and learn a new skill.
I see it a lot where after a few sessions, patients are coming in and they're like, "Wow, I practice these things at home and I'm seeing a difference."
Wade: Nguyen says voice isn't just about sound. It's tied to identity, safety, and well-being. For some people, feeling disconnected from their voice can lead to anxiety or depression.
Nguyen: The mental health and well-being, that is something that we see so commonly connected to voice and a lot of times we do encourage people going through gender-affirming voice therapy or other types of voice therapy, hey, if this is really taking a toll on your confidence or if you are having anxiety, depression just because of the way your voice sounds, you can have that dysphoria to your voice. That definitely impacts your mental health and it's something that is super important to get counseling through as well. So we will often say, "Hey, we're going to do voice therapy, but because of these feelings that you're also having, having a counselor can be super helpful to help you work through these things."
Wade: Nguyen says hormones also shape what's possible. Estrogen won't change the vocal cords, so transfeminine and some non-binary patients rely on therapy to reach a higher pitch. Testosterone, in contrast, thickens the vocal chords and often lowers the voice on its own. No matter the goal, Nguyen says most people can learn to shape their voice into something that feels more like them.
Nguyen: I see it a lot where after a few sessions, patients are coming in and they're like, "Wow, I practice these things at home and I'm seeing a difference." I have seen a lot of patients have a complete 180 flip of, "Wow I feel really good about my voice. I don't think I need you anymore. I think I know what I need to do." And they gain that confidence.
Pitch is not everything when it comes to our voice.
Wade: Most people work with Nguyen for around four sessions total. Nguyen teaches patients how to work with three systems of the voice: breath support, vocal cords, and resonance, the part that shapes the quality of the sound.
Nguyen: Pitch is not everything when it comes to our voice. Resonance, that filter, also plays a big role. So we will work with people a lot of times on resonance and also articulation. For example, my transfeminine-leaning patients, they might want something that's a little lighter or brighter that allows them to be perceived as more feminine.
Wade: During our session, she walked me through some of the same exercises she gives her patients.
Nguyen: First thing I would have you do, if you're looking for a little more bass in your voice, I would first just have you at your comfortable pitch that you've been speaking to me in, go ahead and just briefly hold out and, "ahhhh."
Wade: Ahhhhhh.
Nguyen: Think of that like you're holding your vocal chords in a plank position or a wall sit where it is forcing them to stay in one posture or position and just vibrate. I want you to do a hum. Think of like a "Papa Bear" voice, lots of space in the back of the throat and the back the mouth. And we're gonna do a, "hmmmmmmmm." Go ahead and try that and think lots of space on the back of the throat.
Wade: Hmmmmmmmm.
Nguyen: So, starting with a hum as a little primer. So, "hmmmmmmm," and then leading into saying things that you would normally say in your day. So for me, maybe like a, "Hmm, hi, how are you?" And carrying that over, go ahead and try that.
Wade: Hmm, hi, my name is Lee.
Nguyen: Yeah, exactly like that. So that's the beauty of voice is that we talk all day long. These are all opportunities every time we're talking to alter the way our voice sounds.
Wade: Thank you Marissa Nguyen for helping us better understand voice therapy. I'm Lee Wade, and thank you for listening to Translucent.
This story was produced at the Eichelberger Center for Community Voices at WYSO. Translucent is made possible with support from The Rubi Girls Foundation and Square One Salon.