Voice and Speech Therapy

Transgender Voice, Speech, and Communication

Sara Schneider, MS SLP-CCC, Dr. Katherine Yung, MD and and Dr. Mark Courey, MD have specialized interest and training in evaluating and working with transgender patients to provide behavioral and medical/surgical interventions. Much about voice that identifies gender relates to word choice, phrase structure, and intonation patterns. As with all evaluations related to voice and interpersonal communication, the assessment begins when you walk through the door. People are often unaware of habitual communication patterns. These habitual patterns convey more about gender perception than vocal pitch or quality alone. Therefore, pragmatics (social communication patterns) will be evaluated during the initial visit. In addition, vocal pitch, quality and resonance along with the size of the voice box will be assessed.

As a team (patient, physician, speech pathologist) we will identify areas to target to help you reach your voice and communication goals. This usually begins with behavioral intervention targeting communication patterns and easily accessible pitch range that allow the patient to produce an efficient voice that is more in line with their gender identity. Once these behaviors have been maximized then consideration can be given to surgery to alter pitch. This is rare, as most patients can achieve a gender authentic voice without surgical intervention. Finally, physicians at the Voice and Swallowing Center also have experience with voice box modification to alter the appearance of the Adam’s apple.

What to expect at your appointment:

During your initial appointment, you will be evaluated by a physician and speech pathologist. This visit could last up to two hours. A nurse will seat you in an examination room and will take an initial history, then a resident/fellow (physician in training) will ask you questions about your medical history and initiate the physical examination. The speech pathologist and laryngologist will then perform specialized tests (that will include a recording of your voice and examination of your mouth and throat with a telescope). This examination will be recorded and reviewed with you. This will help the team complete their assessment to help you meet your goals.

The Airway, Voice, and Swallowing Center at UCSF is world renowned as a leading multidisciplinary center designed to serve patients with voice, airway, and swallowing disorders. We provide advanced medical, surgical, and behavioral services for the accurate diagnosis and appropriate treatment of a wide range of voice and speech complaints, swallowing complaints, and other disorders of the upper airway, including larynx and trachea.

The mission of the Center is to provide state-of-the-art care for patients, develop technology for the diagnosis and management of upper airway disorders, participate in research for improved understanding of voice and swallowing disorders, and develop educational programs for trainees interested in field of laryngology.

The UCSF Voice and Swallowing Center is staffed by internationally recognized fellowship-trained otolaryngologists (laryngologists), speech-language pathologists, voice therapists, and swallowing specialists. Our team works closely with neurologists, pulmonologists and physical therapists to care for the entire patient and manage their voice and swallowing difficulties in a holistic environment. Together, we strive to provide personalized, comprehensive care for each patient that enters our Center.