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The article I have selected to work on is titled "Voice Therapy (Transgender)". I plan to contribute to this article by reorganizing the content into a more organized structure. The current format is problematic and the article does not even discuss therapeutic techniques for transgender clients of Speech-Language Pathologists. I would also like to retitle the article to read "Transgender Voice Therapy". Also, many citations need to be added - some paragraphs do not contain a single reference. Other sections need to be rewritten entirely (the paragraph on vocal sound production should be moved or removed entirely).

The following is a draft of the new section to be added titled "Voice Masculinization".

Voice Masculinization

Voice modifications for transgender males typically involve the lowering of the speaking fundamental frequency^[1]. Voice therapy is generally not required for transgender men as the effects of testosterone on the larynx result in a deeper pitch^[2]. However, testosterone therapy does not always deepen the voice to the person's desired level, and others choose to not undergo hormone replacement therapy (female-to-male) at all^[1]. Voice masculinization therapy can help to further lower the pitch of transgender males and address voice problems associated with hormone therapy^[1]. Another option for female-to-male clients who wish to further lower their speaking pitch is to undergo vocal surgery (see Surgical Techniques for more details).^[3]

A Speech-Language Pathologist may be involved in aiding the female-to-male client achieve their desired voice goals, while usually prioritizing the overall health of the voice^[3]. Therapy techniques may involve finding the client's most comfortable pitch range, using breath support and relaxation exercises, introducing voice strengthening warm-ups, stabilizing posture and increasing chest resonance^[3].

Lowering Pitch

A lack of training on how to use their new voice may cause female-to-male clients have increased muscle tension^[3]. Therefore, a Speech-Language Pathologist can give clients vocal exercises to help find their optimal speaking pitch and maintain overall vocal health^[3]. Adler, Hirsch, & Mordaunt (2012), describe the following therapy techniques for transgender male clients:

Optimal Pitch

Rather than straining to achieve a lower speaking pitch, the client should seek to maintain a comfortable pitch range through visualization^[3]. This range is generally approximately between 100 and 105Hz^[3].

Diaphragmatic Breathing Patterns

In order to maintain their new speaking pitch, the female-to-male client needs to establish an appropriate breathing pattern to support their speech output^[3]. Establishing a stable speaking posture is also important to optimize pitch and breath support^[3].

Warm-Up Vocal Exercises

Warm-up exercises that the client can do at home help to strengthen the voice, maintain optimal pitch and prevent vocal fatigue^[3]. Resting the voice after long periods of use is also important^[3].

Relaxation Techniques

The Speech-Language Pathologist may teach their client tension-releasing techniques for the jaw, tongue, shoulders, neck and overall laryngeal area^[3].

Chest Resonance

Head resonance is more commonly used by females, and therefore female-to-male clients must establish a pattern of chest resonance to match their lower speaking pitch. Exercises can help establish this chest resonance and help the client lower their larynx^[3].

Working Bibliography:

^ ^a ^b ^c MSc, Shelagh Davies; RSLP-C; Goldberg, Joshua M. (2006-09-01). "Clinical Aspects of Transgender Speech Feminization and Masculinization". International Journal of Transgenderism. 9 (3–4): 167–196. doi:10.1300/J485v09n03_08. ISSN 1553-2739.
^ Abitbol; Abitbol; Abitbol (1999). "Sex Hormones and the Female Voice". Journal of Voice. 13 (3): 424–446.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m Adler, Richard; Hirsch, Sandy; Mordaunt, Michelle (2012). Voice and communication therapy for the transgender/transsexual client: a comprehensive clinical guide. San Diego, CA: Plural Publishing Inc.

[:0-1] MSc, Shelagh Davies; RSLP-C; Goldberg, Joshua M. (2006-09-01). "Clinical Aspects of Transgender Speech Feminization and Masculinization". International Journal of Transgenderism. 9 (3–4): 167–196. doi:10.1300/J485v09n03_08. ISSN 1553-2739.

[2] Abitbol; Abitbol; Abitbol (1999). "Sex Hormones and the Female Voice". Journal of Voice. 13 (3): 424–446.

[:1-3] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m Adler, Richard; Hirsch, Sandy; Mordaunt, Michelle (2012). Voice and communication therapy for the transgender/transsexual client: a comprehensive clinical guide. San Diego, CA: Plural Publishing Inc.

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