Communicate with confidence: how can Speech and Language Therapy make a difference?

Our Department of Speech and Language Therapy is offering Communicate with Confidence (online) sessions for trans (MTF) people. These free sessions offer support and advice on using your voice in a safe space. Carol Glaister, the academic running the sessions, has been working with trans clients since 1995 and is passionate about this area of her work. We spoke to her about the new clinic, and why she enjoys working with trans clients.

“The first thing I do as a therapist is ask people what they want to change. Many people who transition tend to find that their voice is the most the difficult thing that they need to work on. People put a lot of thought into their appearance, but then when they speak, they feel there is a mismatch between what they are living and what other people perceive. So I talk to them about what they want to achieve – is it about confidence or are there particular features of voice production that they want to address?

“I follow the client’s lead to identify what they need – I ask them to identify a voice of someone they’d like to emulate, and then discuss whether that is feasible for them. Their voice needs to suit their stature and physique, as well as their ideal.

“One of the main things we work on is communication confidence. When you’re talking to another person, it will make them feel uncomfortable if you don’t give eye contact. But it can be hard for someone to maintain eye contact if they feel different. I work with my clients to help them to communicate more confidently, and keep eye contact – if they can do that, it’s more likely that the person they’re talking to will accept them as the person they want to project.

Pitch and resonance

“Pitch is the obvious difference between male and female voices, but this isn’t the only thing we work on in terms of voice production. One of the things that makes a woman’s voice different from a man’s is resonance. Men talk down in their throat more, whereas women produce sound from further forward in their mouth. Women can have a breathier sound, and use lighter contact with the tongue.

“Anxiety can affect voice production – when a person puts their chin down in an attempt to hide themself physically, it can lower the pitch of their voice. If they’re anxious, they will also breathe shallowly, which will make the voice sound tight. So I encourage women to sit in an open way, owning the space they’re in, and teach them supportive breathing. We use relaxation techniques for the musculature – your whole body is involved in voice production!

“We often explore other people’s reactions and how to deal with them, as this can be very difficult and an area of worry for trans people. We talk about how people’s reactions might not be borne of prejudice or dislike, but just not being sure of how to react to a new situation. So therapy helps enable them to deal with others’ comments.

“As well as looking at physical and psychological approaches, with some clients, I also work on language, and the differences in the ways that men and women (stereotypically) use language. For example – women tend to use more ‘tag’ questions, such as ‘don’t you?’ or ‘isn’t it?’ which draw in the person they’re talking with. They also use much more specific terms for descriptions such as colour – preferring turquoise, navy, sky to blue or scarlet, russet, ruby to red. There have been several studies on the choice of vocabulary used by men and women, so it’s something I explore with clients, if it’s an area they’re concerned about.

Bravery and vulnerability

“Trans clients are the bravest people I work with. They have to reveal a lot of their inner self as part of the therapy, far more than other clients I work with. They are also among my most vulnerable clients – your voice is like your fingerprint, and these women are reshaping theirs. I find it very rewarding to work with them and see the impact of therapy.

“I’ve noticed positive changes in the last 25 years. My first patient in 1995, in Wigan, felt that she needed to totally reinvent herself as a woman – she had worked as a TV repair person, and felt this wasn’t an appropriate job for a woman, so became a receptionist. Women felt like they had to dress in a very stereotypically ‘female’ way. But society has moved on now. People don’t feel they have to conform to a particular stereotype – they are more able to own being trans if they want to. They don’t have to fit a stereotype of a gender and are more comfortable wearing the clothes, or doing the job, that reflect their interests and personality, rather than just their gender.

“I’m pleased to be running Communicate with Confidence sessions at BCU. By hosting the sessions on campus, we are offering an environment that is more relaxed and less clinical-feeling than a health setting. My hope is that, over time, we will get to a point where we can offer group therapy as working with somebody else really helps with the motivation to do exercises. Through the therapy sessions, I want to give people a safe space and encouragement to find their new voice.”

Get involved

The Communicate with Confidence sessions take place on Wednesdays at our City South Campus - however, since the start of the COVID pandemic, these have now become online sessions. MTF trans people are welcome to self-refer. The sessions are free and delivered by final year BCU Speech and Language Therapy students, supervised by Carol. Anyone interested in attending a session should email Carol Glaister to find out more. We are also looking at offering sessions for trans FTM. If you would be interested in this, please get in touch with Carol.

Information and support for the transgender community in Birmingham

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