Speech and language therapy

This is also known as Voice and communication therapy. Every patient attending the GIC and currently accessing treatment can be referred for our specialist Voice and Communication Therapy by any of the clinicians.

It is recommended that you make a full-time social gender role change or at least have the intention of doing so, prior to accessing speech and language therapy because voice change takes consistent practice to acquire. It may be that you are close to making a social role change and speech and language therapy can help you move nearer to this point.

Effects of hormones on the voice

Oestrogen does not affect the size or function of the vocal folds and pitch is unaltered. Instead, voice change is achieved through exercises and training within therapy, together with regular home and social  practice

Testosterone  promotes growth of the vocal folds which takes place usually within the first seven months, though this can vary from person to person. This change produces a lower vocal pitch.

Therapy model

Voice and communication therapy is individualised according to your particular goals in achieving authentic voice and communication. You will be seen in one-to-one sessions, and may be offered group sessions.

Initial appointment

This is an information gathering appointment for both you and the speech and language therapist, and an opportunity for you  to discuss concerns and hopes about your  voice and communication . As part of this appointment, we will:

  • take a case history related to your communication goals
  • listen carefully to your voice to ensure it is working healthily
  • take a baseline recording of pitch
  • explain how your  voice works, the process of voice change and what is possible
  • provide initial exercises and advice about home practice
  • make a plan for future therapy sessions, individual and group.

Therapy appointments

You will be offered up to four therapy appointments of fifty minutes in duration at monthly intervals to assist the process of voice practice and change.

For those seeking to feminise their voice, help can be offered to:

  • raise pitch to a comfortable degree
  • achieve a brighter resonance (vocal colour)
  • explore intonation and expression
  • increase confidence with your voice on the phone
  • project your voice over background noise
  • explore other sounds such as coughing and laughing
  • explore some of your singing potential

For those seeking to masculinise their voice, help can be offered to:

  • monitoring the effects of testosterone on your voice by measuring your pitch and how it changes over time
  • develop a robust breath support to accompany vocal changes
  • access increased chest resonance
  • explore intonation patterns
  • increase social confidence through assertiveness training
  • explore placement and range of your new singing voice

For those identifying as non-binary or gender-diverse, therapy goals will be individualised  to support what fits your sense of authentic gender expression, through:

  • exploration of pitch, resonance and intonation
  • development of communicative power and personal presence
  • exploration of your singing potential


Voice Groups

Voice group programmes are offered usually following one-to-one therapy sessions according to demand. Groups consist of up to 10 members and enable you to develop your vocal skills in a wider communicative context and through conversation and peer support. We offer workshops activities on voice projection, presentation skills, assertiveness training, speaking on the telephone and singing.

Important points to consider

Creating and sustaining your authentic voice can take time to develop. It is important, therefore to be patient and be aware that small changes initially will lead to your you achieving your desired voice change over time. Your commitment to practising vocal exercises is an essential part of the process The process is supportive, collaborative, enjoyable and confidence-building.

As in all appointments at the clinic, it is important to attend as arranged, and let us know as soon as possible if you are unable to do so. We have a large waiting list to be seen and thank you for your patience: an appointment will be offered to you as soon as one becomes available.

Some individuals seek information about a surgical option to raise the pitch of the voice. The most common procedure used by Ear Nose & Throat (ENT) surgeons in the UK is the Cricothyroid Approximation (CTAS). Currently funding is not routinely available for this procedure on the NHS. It is also important to remember that pitch is only one aspect of voice and other vocal features need to be developed with a speech and language therapist.

Some individuals seek reduction in the laryngeal prominence (Adam’s apple). This procedure is known as Thyroid Chondroplasty. Reduction in the thyroid prominence does not have any effect on the sound of the voice, and individuals will need to discuss potential referral for this procedure with their clinicians, although funding is currently not available on the NHS.

To be referred for speech therapy:

Ask the clinician at your first assessment, or later clinic appointments