The Exploration of a Combination Therapy on Voice Feminization for Male-to-Female Transgender Individuals

Purpose: The purpose of this case series pilot study was twofold. First, results added to the dearth of research on vocal therapy interventions provided by speech-language pathologists to transgender clients. Second, it piloted the Combination Voice and Communication (CVC) therapy to better understand the components of this therapy related to the feminization of the voice and communication for male to female (MTF) trans individuals Method: Two MTF participants were randomly selected from a pool of 4 participants and were randomly assigned to a team of clinicians. CVC therapy was delivered once a week for 50 minutes for seven weeks. It targeted pitch, breathiness, oral resonance, verbal communication, and nonverbal communication. Naive listeners, clinicians, and participants judged vocal femininity and gender.Results: Naïve listeners, clinicians, and the participants perceived both participants as sounding more feminine after participating in CVC therapy. The perceived increase in femininity after therapy by naïve listeners was found to be statistically significant with a large effect size. Nearly half of naïve listeners perceived Participant 1’s gender as “female” after therapy, however, Participant 2 was still perceived by the majority of naïve listeners as “male”. Additionally, both participants reported dramatically better vocal quality of life scores after therapy. Conclusion: CVC therapy is a successful model for voice and communication feminization for MTF transgender individuals. Results suggested that a number of targets could be trained in a particular set of therapy sessions and minutes with the implementation of a home program. Findings from this study have the potential to guide future voice therapy intervention models with lasting effects on the feminization of the voice