How voice therapists are helping trans people sound like their true selves
You can usually find Rebecca Oppenheimer, one of the world’s most prominent astrophysicists, presiding over her laboratory at the Museum of Natural History on Manhattan’s Upper West Side. But on this Thursday afternoon, she’s in a small, neat office in downtown Manhattan, working on her voice.
“Apple pie is good,” Oppehneimer recites, an earpiece and mic attached around her shoulder-length brown hair. “At the front door. Alley behind the store—”
“Wait, why are these rhyming?” She laughs. She’s with Christie Block, a speech therapist at the New York Speech and Voice Lab who works with transgender women and men who want to change the way they sound to avoid being misgendered or because they feel their voice doesn’t fit with their gender identity.
A trans woman in a field that’s heavily dominated by men, Oppenheimer, at 44, is at the top of her game. She’s the curator and chair of astrophysics at the Museum of Natural History. Later this year, she’s been invited as a V.I.P. guest to watch the launch of a NASA rocket with equipment on board that a colleague built, to help collect samples of an asteroid in space and bring them back to Earth for the first time ever.
She started seeing Block, 47, a few months after coming out as transgender to her professional circles in July 2014. She was concerned, she told me, about how she sounded when she gave lectures and talks in public. But even more than that, her voice was a safety issue for her.
“It used to be the telltale sign, and some people get enraged about this issue. They get really crazy. In fact I’ve been assaulted over it, a really bad thing, that was 13 years ago… It’s not necessarily a need to conform to a male-female stereotype, but to not be spotted instantly,” she says.
Voice training for trans people is a relatively new and metropolitan field: Block, who is a cisgender woman, tells me she’s in the second generation of trained speech therapists who specialize in transgender voices. She thinks there’s a growing interest from young speech therapists as more transgender issues find their way into the national conversation.
Block, who’s been a speech therapist for 14 years, acknowledges that there can be a perception that her work with trans people is all about perpetuating gender stereotypes. Training a person’s voice to be perceived as more “masculine” or “feminine” also falls into a debate about whether it’s right to expect transgender people to conform or “pass” as either masculine or feminine, relying on male-female binaries instead of understanding gender as a spectrum.
But she says voice training is more nuanced than that: she tries to equip transgender people who come to her with vocal skills that suit their individual needs and as they transition. Rather than having a rigid understanding of what all men and all women (transgender and cisgender) ”should” sound like, she says she tries to help clients find a voice that feels right to them.
“I don’t see it that way,” she says. “It’s about showing people what the norms are or what we all think it means to act feminine or masculine and finding a set of skills that fit along that continuum with that person’s personality.”
Laura Jacobs, a psychotherapist and chair of the board of directors of Callen Lorde, one of the largest LGBTQ community health providers in the nation, sometimes sends their patients to Block when they feel they want to work on their voices.
Jacobs, 47, is transgender and genderqueer themself—meaning they consider themself to be somewhere along the spectrum from male to female and doesn’t strictly identify as one or the other (and prefers to be identified by the pronoun “they” or “them”). I asked them whether they think voice training reinforces stereotypes.
“There is part of the trans community that is really trying to push genderqueer issues and thinks that binary is outdated and passé and an artificial construct that’s imposed on us. That may or may not be true but that doesn’t mean that people can’t still want to live in those kinds of ways,” they tell me.
“I have plenty of clients who express themselves in really binary ways, and they understand themselves in really binary ways, and there’s nothing wrong with that. That’s how they have chosen or decided to express who they are,” they continued. “That is no more or less valid a choice than genderqueerness. It’s just where they want to be on that spectrum.”
Block also encourages genderqueer clients to come to her if they’re interested in using combinations of what are perceived to be feminine and masculine expression. “I am a facilitator for empowering you to express yourself not only in an authentic and effective way, but also, should you choose, in a way that challenges societal concepts of what it means to be feminine, masculine, both, neither, or other. Viva la gender variance!” she writes on her website.
She sees 20–30 patients per week, half of whom are transgender women and men. That includes more trans women than men, partly because transgender men’s voices tend to naturally drop in pitch once they start hormone therapy. That doesn’t mean they don’t need help with their speech patterns, but on the whole, more trans women seek Block out for help.
They start with an hour and a half session where Block gets clients to speak into the headset, which feeds audio into a program that tracks the pitch of a person’s voice. Based on that reading and an in-depth conversation with her client, she comes up with a target pitch somewhere on this chart:
The chart is based on studies of cisgender people’s’ voices and how trans women are perceived based on their voices, Block says.
They work toward that range over several months with training exercises that develop three areas: pitch, intonation, and resonance. Pitch and intonation refer to how high or low a person’s voice is, what their speaking range is, and how they use that range. Resonance has to do with how a person uses their mouth, tongue, and throat to shape the sound they’re projecting.
“I learn a lot about the person’s identity and expression and their plans for that, but also how much they have to talk, what they don’t like about their voice, are they wanting to change their voice because of being misgendered or because of a dysphoria that’s related to the voice?” Block says.
Trans women who work with Block are generally aiming to raise their pitch to make their voices higher within a safe and comfortable range and to change some speech patterns: for example, speaking less abruptly, a trait that’s strongly associated with masculine speech patterns. Trans men come to Block’s clinic aiming to lower their pitch and change their patterns to be perceived as more masculine.
For most people, Block says, it takes about three months of regular practice to start to get comfortable with a new vocal range. “That is to kind of learn some basic skills, to get in the right range vocally,” she says, adding that it takes about a year for most people to settle into their new voice and speak without having to think about how they sound.
An essential part of what Block does with her clients involves an element of counseling: from listening to their concerns about their voices in their first session to coaching them through how to start using their voices with friends and family.
“It’s not psychotherapy but it’s talking about what we’re doing, how to make it work and how to own it. And that can just be a long conversation, that could be just little reminders, that could be recording the voice and explaining where they’re at and where they went,” she says.
But it’s important to remember, she says, that speech therapy can be a health concern for trans people. Though it’s often overlooked, it can be just as much a part of the picture as hormone therapy. She says she’s had patients who have tried to modify their voices on their own, which can cause damage to their voices if they’re straining their vocal chords.
“I come from a health background, and that’s an important perspective when it comes to working with trans people, because sometimes trans people work on trying to modify their voice on their own, they can do so in a way that’s not healthy,” she says. “It really keeps me focused on helping people make changes in a healthy way and a natural way.”
Jacobs, the psychologist and leader in the trans health field, says that along with greater visibility for transgender people and health care overall, voice training is becoming more popular. And Jacobs says it’s about empowering trans people to speak up for themselves.
“We primarily communicate through voice, so having the ability to speak comfortably is just so important,” they say.
Jacobs says that for their clients who also go through speech therapy, working on their voices helps them think through how they want to present themselves, and how they feel they fit into the world. Many of their clients feel self-conscious that their voices don’t match their gender identities.
Voice therapy is at the less expensive end of the spectrum of transgender health services, compared to the cost of hormone therapy and surgeries, but that doesn’t mean it’s easily accessible. Block says her transgender patients are mostly those who are better off financially and able to afford her sessions regardless of whether or not their insurance covers them.
“I think there are a lot of issues of privilege that go along with some of this. It does take a certain amount of money to access someone like Christie or even private psychotherapy or hormones or surgery,” says Jacobs.
At the same time, voice training is still something that insurance companies often try to exclude. Under the Affordable Care Act’s anti-discrimination provisions, it’s been illegal since 2010 for federally funded clinics or programs to deny patients service based on their gender identity. That includes all aspects of transition, but Block says many of her patients struggle to get their treatment covered because insurance companies often try to classify speech therapy as optional. If a psychologist diagnoses a trans patient as having gender dysphoria and recommends speech therapy as part of their treatment, insurance companies are a little more likely to accept claims.
Though it isn’t what every trans person wants, Oppenheimer thinks speech therapy should certainly be included in trans health coverage and be more available as an option for all trans people. It’s clearly made a significant difference to her day to day life, whether it’s picking up groceries at the store, giving a talk on complex astrophysics in front of hundreds of people, or just laughing with friends.
“You have a great laugh,” Block tells Oppenheimer at one point.
“Thank you, I like that,” says Oppenheimer, smiling slightly. “I really like to laugh so it’s the easiest one to practice.
Later in the session, we listened to a clip of Oppenheimer reading a test passage during her first meeting with Block in 2014. Her voice has risen more than an octave in the last two years (from 112 Hertz to 180 Hertz, one of the measures of pitch that speech therapists use).
“When the sunlight strikes raindrops in the air, they act as a prism and form a rainbow,” the voice on the recording, significantly deeper, says. “The rainbow is a division of white light into many beautiful colors. These take the shape of a long, round arch with its path high above and its two ends apparently beyond the horizon…”
Oppenheimer is shaking her head at the voice. “It’s weird, I can’t even do that anymore. If I forced myself to I could, but it just feels weird now,” she says. It’s been hard work but she says it’s also been an important part of transitioning or, as she prefers to describe it, “self-realization or actualization.”
“I don’t feel like anything about me has changed, I just feel more me. And I knew this from when I was a kid,” she says.
Aside from wanting to feel safer and more at ease with her voice, working with Block has changed how she’s perceived at work, Oppenheimer says. Despite her impressive accomplishments and position of authority at the Museum, it was not easy coming out. Though many of her colleagues have been supportive, she’s had to deal with both transphobia and sexism based on the way she looks and talks.
There are small cues that she’s learned to pay attention to since working with Block, which have helped her avoid being misgendered as often. She says she introduces herself by name as soon as she answers the phone. And in person, she says the way she presents herself is part of how easily she feels she’s accepted as a woman.
With time, she’s become more relaxed and confident about the image she’s presenting the world. During her session, she’s dressed in a knee-length black skirt and a grey long-sleeved v-neck blouse.
“I think when I had the deeper voice and the harsher voice, people just saw me as a man in a dress or something like that, which was really irritating because it’s just not true either legally or physically. So it didn’t feel right to me,” she says.
Block tells me many of her clients who are trans women have experienced similar discrimination. “There are trans women who will be in a professional situation where they get attention and listened to, and after they start presenting feminine they’re taken less seriously. They have to speak up more, they’re interrupted more, they’re questioned more. There are enough to see that there’s a pattern,” she says.
“A big part of it is just confidence. It’s given me much more confidence,” Oppenheimer adds. “Regularly now I meet people and when they find out I’m trans they’re like, ‘Oh I had no idea!’ Which is cool. I’m out, but I don’t want it to be the central thing in my life. Like I said, of course I’m going to advocate [for trans rights], and I do and I write about it and whatnot, but I mainly just want to be seen as a woman, which is what I am. The trans thing is a detail.”
Correction: This story has been updated to accurately reflect Oppenheimer’s involvement in a forthcoming NASA project launch and Jacobs’ title and role with Callen Lorde. The headline has also been updated to reflect Block’s occupation as a speech therapist.