To celebrate Transgender Awareness Week we catch up on a musical project here at Marjon which is helping trans women to find their voice.
Senior lecturer Gillie Stoneham says: "As a practicing speech and language therapist, my passion is to help where there is a degree of gender dysphoria, or distress, because voice and communication does not match a person’s perceived identity. For all of us, voice is a key part of our identity, expressing values, needs and emotions in social situations. For trans people, wanting help in developing a voice that reflects who they really are, and how they want to be seen by others, can be an important part of transition.
Although the majority of clients who seek voice and communication therapy are trans women, trans men and non binary people may also benefit from help in modifying voice for authentic gender expression. Voice therapy focuses on what the person needs in order to achieve gender comfort, for example, some may find it distressing to be mis-gendered on the phone, or to see someone do a ‘double-take’ when ordering a coffee. Many clients will develop strategies for coping, but where this strategy is avoiding talking altogether, life can become much less active and fulfilling.
For a trans man who is taking testosterone, the voice will automatically deepen in pitch, although help may still be sought to fully inhabit this ‘new’ voice through developing resonance and modifying expression. For a trans woman, developing a voice to match identity involves a much more complex and challenging journey. Feminising the voice is really hard work, requiring effort, daily exercises and time. People often need to work systematically for about a year on all aspects of using their voice, from pitch, resonance and intonation through to whatever social and work situations are important. Group work enables people to work together on specific situations that need, for example, assertiveness, voice projection and public speaking skills.
Thankfully we are moving to a more fluid notion of gender, which brings with it a much freer, richer expression of voice. Despite this, we still have stereotypes and assumptions about what a masculine or feminine voice sounds like and trans people’s expectations about how they should sound may be influenced by this. Through discussion and gentle challenge our clients are encouraged to find a voice and communication style that feels authentic and appropriate for them as an individual.
I know how much singing has helped my speaking voice, so I was curious to see how it could form part of our voice work with trans clients. With Marjon students and a choir director we set up a project with a group of ten trans women. We worked together over eight weeks, both singing as a choir and practicing spoken voice, with the project culminating in a performance. Clients reported that incorporating singing into a structured group increased their understanding of their own voice and its potential. The sense of camaraderie and group support fostered a positive attitude to learning and having a go, not just for the clients but for the students as well. Participants also reported an increase in self-efficacy and some developed the desire and confidence to join an inclusive community choir with the choir director of the project. The evidence base is still in its early stages, but this research has given us a platform for continuing to investigate the potential for singing as part of trans voice and communication work.
Service provision for transgender clients is currently uneven across the UK, despite the significant increase in referral rates, with some trusts not even agreeing to commission a service. I am part of a group of specialist speech and language therapists providing recommendations for an agreed service specification to the commissioners. This will recommend a specialist speech and language therapist as part of every Gender Identity Clinic in the UK, to coordinate a provision that is both equitable and also provided by therapists with the right knowledge and skills. The work we are carrying out demonstrates the crucial role we have in supporting trans people to find their voices."
Gillie Stoneham is a Senior Lecturer on the BSC Speech & Language Therapy degree at The University of St Mark & St John.
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