Speech and language therapists are specialist professionals who work with a wide range of different individuals with vocal difficulties. These can include people with medical conditions affecting the larynx (voice box) such as throat cancer patients, people with muscular problems of the neck and structural abnormalities of the larynx, all of which can lead to voice problems.

In addition, some speech and language therapists are able to treat a variety of psychogenic voice disorders (psychological problems related to stress or anxiety) and an increasing number are now working with transsexual clients.

Speech and langauge therapists often work within the large multidisciplinary team of the gender specialist services, although many can work within general health organisations (including the National Health Service) or privately. It is important to find a therapist who has a full understanding of the transition process and a sound knowledge of the psychiatric, hormonal and surgical elements of gender change, as well as a sympathetic attitude regarding the emotional and psychological strain involved, particularly as many people seek their help midway through the experience.

Voice therapy can treat both Male to female (MTF) transsexuals and Female to male (FTM) transsexuals, but there are a far greater number of MTF. This reflects the greater incidence of MTF transsexualism in the general population. Also hormone treatment for MTF individuals has no effect on the vocal cords, unlike with FTM transsexuals where testosterone causes thickening of the vocal cords and a natural deepening of the voice. Therefore MTF transsexuals need to learn how to produce a more feminine sounding voice and are encouraged to seek specialist help to do this.

Voice therapy (or training) usually starts with the basics including advice and information about "voice hygiene" and general voice care, such as stopping smoking or exploring previous voice problems, as well as general education about how voice is produced. An objective assessment is made of the voice as each individual has a unique voice and responds differently to treatment.

There are different exercises and techniques that can be learned, practiced and mastered, to good effect. These skills can be practiced in one-to-one therapy (alone with the therapist) or within groups.

There are 3 main components of speech quality, that make a voice distinguishable as male or female. These are pitch, tone and resonance.

Voice pitch can be increased with certain tongue exercises, such as raising the back of the tongue when speaking.

Feminine tone is characterised by increasing the range of expressions of the voice, whilst making the shifts more gentle and smooth. This can be practiced and mastered very easily.

Resonance refers to the vibration of the voice, and can come from the mouth and chest. Male voices tend to have greater chest resonance and therefore by learning to decrease this and focus the vibrations in the mouth area, this can lead to a much more female voice quality.

There are many different techniques that can change even the most stubborn voice. With the help and guidance of a speech and language therapist, many transsexuals have made enormous progress with changing their voice and report it as being vital in terms of improving confidence and being more comfortable in social situations, feeling at ease in the workplace and managing the (often terrifying) challenge of telephone conversations.

Have you ever tried speech and langauge therapy? How effective did you find it? What produced the best results? Don't forget to tell us in the Blog!