In the seventh version of their Standards of Care, WPATH recognizes that, as each person is unique, so is the person's gender identity. The goal of speech-language therapists/ pathologists is to help transgender people develop voice and communication that reflects their unique sense of gender. When outer expression is congruent with an inner sense of self, transgender people may find increased comfort, confidence, and improved function in everyday life. Transgender voice and communication is a relatively new area of practice within speech-language pathology/therapy and this document is intended to support clinicians and researchers working in this field. It begins with a review of the evidence-based literature in transgender voice and communication. The paper then discusses these clinical topics: trans-specific voice-and-communication assessment, voice feminization protocols and voice feminizing surgeries. There is also a section on speech and voice masculinization-an area that has received little previous attention. As minimal standards have yet to be established in this field the paper concludes with recommendations for good clinical care.

An increasing number of speech-language pathologists (SLPs) are working with individuals who are transgender (TG) and gender diverse people. This trend likely reflects a growing number of TG and gender diverse patients seeking treatment. Whilst voice and communication outcomes can be highly satisfying for both the client and the therapist, there can be many challenges associated with service delivery to the transgender population. This article will discuss the challenges for SLPs, both in public state-funded health care systems, and clinicians in private practice. This discussion is informed by my 15 years of clinical experience in both systems and by recent developments in the field of TG voice and communication work.

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