Clinical considerations in speech therapy for female-to-male transgender populations

Purpose: The purposes of the present study consisted of primary, secondary, and tertiary purposes: 1) to determine what factors that can be addressed in speech therapy are the most important for female-to-male (FtM) transgender individuals in passing as their true gender, 2) to determine what factors may contribute to these individuals seeking speech therapy services and to the importance that they assign to speech therapy as part of the transition process, and 3) to determine awareness of this population in regards to the availability and scope of speech therapy services relative to transitioning or passing as their true gender. Method: A 38-item survey was developed to address these research questions and a link to the online survey was distributed via email to various listservs, organizations, and personal contacts to assist in the electronic distribution of the survey link. The responses of the final participant pool of 63 respondents were evaluated. Results: Overall, the participants ranked voice characteristics as the most important for passing followed by nonverbal communication and social language use. These broad categories rankings are generally supported by the existing literature. Within category rankings revealed rankings that are in accord with the existing literature, others that oppose the existing literature, and others that have not been explored in the literature. The following factors stood out as possibly contributing to how important FtMs find speech therapy as facilitating their ability to live as their true gender: desire to pass, satisfaction with hormone related pitch changes, current overall presentation, and whether speech/language contribute to instances of not passing. Factors that appear to possibly contribute to how likely FtMs are to have sought speech therapy include: satisfaction with hormone related pitch changes, voice prior to transition, and if aspects of speech and language contribute to instances of not passing. Overall, FtMs have little awareness regarding speech therapy as part of the transition process, particularly for FtMs.