At the Washington University Transgender Center at St. Louis Children’s Hospital, we offer voice and speech therapy for teens and young adults who want to change their voice and way of speaking to better express their gender.

Experts in Voice Feminization and Voice Masculinization 

Speech-language pathologists at the Transgender Center are experts in both voice feminization and voice masculinization.

By teaching patients to use their voice muscles safely, speech-language therapists at the Transgender Center can help them change their voice without damaging their vocal cords.

But voice changes are only one part of changing verbal expression to bring it in line with gender identity. Our speech-language pathologists can also help patients change intonation, word choice, body language and other habits that are perceived as signs of gender.

How Transgender Voice and Speech Therapy Works

A personalized plan. Speech-language therapists at the Transgender Center work with each patient to develop a personalized plan. The plan typically includes an evaluation of the following, and strategies for modifying them as the patient desires:

  • Pitch: how high or low their voice sounds
  • Diction: their choice of words 
  • Resonance: the quality of the sound of their voice
  • Intonation: the rhythm of their speech
  • Speaking rate: how fast or how slowly they speak 
  • Volume: the loudness and variability of their voice
  • Speech sound production: how clearly they produce the sounds that make up words
  • Social communication habits: gestures, body language and aspects of social communication

Weekly therapy sessions. We typically find that frequent therapy sessions lead to the best results. While results depend on a variety of factors, including frequency of practice, most of our patients begin to see results within a few months. 

Exercises to do at home. After every session, we provide exercises to do at home. Voice and speech therapy requires regular practice — it isn’t a quick fix — so these exercises are an important part of the process.

What to Expect at Your First Visit

Each patient’s initial evaluation lasts about two hours, and includes the following:

  • A medical exam to check for healthy vocal cords
  • Review of any medical concerns 
  • Discussion of goals and expectations for treatment
  • Recommendations for breathing and posture 
  • Demonstration of exercises to do at home 

Can You Change Your Voice on Your Own? 

We don’t recommend trying to change your voice on your own. 

We typically see patients after they’ve unsuccessfully tried to raise or lower their pitch by themselves. 

Without guidance, many people strain their vocal cords when trying to change their pitch. The resulting damage can cause hoarseness or raspiness. We can safely help patients make changes that will improve their lives for years to come.

Why Choose the Transgender Center for Voice and Speech Therapy

Coordinated, comprehensive care: Speech-language pathologists work closely with other Transgender Center specialists to coordinate voice and speech therapy with other aspects of each patient’s transition. For example, we make sure that masculinizing voice and speech therapy is coordinated with testosterone therapy (a form of hormone therapy), which also plays a role in lowering the voice, if patients are undergoing both.

Help navigating insurance and payment: Health insurance plans don’t typically cover voice and speech therapy, but they do cover breathing issues. For that reason, we begin by focusing on breathing issues that can be addressed with voice and speech therapy. For patients who want further therapy, we figure out a payment plan that works for them. 

Patient-centered approach: From our initial evaluation, we focus on each patient’s goals and expectations. Each patient receives an individualized voice and communication treatment program that fits their individual needs.