Voice Training Is a Medical Necessity for Many Transgender People

Customer service is something we all dread. We are trying to speak with a real person by navigating a maze of voice commands. It isn't for everyone, but for some it is a relief.

The customer service agent can make a decision within seconds to describe the caller assir orma'am based on the pitch of the person's voice. When a person is misgendered, the language they use can be distressing.

We may put a person at greater risk for depression and suicide if we don't affirm their identity. The quality of life for members of the trans community can be affected by someone's voice.

I am a doctor and activist. My research shows that there are two ways in which we can support people who have voice and gender identities that don't match. First, small changes in language can make cisgender people more sensitive and accurate in their descriptions of gender. Second, surgical and non-surgical gender-affirming voice interventions can be effective in medical care and give people a valuable tool to express their gender.

Many people perceive certain vocal characteristics to be either male or female. High pitch and vocal resonance from the face and mouth are associated with a feminine identity. Many people think low pitch and resonance from the throat and chest is feminine.

Voice perception can be visualized in the brain. The voices of men and women appear to be processed in different brain areas. Listeners show different brain activity when people are unsure about a speaker's gender.

People have long-standing beliefs about voice and gender that are reflected in their perception. The ability to describe voices that are more gender ambiguous or intermediate is limited due to the fact that many people have been taught that gender is only a pair of genders. Some people are more likely to identify other people with similar voices.

The research shows that assumptions about voice and gender are not always correct. Just because scientists can see these associations in the brain doesn't mean they're un changeable. It is possible to unlearn or relearn learned behaviors. There are ways to change people's opinions about genders.

We published a study in the Journal of Speech, Language, and Hearing Research looking at how language affects gender perception when hearing someone's voice for the first time. A group of people are repeating a range of short words. 105 people of diverse genders from across the U.S. listened to the recordings and rated the gender of the speaker. The gender of a speaker's voice could be influenced by the terms used in the scales. A scale that included both male and female options resulted in more extreme results. The results were better for people with an ambiguous or intermediate gender if they were ranked closer to the center. It is important for language to recognize that many people lie outside the gender binaries. Our work shows how a small change in language can help reduce the chances of being misgendered.

There are surgical and non- surgical interventions that can help a person change their vocal characteristics to match their gender identity. Voice training is less expensive than surgery and can be used to explore one's voice expression. Trans people learn to control their voices through weekly speech therapy sessions. Two of the most important indicators of how people perceive gender from voice are vocal pitch and resonance.

Most people who go through this training are happy with their results. Quality of life, voice-related disability, and self-confidence can all be improved by such training.

Many public and private health care insurers don't cover voice training or surgical options for trans people. Several U.S. states are trying to ban gender-affirming health care for trans adolescents. Tens of thousands of people don't have access to speech-language pathologist and surgeons. Many in the trans community pursue self-training at home without professional supervision, which increases their risk of learning harmful speech patterns.

Insurers should be reimbursable for gender-affirming surgeries and voice training. These interventions save lives.

Everyone can benefit from acknowledging different ways of expressing gender. Creating affordable, accessible avenues for the trans community to explore their identities is part of the effort. We can all try to be aware of the words we use for each other.