SLPCase SeriesJournal of voice : official journal of the Voice Foundation2026

Outcomes of Gender-Affirming Voice and Communication Modification Training for Non-binary Individuals: A Case Series.

Keith A Chadwick, David Liao, Isaac L Alter and 7 others

PMID 37673753

WHAT IT FOUND

Four non-binary clients showed mixed results after 12 weeks of voice training.

Pitch changes did not consistently match satisfaction scores. One client improved in both areas. The other three improved in some tasks but not others. This shows the need for goals based on client preference rather than standard acoustic targets.

Key findings

01Only one of the four participants improved both their fundamental frequency and their self-reported voice satisfaction score.

02Changes in acoustic measures such as pitch did not consistently correlate with changes in self-reported outcomes.

03Participants had varied goals, with some seeking a gender-neutral voice and others seeking a somewhat feminine or masculine voice.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample size of four participants is too small for statistical analysis or generalization. The study was retrospective and relied on previously collected data. Data collection was disrupted by the COVID-19 pandemic, leading to incomplete data for one participant and a shift to telehealth. The study did not measure resonance, which is a key component of voice perception. Clinicians were graduate students without prior experience in this specific population, though they were supervised.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that changing a client's pitch will improve their satisfaction with their voice. In this series, three of the four clients saw no improvement or a worsening in their self-reported satisfaction despite changes in acoustic measures.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →