Areas of Practice

Gender Transition and Speech/Voice Therapy

During gender transition, finding your new voice is a voyage of discovery. It involves learning about the possibilities, making choices that feel right for you, and practicing to make the changes habitual. There is no denying—this takes time and work. It is easier for some people than others. But as speech is the main way we express ourselves, it is important that the voice matches the person within.

Most experts would agree that the main distinguishing characteristic between male and female speech is the pitch of the voice. Voice therapy can be useful in safely raising/lowering the average speaking pitch. However there is much more to speech/voice change than just pitch, and addressing other aspects of speech can have a profound effect on how well the speaker passes. Speech characteristics like vocal inflections (how the voice moves up and down in speech), voice quality, vocal resonance, and even how the consonants are produced can give powerful cues about the speaker’s gender.

For more information on changing speech in gender transition, go to the Transgender Health Information Program of BC’s website: Transgender Health Information Program – Resources – Consumer Information – Changing Speech.

The best time to begin voice therapy is when you are living most or all the time in your desired gender or are gender-neutral. This allows you to transfer the new habits immediately into your everyday life and gives many more opportunities for practice. Voice feminization therapy can take place privately or in a small group therapy program. At the moment, voice masculinization is offered only in private sessions.

Speech/voice assessment

This is a complete evaluation of your speech and voice production habits. It includes an assessment of:

  • average speaking pitch
  • speaking pitch range and inflectional contours
  • voice quality
  • gender-related communication characteristics

We will discuss:

  • how speech and voice are produced
  • differences between men and women’s voice production systems
  • masculine/feminine characteristics of speech, voice and communication
  • what feels best for your own communication style
  • surgical options for elevating vocal pitch

Speech/voice therapy

People wishing speech and voice feminization training have 2 options: attending private sessions or joining a group program called Changing Keys. This is a free voice feminization program for transgender women offered by the Transgender Health Information Program of BC. For information go to:

Your role

During speech/voice therapy, regular daily practice is very important. You will be given an exercise program to help your vocal system adapt to the changes. You will also begin to use your new speech and voice every day in real life situations. This gives you a chance to practice, experiment, and gain confidence while you have the support of the therapy program.

In my experience, the length of time in speech/voice therapy varies widely but is measured in weeks/months rather than years. Some people prefer to have their sessions spaced out over 3 or 4 months, to give them time to practice and adjust to the new habits. Others like weekly input so they can progress more rapidly. There is no one way—whatever works best for each person is the right thing to do.


Contact Shelagh for current fees. Extended medical benefits may cover some or all of the cost—you should check your plan for details under ‘speech therapy’ or ‘speech-language pathology’.