Episode Summary

The voice is like a fingerprint-a source of identity and an instrument used for not just communication, but connection. For some, this fingerprint does not align with other elements of their identity, motivating them to take on the hard work of forming new voice “habits” to reach their goals. In this episode, SLP’s Barb Worth and AC Goldberg return to the podcast to share their perspective on how best to support individuals who are seeking gender aligning voice intervention. Tune in to explore tangible and compassionate evaluation and intervention strategies that are client-centered, culturally competent, and evidence-based. You’ll get a refresher on the larynx and the vocal process, as well as some helpful reminders on the importance of helping clients reach their goals, not yours, or those of society at large.

Learning Objectives & Course Description

The episode reviews the importance of clinical competency in gender-affirming voice and communication training.  This course also reviews components of gender-affirming voice and communication evaluation and potential therapy targets.

After attending participants will be able to:

  1. Identify at least two steps you can take towards cultural and clinical competency in the area of gender-affirming voice and communication training. 
  2. Describe at least two components of a gender-affirming voice and communication evaluation.
  3. Describe at least three potential therapy targets areas for a client receiving  gender-affirming voice and communication training

About the Speakers

SLP/BCBA; SLP Kate Grandbois (she/her) & Amy Wonkka (she/her

Kate and Amy are co-founders of SLP Nerdcast. Kate is a dually certified SLP / BCBA who works primarily as an "AAC Specialist." She owns a private practice with a focus on interdisciplinary collaboration, augmentative alternative communication intervention and assessment, and consultation. Amy is an SLP who also works as an "AAC Specialist" in a public school setting. Amy's primary interests are AAC, typical language development, motor speech, phonology, data collection, collaboration, coaching, and communication partner training and support.

AC Goldberg, Ph. D., CCC-SLP (he, his,him)

AC began his career in hospitals where he faced various forms of workplace discrimination due to his transgender status. For the past 16 years, he has been a school clinician, specializing in pragmatics and working with adolescents with complex neurological profiles. AC is dedicated to ending the mistreatment and discrimination transgender/gender nonconforming people face in educational, medical and clinical settings. He offers cultural responsiveness, safe space and active allyship trainings for all healthcare professionals and educators.

Barbara F. Worth MS, CCC-SLP (she, her, hers)

Barb is a faculty member at Emerson College in Boston, MA. For over 25 years she has been a medical speech-language pathologist and voice specialist and over the past ten years has focused her work in the area of gender-affirming voice modification. Barb is passionate about teaching and training graduate students and the next generation of SLPs. When not in the clinic or classroom, Barb can be found dreaming about her first post-COVID trip to some amazing beach destination!

Speaker Disclosures

AC Goldberg financial disclosures: AC is employed full time as an speech pathologist working primarily in gender voice modifcation and is the founder and co-owner of transplaining.info AC Goldberg non-financial disclosures: AC is a person of transgender experience, which gives me (him) personal perspective. 

Barb Worth financial disclosures: Barb is a Clinical and Academic Instructor
Communication Sciences and Disorders at Emerson College. She instructs students in the delivery of voice services to all populations. Barb Worth non-financial disclosures: Barb has a decade of experience working with the TGNC population.

Kate Grandbois disclosures: Financial: Kate is the owner / founder of Grandbois Therapy + Consulting, LLC and co-founder of SLP Nerdcast.  Kate Grandbois non-financial disclosures: Kate is a member of ASHA, SIG 12, and serves on the AAC Advisory Group for Massachusetts Advocates for Children. She is also a member of the Berkshire Association for Behavior Analysis and Therapy (BABAT), MassABA, the Association for Behavior Analysis International (ABAI) and the corresponding Speech Pathology and Applied Behavior Analysis SIG. 

Amy Wonkka disclosures: Financial: Amy is an employee of a public school system and co-founder for SLP Nerdcast. Amy Wonkka non-financial disclosures: Amy is a member of ASHA, SIG 12, and serves on the AAC Advisory Group for Massachusetts Advocates for Children.

Time Ordered Agenda

15 minutes: Introduction, Disclaimers and Disclosures

25 minutes:  Review steps you can take towards cultural and clinical competency in the area of gender-affirming voice and communication training

15 minutes:  Descriptions of components of a gender-affirming voice and communication evaluation

10 minutes:  Descriptions of potential therapy targets areas for a client receiving  gender-affirming voice and communication training

5 minutes: Summary and Closing

References and Resources

Adler, R. (2017). The SLP as counselor for the transgender client. Perspectives of the ASHA Special Interest Groups, 2(10), 92–101. https://doi.org/10.1044/persp2.SIG10.92

Adler, R., Hirsch, S., & Pickering, J. (Eds.). (2018). Voice and communication therapy for the transgender/gender diverse client: A comprehensive clinical guide (3rd ed.). San Diego, CA: Plural.

American Speech-Language-Hearing Association. (2016). Code of ethics [Ethics]. Retrieved from www.asha.org/policy/

American Speech-Language-Hearing Association. (2017). Issues in ethics: Cultural and linguistic competence. Retrieved from www.asha.org/Practice/ethics/Cultural-and-Linguistic-Competence/

Carew, L., Dacakis, G., & Oates, J. (2007). The effectiveness of oral resonance therapy on the perception of femininity of voice in male-to-female transsexuals. Journal of Voice, 21,591–603. https://doi.org/10.1016/j.jvoice.2006.05.005

Dacakis, G., Davies, S. The Transwomen Voice Questionnaire (Formerly TVQ MTF) ). (2012) Retrieved from: http://www.shelaghdavies.com/questionnaire/

Dacakis, G., Davies, S., Oates, J. M., Douglas, J. M., & Johnston, J. R. (2013). Development and preliminary evaluation of the Transsexual Voice Questionnaire for male-to-female transsexuals. Journal of Voice, 27, 312–320.  https://doi.org/10.1016/j.jvoice.2012.11.005

Dacakis, G., Oates, J. M., & Douglas, J. M. (2017b). Further evidence of the construct validity of the Transsexual Voice Questionnaire (TVQMtF) using principal components analysis. Journal of Voice, 31, 142–148. https://doi.org/10.1016/j.jvoice.2016.07.001

Davies, S. (2017). The evidence behind the practice: A review of WPATH suggested guidelines in transgender voice and communication. Perspectives of the ASHA Special Interest Groups, 2(10), 64–73. https://doi.org/10.1044/persp2.SIG10.64

Davies, S., Papp, V., & Antoni, C. (2015). Voice and communication for gender nonconforming individuals: Giving voice to the person inside. International Journal of Transgenderism, 1, 117–159. https://doi.org/10.1080/15532739.2015.1075931

Gender Spectrum Voice and Communication (Private Facebook Group) 2021 

Goldberg, AC., (2019). Our transgender language choices make all the differences The ASHA Leader,  24(4).  .https://doi.org/10.1044/leader.FMP.24042019.6

Hancock, A. B., & Garabedian, L. M. (2013). Transgender voice and communication treatment: A retrospective chart review of 25 cases. International Journal of Language and Communication Disorders, 45, 313–324. https://doi.org/10.1111/j.1460-6984.2012.00185.x

Hirsch, S. (2017). Combining voice, speech science and art approaches to resonant challenges in transgender voice and communication training. Perspectives of the ASHA Special Interest Groups, 2(10), 74–82. https://doi.org/10.1044/persp2.SIG10.74

Mills, M., Stoneham, G. (2017). The voice book for trans and non-binary people. London: Jessica Kingsley. 

World Professional Association for Transgender Health. (2011). Standards of care for the health of transsexual, transgender, and gender nonconforming people (7th version). Retrieved from https://www.wpath.org/media/cms/Documents/

******Note: Since recording of this podcast there is now a published voice questionnaire for non-binary folx:

Shefcik, G., Tsai, P. (2021). Voice-related experience of nonbinary individuals (VENI) development and validity.  Journal of Voice, published online 01/28/21. DOI: :https://doi.org/10.1016/j.jvoice.2020.12.037


The contents of this episode are not meant to replace clinical advice. SLP Nerdcast, its hosts and guests do not represent or endorse specific products or procedures mentioned during our episodes unless otherwise stated. We are NOT PhDs, but we do research our material. We do our best to provide a thorough review and fair representation of each topic that we tackle. That being said, it is always likely that there is an article we’ve missed, or another perspective that isn’t shared. If you have something to add to the conversation, please email us! Wed love to hear from you!


Episode Summary provided by Tanna Neufeld, MS, CCC-SLP

Audio File Editing provided by Caitlan Akier, MA, CCC-SLP/L, Contributing Editor

Promotional Contribution provided by Paige Biglin, MS, CCC-SLP, Contributing Editor 

Web Editing provided by Sinead Rogazzo, MS, CCC-SLP, Contributing Editor