Gender-Affirming Voice Care

Voice Therapy, Vocal Modification for Transgender and Gender-Diverse People

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Duke Health voice therapists are specially trained to offer evaluations and interventions for transgender and gender-diverse people who want to modify their voice. This includes people who experience vocal dysphoria -- displeasure with your voice and/or how it is perceived by others. By creating a personalized care plan, we help you optimize your vocal pitch, intonation, resonance, nonverbal communication, and more. We're here to help you align your voice with your gender identity and meet your functional voice needs without causing vocal strain or fatigue. 

Voice Evaluation

During your initial consultation, we take time to understand your personal and medical history and learn more about your vocal goals. We create a safe space for you to share your voice story. For your comfort and convenience, our gender-affirming voice therapists offer initial consultations in person or through virtual video visits

A videolaryngostroboscopy allows us to visualize your vocal cords (also known as vocal folds) and larynx (voice box) and determine whether they are strained or injured. During the exam, a voice therapist inserts a tiny camera attached to a small tube called an endoscope through your nose and into your upper throat. Your nose may be sprayed with topical anesthetic for your comfort. A flashing strobe light simulates slow motion video of your vocal cords, and images are recorded. After the exam, which only takes about a minute, a laryngologist and voice therapist will review the recorded images with you to determine a care plan, including voice therapy. 

If you prefer, we can arrange for you to undergo videolaryngostroboscopy during the same visit as your initial voice evaluation. If you choose a virtual visit for your initial consultation, this test will be performed during a follow-up, in-person visit.

Voice Therapy

During voice therapy sessions, our speech-language pathologists teach you strategies to access your authentic voice -- for example, changing your inflection, altering your resonance to achieve a darker or brighter vocal quality, or relaxing your throat to produce your most natural and desired sound. We also teach proper vocal hygiene, including hydration, avoiding throat clearing, and smoking cessation, to keep your voice healthy.

It may require only a few weekly or biweekly sessions to learn the basics of what you need to achieve your desired results. We are confident you can reach your voice goals by following your therapist’s expert guidance and consistently practicing what you learn. 

Call for an Appointment

Why Choose Duke

Speech-Language Pathologists with Gender-Affirming Training
Our specialized speech-language pathologists have completed additional training and continue to seek out education about gender-affirming care. We present locally and at national conferences and proudly work as allies with the trans community to share expertise on this topic. Membership within the World Professional Association of Transgender Health (WPATH) helps us to remain sensitive to the unique needs of transgender and gender-diverse people and to work to increase access to evidence-based health care and other vital services.

Team Approach
We work closely with the wider Duke gender care team, which includes experts in endocrinology, family medicine, plastic surgery, gynecology, dermatology, physical and occupational therapy, psychiatry, social work, and more. We meet monthly to review gender-affirming initiatives and strategies to serve gender-diverse clients at Duke and within the larger community.

Education and Social Support
We offer interactive webinars on voice modification, and our voice specialists moderate the Gender-Affirming Vocal Skills Virtual Group for transgender and gender-diverse adults. Participants can practice using their authentic voices in a safe and supportive setting.

LGBTQ+ Equality Leader

Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital are recognized as LGBTQ+ Healthcare Equality Leaders by the Human Rights Campaign Foundation and received perfect scores for providing patient-centered care, support services, and inclusive health insurance policies to LGBTQ+ people.

This page was medically reviewed on 05/03/2022