Background: Speech and language therapists (SLTs) deliver voice and communication therapy for trans and gender diverse people to facilitate authentic vocal and communicative expression. Davies, Papp, and Antoni (2015) have provided a comprehensive review of the literature, with recommendations for good clinical care. Several areas highlighted as gaps in the research were identified by the current authors as ones in which evidence is expanding.\ud \ud Aims: To demonstrate 1) an expansion of the evidence base in particular innovations in voice group therapy for trans women and trans men; 2) the importance of delivering voice and communication therapy as part of a complete approach to trans and gender diverse health care; and (3) developments in training and competency in the UK.\ud \ud Method: Data were drawn from three small-scale projects, two surveys, and one audit.\ud \ud Measurements: Data from survey and audits and pre- and post-group acoustic measures of and client self-perceptual measures, including the Transsexual Voice Questionnaire (TVQMtF); a client-generated set of questions for trans men; and the migration of vocal identity map, adapted from Narrative Therapy practices.\ud \ud Results: Positive outcomes for both pitch measures and client perception were recorded. Audit and survey data provided evidence of developments in training and competency in the UK.\ud \ud Conclusion: Evidence supports group therapy as a successful approach for trans individuals across a number of parameters of voice and self-perception. Voice group protocols for both trans men and trans women should take account of the social context within which to explore relational presence and authentic voice. SLTs within gender identity clinics provide voice and communication as part of a broader pathway of care, alongside sharing professional knowledge and skills. Current UK developments are documented as indicators of positive responses to the growth in the number of SLTs seeking to develop specialist skills within this field

An investigation into friendship skills of pre-school children with specific language impairment was carried out in both mainstream and specialist play settings. Significant differences in onlooker behaviour were found suggesting that the children benefited from observation and information-processing time within their mainstream play setting. The amount of solitary play behaviour found within the specialist setting supported these findings. Conclusions are drawn for inclusive education and collaborative practice.

Purpose: A service evaluation was undertaken with 10 participants identifying as trans men who received voice and communication group therapy and 12-month follow-up at the London Gender Identity Clinic between February 2017 and March 2018, to investigate levels of satisfaction, how helpful they found the program in facilitating vocal change and skill development, and whether they would recommend it to others. Methods: Participant evaluations of overall and ideal rating of masculinity of voice, and level of feeling comfortable with voice, evaluations of voice skills and changes in speaking and reading fundamental frequency were retrospectively reviewed and analyzed. Results: Six participants reported being very satisfied with the service; four were satisfied . Eight participants found the program very helpful in achieving voice and communication change; two found it helpful . Eight strongly agreed and two agreed with recommending the service. Participants' overall and comfort ratings of voice significantly increased ( p <0.01), while there was no significant change in ideal ratings ( p =0.063), and a significant decrease in the difference between overall and ideal ratings ( p <0.01). Participants achieved a significant decrease in fundamental frequency for reading and speaking ( p <0.01), a significant decrease in voice fatigue ( p =0.039) and restriction in voice adaptability ( p <0.01), a significant increase in confidence in public speaking ( p <0.01), but no significant change in vocal projection ( p =0.07). Conclusion: Ten trans men reported high levels of satisfaction with the voice group program and long-term follow-up, making significant positive shifts in voice skills and vocal self-perception. These findings apply locally but suggest appropriate interventions toward a transmasculine voice modification protocol.

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