I had the opportunity to sit down with Well Said: Toronto Speech Therapy director and Speech-Language Pathologist, Melissa James to talk about speech therapy and its role in Transition for Trans, non-binary and gender diverse folks.

There are many facets to transitioning which, when misunderstood or erased from narratives, can create barriers when those services aren’t covered by health insurance or OHIP in general, despite their impact on overall well-being for members of the community.

While interviewing Melissa, I also had the opportunity to speak to a client who wished to remain anonymous, but who wanted to contribute their experience and knowledge to the conversation.

PPM: What services do you offer clients? How can they access those services?

Melissa: We offer transgender (MTF and FTM) voice and communication therapy which includes helping individuals on the gender spectrum to find a congruent voice that matches their Self. This can be achieved through pitch and resonance training. Aside from the voice, we also help clients to align their non-verbal communication with their gender identity.

Clients can access these services through our Toronto-based clinic (Bathurst & Bloor). Services are confidential and often covered by insurance.

PPM: Why did you decide to pursue voice therapy?

Anon: I wanted more pitch flexibility as I sometimes felt a bit uncomfortable with my more characteristically male voice; especially when speaking with people I don’t know.

Do you think other folks are unaware that the services exist?

Anon: I think that’s likely. And more than knowing about their existence, I would emphasize the benefits and all the areas of life it can touch. For example I found some buried emotion in my throat and face, which I’m glad to have released – I wouldn’t necessarily have discovered that otherwise. Also would emphasize voice in the larger sense, since Trans folks maybe more than others benefit from being comfortable with their voice – even with what they are ‘saying’ in the form of their transition.

PPM: What about transitioning do you wish more cisgender folks had compassion for, as a service provider?

Melissa: Cisgender folks must recognize the immense bravery and strength it requires to transition. Transitioning is a logistical ordeal and at the same time a deeply emotional journey. Voice and communication training represent only one piece of a much larger puzzle. I am fortunate to work with transgender folks and to see their hard work turn into joy when they find their congruent voice – most cisgender folks don’t have the opportunity. And, if they did, they would as I do, better respect the process of transition.

PPM: How can speech therapy help folks in transition?

Melissa: Voice and communication therapy for folks in transition is about helping align the Self with the voice and communication. The way our voice sounds, our intonation, our speech patterns, in conversation or on the phone, gives the listener an impression of who we are. Our goal for folks in transition is to align your sense of who you are, with how you present from a communication standpoint.

There is no rule about when during the process of transition one should start voice and communication training. For some, it’s their first transition step and others it’s their last

What are you liking about the experience so far? Anything different than you expected?

Anon: I didn’t expect the role the emotional/personal journey would play in the therapy and I love that. I also liked that it was very client centred and flexibly responsive to my personal needs and goals.

How will achieving your ideal voice help you?

Anon: I feel I have more flexibility with pitch and resonance, and this has translated into huge improvements in my singing voice as well. Psychosocially, I feel more comfortable in my body and feel less shame in relation to my voice. I am more confident in more situations.

PPM: Does speech therapy just serve to reinforce gender binaries, because folks are trying to sound more masculine or feminine? How does it fit into the gender spectrum that doesn’t rigidly define gender roles?

Melissa: I can only speak for my clinic is this regard, where as a team we embrace non-binary goals and often work with clients to move away from stereotypical “male” and “female” indicators in voice and communication. During our assessment process, we work with the client to establish their goals, and where on the gender spectrum they would like to go with their communication. We ask clients to find voice idols, people whose voices they like, then we work to deconstruct the liked voices to truly understand the qualities that we are working towards.

PPM: How does speech therapy work in concert with other therapies and tools, to help affirm someone’s gender identity?

Melissa: We work in concert with other tools that our clients are finding helpful and other therapies, like psychotherapy and medical. Collaboration among service providers is a truly important quality of our work. This means we readily coordinate our schedule with other appointments that come up during transition, for example, surgery, which requires clients to take time off.

What would you say to folks considering speech therapy but who aren’t sure that it would help them?

I would say, ask yourself the following questions and if you say yes, then voice and communication therapy may help you.

Do you feel that your voice, speech and communication could reflect your gender identity better?

Do you feel nervous speaking on the phone?

Do you like your voice and the way you communicate?

PPM: Are there any ways which allies can help serve the Trans, non-binary and Two-Spirit communities through the speech therapy work you do? How have you seen allies “show up” in the speech therapy area of gender identity affirmation in the past?

Melissa: The community can support the Trans, non-binary, and Two-spirited communities through providing funding and safe spaces to work on voice, speech and communication therapy. This is one of the biggest hurdles in getting access to people who need this service as TGNB people are over-represented in the low-income population. Within my clinic, we’re currently doing one-on-one voice therapy and workshops for folks in transition that is a pay-per-service model. Nonetheless, I’d love to see allies support more TGNB folks through providing funding and space for voice and communication work.

Sherbourne Health Centre recently offered their space, and they hired and supported a speech therapist, who provides gender spectrum voice therapy, to run an annual voice therapy program for folks in transition. The Gilbert Centre in Barrie is also providing space and they are working on providing funding too. So we have some allied organizations who recognize this and are showing up, and hopefully more groups will start following suit going forward

Any advice to someone who is cautious about taking the first step towards their voice and communication goal?
Anon: Go for it! It’s a journey well worth taking.

For more information or to book an appointment today:

Well Said: Toronto Speech Therapy Clinic
670 Bloor St W.
#201 – Steps from the Bathurst Subway Station
Toronto, ON M6G 1L2
P: 647-795-5277

About the Author

Cheryl Costello is the founder of The Finding Hearts Project, also writes for the Brampton Focus and formerly wrote at The Loving Instant. She has also worked with Fortune 500 and Financial Post 500 companies to bring greater attention, awareness and action for LGBTQ+ issues, giving the community a powerful voice. She has conducted workshops for LGBTQ+ students on the power of reclaiming their power through owning the stories they tell and was also a Keynote speaker at a Toronto World Pride event in 2014. If she isn’t writing or organizing in the community, she’s out with her camera, wandering a bookstore or out hiking among trees and water. Have a question you want to see answered on the blog? Stop by her page on Instagram, join in the good vibes and send her a message: @cherylalisoncostello