The V in Voice and Communication Change

Updated: Jul 7, 2021

With #MentalHealthAwarenessWeek having drawn to a close, I've been thinking a lot about the relationship between my work and its impact on the service user's mental health, both good and bad.

A favourite author and researcher of mine, Brené Brown, writes:

Vulnerability is not winning or losing. It's having the courage to show up and be seen when we have no control over the outcome.

Rising Strong (2015)

The V in voice change, then, must surely stand for Vulnerability.

When we decide to explore or change a part of ourselves, this inherently comes with risk: Will I be happier when I've reached my goal? Will I regret taking this journey? Will people still see me as me? Will I still see me as me?

While I talk about voice and communication change on this site, it's not about changing, really. It's about coming out and being. My service users know themselves better than anyone else. They often have a very clear idea of how they want to sound and present. It's just that their projected voice and communication style doesn't yet align with this.

The process of unlearning years of communicating in a certain way takes time. Along the way there are both ups and downs. On a positive note, I've seen the delight on people's faces when they realise just how much progress they have made towards their goals. The impact that that has on confidence, on getting out and about and living life as your authentic self. In my area of work we use something called the ICF Framework (World Health Organisation). This tool does a wonderful job of capturing this "real life" impact of voice and communication change. Is absolute pitch measurement (in Hz) the goal, or is being able to pick up the phone with confidence? These real life goals are the kinds of goals I LOVE to work towards with my service users. They are meaningful, and they reflect the value in being vulnerable.

On the flipside, the vulnerability of voice change has the tendency to uproot internalised shame:

I can't get it right.

My voice still sounds like a teenage girl.

I sound silly.


As if there's only one way to be a woman or a man. Yes, I stick with the gender binary here deliberately. Because I believe it's society's obsession with boxes and perfection that leads people to betray their spontaneous inner Child - who does actually like themselves - in favour of fitting in, of passing.

Passing, to me, is a lot like masking (for those in neurodiverse circles, you'll have come across this before). Masking and passing are skills. They are essentially about camouflaging, blending in, or dare I say it, "fitting in" (whatever that looks like... who decides if we're even fitting in anyway...?)

For a trans or non-binary person, passing can be a double edged sword. It keeps them safe, physically speaking. Yes, cis folks have a tendency to treat non-passing gender diverse people pretty unkindly. It may give them a feeling of gender euphoria, with others seeing and treating that person how they want others to see and treat them. Yet donning a mask for others' sakes will inevitably lead to burnout. Stonewall released a report on LGBT mental health in 2018. Rates of depression, anxiety and suicidal ideation or action are rife in our community. Not because of the individual masking or passing, but because cis / straight / white / male societal norms lead people to feel they are not good enough as they are. Like they don't fit the mould.

To my trans and non-binary readers:

I hear you.

I see you.

You are good enough.

You deserve to take up space as your authentic self.

To my cis readers, please take action. Go beyond "I'm not transphobic". Be anti-transphobic. Any action, small or large, can have a big impact when you have privilege. And you do. And while you're at it, it might be worth examining your (un)conscious biases so you can earn the privilege of calling yourself an ally.

Take care,


Recent Posts

See All

Fresh from delivering my first ever presentation at a professional conference #RCSLT2021, I've been reflecting a lot about coproduction. Many of the presentations across the three-day conference had a

It's been a bit quiet on the blog front lately for a few reasons: life - I'm sure we can all relate to that - and self-care. I've been writing an essay for my PG Dip in Gender Identity Healthcare Prac

If you are in crisis, call 999 or go to A&E if you are safe to do so.
You are not alone.