text: As seen with various minority groups, the Lesbian, Gay, Bisexual, Transgender Queer (LGBTQ) community has group diversity. Factors such as social, economic status, race, and ethnicity contribute to these differences.
  Transgender is an umbrella term that means that a person identifies with a gender different than the gender allocated at birth. This could encompass:
  Identifying with the opposite sex assigned at birth. Identifying as gender-queer or gender non-conforming in which individuals don’t conform with conventional gender distinctions (includes both masculine and feminine traits).
  Identifying as agender, not identifying with any gender. Individuals who cross-dress, are intersex (i.e., people born with variations in sex characteristics), or are transsexual (i.e., seek medical assistance to help transition to identified gender).
  Research Paper on Transgender Essay
  Many transgender individuals wish to live as a gender other than what they were allocated, and some may opt to surgically modify sex features to form a balance with the gender they identify with. However, it is important to keep in mind that some do not, and each transgender individual is unique from one another.
  Despite the diversity within the LGBTQ community, this group is considered a single body and a minority group. Individuals in this community are united by the hetero-normative culture they reside in, in which sexual and gender minorities are considered offensive and, as a result, condemned.
  Argumentative Essay Examples on Transgender Essay
  Historically, the LGBTQ community has been discriminated against in both legal and medical fields. Despite homosexuality being removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1986, following 30 years of proof showing that it is not a psychological pathology, there are still government policies marginalizing the LGBTQ community (i.e., military personnel and blood donation).
  The DSM-5 includes gender dysphoria as a mental illness. The term gender identity disorder was changed to gender dysphoria in order to highlight the conflict between assigned gender and gender identity being a disorder if it causes emotional distress. Transgender supporters argue that the distress caused is a result of mainstream culture rather than transgender identity. However, the diagnosis is required to qualify for insurance when seeking medical intervention. Beliefs and behaviors can identify a culture because culture is not just about race or ethnicity.
  Thesis Statement for Transgender Essay
  Transgender individuals may need to juggle more than one cultural identity. In addition to identifying with the LGBTQ culture, many transgender individuals are also connected to the culture associated with their racial, political, ethnic, or religious background. This can result in a mismatch between the individual’s ability to balance many or even conflicting cultural norms, values, and beliefs. (Battle, 2012) Individuals within the transgender community differ greatly on both overt cultural and covert aspects, which are impacted by their background. Overt aspects include tangible behaviors passed down, such as music, dance, body language, and non-verbal language. Covert aspects involve intangible learned behaviors such as body language, vocabulary, gestures, intonation, and pitch.
  Most transgender individuals who seek speech-language pathology services come with a voice disorder but also desire to have modifications. These clients may report feeling misgendered in regard to feminine or masculine communication styles. For many clients, our goal is to address issues that would help establish congruence with their gender identity.
  Unless the client is seeking services in regard to a communication or voice pathology, intervention is considered a difference and not a disorder. Modifying voices, language, and communication styles aid in achieving perceptions of femininity and masculinity. A person’s voice has been described as the blueprint for expressing one’s self. If an individual is transitioning, they might wish to modify their voice. There are gender differences in vocal facets, syntactic and semantic vocabulary choices, and pragmatic aspects of speech and language.
  The World Professional Association for Transgender Health states that the goal of assessment and intervention is to help clients modify their voice and communication in a manner that is safe and true to their sense of self. This will result in a communication style that aligns with their gender identity rather than conforming to binary gender expressions. Treatment varies for each client and should be personalized to each person’s preferences.
  Speech-Language Pathology and Transgender Clients
  Communication, which encompasses style, voice, language, etc., is personal, and thus, treatment should emphasize what the client is comfortable with. Clients can choose to focus on a specific aspect (i.e., voice or language) or utilize a collaborative approach that addresses the client and others’ perception of him/her as a whole beyond the voice.
  Although there is no clear assessment protocol, there are themes to be highlighted during the evaluation process. An assessment with a transgender client would involve utilizing a case history form to gain information regarding medical, surgical, occupational, and social history. The client would be able to express their concerns regarding their communication style and voice and how it affects gender role expression.
  Titles: Intervention and Treatment for Transgender Clients
  It is important to identify the reason why they are attending therapy and what their goals for intervention are. Since many transgender individuals seek voice treatment, the evaluation generally involves an endoscopy to visualize the larynx. The client can be screened for voice disorders, educated on vocal hygiene, and evaluated on auditory perceptual features.
  At the end of the assessment process, speech-language pathologists should make sure to understand their client’s concerns regarding their concerns and desires for optimal expression of gender identity.
  It could be difficult to use general case history forms for transgender individuals due to their specific needs. As a result, the intake form may require some modifications. Gender identification is an important factor when completing an intake form. Usually, case history forms require name and gender, which may not be as straightforward for transgender clients.
  Transgender clients may be required to write their legal or birth name on the form when they would prefer to be called by something else. Thus, it is important to include both a legal name and a preferred name on the intake form. Case history forms may also include boxes for Males and Females. This could exclude transgender individuals, so it is beneficial to include other options such as: transgender, male to female, female to male, and “other” in case they classify as something else.
  In order to prepare to meet a transgender client, it’s important to be aware of the client’s current form of gender expression and their preferred pronouns. This information can be attained through the intake form or by asking friends or family. General voice questions on the case history form may not apply to transgender individuals.
  Specific questions regarding concerns and desires in relation to voice should be asked. Additionally, the intake form should include questions targeting the client’s perception regarding the effect of voice and communication on quality of life. The most optimal way to attain this information is through questionnaires and self-rating scales, which can be used throughout the intervention to determine progress.
  In many cases, voice and communication therapy is sought after transgender individuals attempt self-training. This could result in harmful vocal habits, eventually causing a voice disorder. It’s vital to gain insight as to whether the client has engaged in self-guidance because it will influence the SLP’s treatment approach by warranting behavioral goals. (WPATH, 2011, pp. 52–54) The treatment process will differ for male-to-female (MtF) versus female-to-male (FtM) clients.
  Language: can address vocabulary choice, syntactic, and pragmatic areas of language.
  Non-verbal communication: gestures
  In order to address each client’s unique goals, the SLP has to ensure that the client is first educated on vocal hygiene techniques. Training in this area includes:
  Decreasing phono-traumatic behaviors
  Implement easy vocal onset to reduce hard glottal attacks
  Addressing hydration levels
  Frequency and intensity of voice usage
  Optimal voice behaviors as opposed to maladaptive ones
  During the treatment planning process, the SLP should make sure to educate the client on the duration and frequency of therapy in order to meet the client’s individual needs. The client should also be educated on anatomical and physiological constraints, which cannot be modified through the therapy process.
  For example, the size of the larynx and vocal folds can not be adapted with voice therapy. This can affect the vocal transition to masculinization or feminization.
  The client should be informed that although there are biological constraints when it comes to voice, there are communication styles that can be modified to achieve congruence with the client’s gender identity. Thus, there are other facets of communication, including both verbal and nonverbal language, which can be targeted to achieve optimal gender expression.
  Male to Female (MtF) clients
  Pitch: Increasing FF to achieve voice feminization should begin by establishing a habitual and functionally normal FF. The clinician should utilize an acoustic analysis system to establish a habitual FF during speech production (i.e., humming, counting, responding “uh-huh”), all while varying pitch range from low to high. Once the habitual FF is determined, the client can work on progressing toward a feminine pitch.
  Reduce muscle tension while achieving desired pitch. Tasks targeting this can include relaxation exercises, the yawn-sigh technique, and the use of breathier voice quality.
  Begin at the isolated sound level and progress to words, sentences, and eventually conversational speech.
  Rate and Volume: Males possess a faster rate and higher volume than females; thus, reducing the rate and intensity could be targeted. Possessing a lower volume could support the perception and congruence of gender identity expression.
  Respiration: Train clients in diaphragmatic breathing as opposed to clavicular for voicing.
  Male to Female (MtF) clients (contd)
  Resonance: Men possess chest resonance (a fuller-sounding voice resonating from the chest), while women possess head resonance (vibrates in the oral cavity). Using anterior tongue carriage can aid in achieving a forward resonance. Resonant Voice Therapy has been beneficial in treating this population.
  Vocal quality: Gender perception can be affected by differences in vocal quality. Females tend to possess breathier voices constituted by incomplete glottal closure.
  Female to Male (FtM) clients
  Some FtM requires additional voice services following hormone therapy:
  Pitch: Implement vocal exercises to reduce the fundamental frequency (FF) to achieve a masculine voice (100-105 Hz).
  Rate and Volume: Men generally speak at a louder and faster rate than females. Incorporating structural conversational activities such as reading, decreasing the duration of phonemes, and pausing time could target this goal.
  Respiration: Facilitating appropriate breath support through diaphragmatic breathing will help result in successfully lowering the pitch.
  Phonation: Reduce hard glottal attacks (due to maladaptive self-therapy to lower pitch) and introduce easy onsets. Explain that easy onset is not associated with the feminization of the voice; rather, it is to promote appropriate phonation to achieve the desired pitch.
  Treating articulation aids in how others perceive the feminization and masculinization of the client as a whole by changing resonant frequencies and even contributing to frequency increase.
  When targeting speech sound production, the clinician should be knowledgeable in the differences between female and male speaking patterns.
  Generally, females’ speech is more articulate than males. Women tend to prolong vowels (i.e., “no way!”), have a slower speaking rate, frequent pausing, and more articulate and precise speech. In addition, women place emphasis on certain phonemes (i.e., /ing/, voiceless /th/), while men tend to omit phonemes or shorten final consonants.
  For MtF clients, treatment can include modifying consonants and vowels. Vowel modification therapy could encompass utilizing easy onset of voice, as opposed to hard glottal attacks.
  Frequent use of conjunctions to connect sentences
  Frequent use of tag questions (i.e., “Is he?”)
  Use of questions to express wants (i.e., “Are you cold?”)
  Use shorter sentences
  Don’t use conjunctions frequently to connect sentences
  Frequent use of contractions
  Descriptive adjectives and adverbs (i.e., gorgeous)
  Use “so” often (i.e., “I was hungry, so I went out to eat”)
  More empathetic (i.e., “I understand”)
  More affectionate (i.e., “love”)
  Uses inclusive pronouns
  Curse more often
  Not descriptive word choices (i.e., “It was good/nice/funny”)
  Use personal pronouns
  Offer conversational partners many chances to speak
  Tentative language (i.e., I think)
  Use of compliments
  Shares more personal information
  - Shares advice
  - Holds back from sharing personal information
  - Refrains from using “emotional” language
  - Tends to brag and argue
  - Interrupts conversational partner
  - Uses authoritative tones
  - Mirror movements of a conversational partner
  - Will tilt the head or lean towards the partner
  - Uses entire body to express themselves
  - Maintains closer proximity to conversational partners
  - Uses touch to show support or warmth
  - Frequently uses eye contact
  - Smiles more
  - Head remains in a fixed position
  - Keeps fingers together when gesturing
  - Reserved stance and less bodily movement
  - Requires personal space
  - Uses touch to establish domination
  - Less use of eye contact during conversation
  - Frowns more often
  Speech-language pathologists (SLP) treating transgender clients need to possess a basic knowledge of trans-sensitive issues, including health (i.e., hormones/surgery) and psychosocial issues (i.e., preferred name/pronoun). The SLP’s goal should be to help the client achieve a voice and communicative style which is in congruence with the client’s sense of self. The client is responsible for objectives formed in treatment planning, supported by the SLP’s educated professional opinion. Post-treatment evaluation should determine client satisfaction with the outcome of perceptual and objective measures of change (i.e., done through questionnaires).