Professionals Who Help with Transition
Many different professionals may be involved in helping the transgender/transsexual individual make the transition to his or her preferred gender.
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Therapeutic Approach
The therapeutic approach usually involves three elements: experience living in the desired sex role, hormone treatment, and surgery (Meyer et al., 2001).
Minimal Competencies for SLPs
According to the American Speech-Language-Hearing Association (2007), voice and communication therapy for transgender/transsexual individuals is included within the scope of practice for SLPs. The World Professional Association for Transgender Health (WPATH, 2012) states that the SLP can play an important role in helping the individual to find a voice and communication style that is "both safe and authentic." The following videos are of two SLPs speaking briefly about their experiences working with this population (ASHAWeb, 2010a; ASHAWeb, 2010b).
WPATH (2012) recommends that voice and communication professionals have the following minimal competencies:
- Specific training and competence in working with transgender/transsexual clients
- Basic understanding of health and medical issues specific to this population
- Familiarity with sensitivity protocols, such as those related to preferred name and pronoun use
- Relevant continuing education.
Important Considerations for SLPs
- Before providing treatment, the speech therapist must be aware of the goals the client has for therapy. For example, some people may want to make a quick transition while others prefer slow, subtle changes. Some clients wish to have a very masculine or feminine voice, while others are comfortable with having an androgynous voice.
- The SLP should be made aware of any health problems the client has. Whether or not the client has already been seen by a laryngologist, any concerns require a referral.
- Speech therapy for changes in voice perception is not typically covered by health insurance. Some clients want quick results because they are paying for services out of pocket.
- Clients may also seek out quick voice change because they feel pressure to make their voice match their physical appearance (Friedenberg, 2002).
- There is no consensus on what duration of therapy is the most effective. One study showed that clients can become frustrated and unmotivated when therapy continues for too long. Shorter, more intensive therapy seems to help maintain motivation and show change (Davies & Goldberg, 2006).
- Finally, the SLP should always consider the client's privacy. The clinician needs to know if he or she can leave messages and what information is okay to share with others (Friedenberg, 2002).
Detailed discussions of the responsibilities and required competencies of various professionals who work with transgender/transsexual individuals can be found in the World Professional Association for Transgender Health Standards of Care (2012) and the Harry Benjamin International Gender Dysphoria Association's Standards Of Care (Meyer et al., 2001). These documents also provide comprehensive information about treatment options and procedures.