In recent years, the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has gained more recognition, understanding, and acceptance in today’s society. At present, there are approximately 1.4 million people in the United States who identify as transgender (Flores, Herman, Gates & Brown, 2016). The word “Transgender” is an umbrella term for individuals who consider their gender identity, sex, and/or gender expression to be different from their natal sex as dictated by chromosomes and sex organs (Hancock, Colton & Douglas, 2014). In order for one to live comfortably as their affirmed gender and/or sex, and achieve congruence between gender identity and gender expression, individuals may undergo a series of treatments and therapies, such as hormone replacement therapy, psychotherapy, voice therapy, and surgery during the transitional process (Teich, 2012).
While an individual may elect to change their physical appearance to match their affirmed gender, another integral part of one’s identity, specifically gender identity, is voice. This is because voice is an important characteristic of who we are as individuals. It is vital for self-expression, communication with others, and it affects how others perceive us (Schwarz et al., 2017). Studies have shown that one’s satisfaction with their voice is important for many reasons – it can improve mental health and quality of life, and reduce gender dysphoria (Morrison et al., 2017). In fact, one’s self-perception of voice can have a remarkable psychological impact on transgender persons (Bultynck et al., 2017). This can be shown through substantial evidence that demonstrates a significant correlation between voice-related quality of life (QoL) and speaker’s self-rated perception of voice. It has also been noted that there is a correlation between QoL and how other individuals perceive their voice (Hancock, Krissinger, & Owen, 2011). Transgender individuals who are not satisfied with their voice, or feel that their voice does not match their affirmed gender, have reported that their voices restrict their ability to successfully and completely integrate into society (Hancock, 2017). This research demonstrates the importance of achieving a sex-appropriate and authentic voice for transgender individuals, and exhibits how crucial it is for one’s quality of life (McNeill, 2006).
Transgender women are more likely to seek treatments and therapies in attempt to achieve their desired voice than transgender men. While hormones, such as testosterone, can alter the voice of transgender males and lower their pitch to what would be perceived as a biological male’s voice, this therapy is not effective in modifying the voice of transgender women (CITATION). This is why many may seek professional treatment in attempt to change their voice. These treatments may include surgical procedures including: laryngoplasty with or without thyroid approximation, Wendler glottoplasty, cricothyroid approximation, laser glottoplasty reduction, and vocal fold shortening and retrodisplacement of the anterior commissure.
While studies have shown that these surgical procedures display an immediate increase in transgender women’s fundamental frequency (F0), also known as pitch, there is no evidence stating which surgical technique is superior for vocal treatment (Schwarz et al., 2017). It is also noted that these procedures are not done without risks (Morrison et al., 2017) and further research must be conducted on the long-term results of patient satisfaction, and possible side effects of these types of pitch-raising surgeries (Van Damme, 2017). Other possible factors to regard when an individual is considering a voice procedure are the costs, the lack of accessibility to surgical specialists, and other non-invasive options, such as voice and communication therapy.
An effective non-surgical intervention to acquire an authentic voice that is congruent with one’s affirmed gender is voice and communication therapy (Morrison et al., 2017). This treatment has been found to be effective with both adults and adolescents. However, the current research is limited and will need to be looked into further (Hancock & Helenius, 2012). nonsurgical options, such as voice modification should be carefully considered.