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Therapy has been shown to be effective in voice feminization, and the modification of certain voice characteristics, such as fundamental frequency and voice resonance , can help in that effect.


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Fundamental frequency, also called pitch, was initially thought to be the characteristic most effective in voice feminization. Raising the fundamental frequency can help towards voice feminization. However, each person might have different perspectives regarding speech and voice, and therefore the salient characteristics, and their relative impact towards femininity, can vary from person to person, and many clients are not satisfied with only a change in fundamental frequency. What is considered a feminine or a masculine voice varies depending on age, region, and cultural norms. Other characteristics that have been explored include intonation patterns, loudness, speech rate, speech-sound articulation and duration.

Eva: transgender voice-training app helps women and men talk the talk

Voice modifications for transgender males typically involve the lowering of the speaking fundamental frequency. A speech-language pathologist SLP may be involved in aiding the female-to-male client achieve their desired voice goals, while usually prioritizing the overall health of the voice. While hormone replacement therapy and gender reassignment surgery can cause a more feminine outward appearance for trans women, they do little to alter the pitch of the voice or to make the voice sound more feminine. Usually, trans women consider vocal surgery when they feel dissatisfied with voice therapy results, or when they want a more authentic sounding female voice.

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However, it is important to note that vocal surgery alone may not produce a voice that sounds completely feminine, and voice therapy may still be needed. A positive effect of surgery can be protecting the voice from damage due to the strain of constantly elevating pitch while speaking.

Because of the risks, vocal surgery is often considered a last resort after vocal therapy has been pursued. As for trans men, it is generally presumed that hormone therapy does successfully masculinize the voice and lower vocal pitch.


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    4. Although it is far less common, surgery to lower vocal pitch does exist, and may be considered if traditional hormone therapy did not adequately lower it. Medialization laryngoplasty or masculinization laryngoplasty is a procedure where the vocal fold contours are medially augmented with the injection of silastic implants.

    This mimics the changes that the vocal folds go through during male puberty, which causes a lower sounding voice. Therapy may take place in an individual or group setting. The most common focus in transgender voice therapy is pitch raising or lowering; however, other gender markers may be more important for the client to work on. In a review of speech literature, Davies and Goldberg were unable to find any clear protocols for treating the female to male transgender man voice.

    Based on the protocols they found for treating the male to female transgender woman voice, they proposed the following therapeutic techniques for both voice feminization and masculinization: [4]. While there is some evidence for the effectiveness of voice therapy for transgender people, it is still weak.

    The most common concern for male-to-female transgender individuals is their pitch and speaking fundamental frequency SFF the average frequency produced in a connected speech sample because they typically perceive a feminine voice as using a higher pitch. Although pitch is the not the most essential element of voice change for these individuals, it is necessary to raise the SFF to a gender appropriate pitch to help with vocal feminization. The first step in therapy is determining the habitual speaking fundamental frequency of the individual using an acoustic analyzing program.

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    Then the therapist and the individual determine what the target pitch should be, based on the gender acceptable range for cis women i. When therapy begins, they establish a starting frequency to work on, that is slightly above the client's SFF. Progression moves from using the target pitch in a sustained vowel to using it in a minute conversation. Semi-occluded vocal tract SOVT techniques may be used to facilitate voice production in the higher pitch range. There are two exercises that are often used: producing a pitch glide that goes from the middle of the pitch range to the upper pitch range; and a messa di voce exercise , where the voice goes from soft to loud to soft again.

    SOVT techniques have the individual prolong their voice at a higher pitch, which may help make voice production at a higher, non-habitual pitch easier and more efficient. Pitch can also be altered through voice resonance modification. The length of the vocal tract affects the resonance of the vocal tract, which in turns affects the pitch. Transgender women can use techniques, such as retracting the lips, to shorten the vocal tract and sound more feminine.