Gender Affirming Voicework:

Preface

Over the past two-plus years, I have been immersed in a personal journey of accessing and embodying affirming gender expressions, particularly vocal expressions, as a nonbinary trans person. This further evolved into beginning to develop a gender affirming voicework method in music therapy for gender-based work. Various types of experiences have surrounded my early development of this method, including engaging in voice lessons with a former voice teacher, several Alexander Technique¹ lessons, and both full and adapted Guided Imagery and Music (GIM)² sessions. It also has involved engaging in voicework sessions completely on my own, where I explored beginning possibilities of what gender affirming voicework might become. Here, I brought together my knowledge as a music therapist and trained singer as well as my experiences from within those voice lessons, Alexander Technique lessons, and GIM sessions. For the purposes of my Master’s thesis, which I completed as part of my degree requirements at Slippery Rock University (PA, USA), I more deeply considered the development of gender affirming voicework through the research method of queer autoethnography (2019).

Queer autoethnography is the telling of self-stories as informed by queer theory (Tony Adams³ & Stacy Holman Jones, 2008, 2010, 2011, 2016). This research method emphasizes telling stories that dismantle binary, fixed, and normative understandings; contextualize meaning making; and interrogate issues of power and privilege. In the spirit of autoethnography, which often turns to showing an idea instead of strictly telling it to the reader, I encourage you to refer to my full thesis (2019) – firstly, for an example of what queer autoethnography might be, and secondly, to witness a more complex and nuanced exploration of what presides in this current article. Autoethnography is a method that emphasizes creative processes such as writing, art, and music to not only be final products but also ways of engaging in research (Tony Adams & Carolyn Ellis, 2012; Carolyn Ellis, Tony Adams, & Arthur Bochner, 2011; Carolyn Ellis & Arthur Bochner, 2006). Queer autoethnography, in particular, emphasizes that as we write, we continue to become something different, realizing new and ever-evolving meanings within the stories we tell (Tony Adams & Stacy Holman Jones, 2011). Even as I have re-engaged with my own queer autoethnography for the purposes of writing this article, I have come to new and deeper understandings of what gender affirming voicework in music therapy might be.

All things considered, my understanding of gender affirming voicework is deeply informed by my own personal experiences of accessing and embodying more affirming gender expressions for myself. As I have more recently begun to work as a music therapist alongside others who wish to access and embody more affirming gender expressions, my understanding has further expanded to begin more deeply considering the complexities of this work within the context of a therapeutic relationship. This work continues to be informed by a queer theoretical framework as I aim to dismantle my own binary, dichotomous, fixed, and normative thought processes; contextualize my understandings; and interrogate issues of power and privilege within therapeutic relationships and in relationship to the accessibility of this work.

Attempting to queer Self

As I aim to continuously queer my understanding of gender affirming voicework, I am still struggling to find the language. Within my master’s thesis (2019), I have previously stated that I use Self with a capital S, referring a person’s innermost world – to their truest and most whole understanding of themself as it may change from moment to moment. I’ve expressed that I understand Self to be the notion of being connected with the center of your being – to being fully with yourself. I’ve aligned this with poststructuralist thought (John Paul Jones III, 2013), not understanding the Self to be a stagnant, fixed essence that carries with it a singular truth and which remains unchanging, existing in isolation from others, but instead that the Self is in a constant state of becoming something else, impacted by its interconnectedness to other people, to other Selves. Self has been used and understood as fixed truth within traditional psychoanalysis (Winnicott, 1988), and because of this, my thesis advisor, Susan Hadley, has challenged me to consider whether I should continue to use the word. I continue to grapple with the ways I have compartmentalized aspects of experience and equated Self to only be the inner emotional world. I’m growing into a more complicated way of thinking, understanding the Self as a complex interplay of the body, bodily functions, intersectional identity, experiences, emotions, and so on. My descriptions of the Self have, at times, been antithetical to this understanding. I’m now wondering in what ways my ideas of Self have become intertwined with my ideas of authenticity, which I understand to be a central focus of gender affirming voicework. I will explore this in more depth later in this article. While I continue to wrestle with the history of this word and my own understandings, I am resistant to abandoning Self, instead wanting to intentionally re-author it into a more fluid, complex, and queer understanding.

I offer a creative attempt at describing my Self using imagery and metaphor. I experience myself as one person, one body of ocean with countless possibilities of expression. That body is both physical (i.e., my physical body) and mental (i.e., my inner emotional and cognitive experiences of myself). The ocean is vast and something I will likely never completely understand. I can never witness the full ocean – not the distance it covers vertically (its depth) nor the amount of land it covers horizontally (its breadth). Even if I were to go out into outer space and turn around, I wouldn’t be able to take in the intricacies of the ocean; I wouldn’t be able to witness what lies beneath the surface of the water. And even if I went down to the ocean’s bottom, I wouldn’t be able to recognize the fullness of how large the ocean actually is. All of that expressed, the ocean is still a singular body of water that overlaps with other bodies of water, so it is unclear where my body of water really ends or where another one starts, as there are no clear distinct edges. That is my understanding of my Self. It is complex, never completely figured out, and always in a state of becoming by the movement of water on Earth and by the boats, people, animals, objects, etc. that enter and leave that ocean. It is a fluid and shifting me that bears witness to my personal experiences and the experiences of others. I share this, yet I don’t fully understand how it all relates to ideas of the Self and gender affirming voicework.

Stigmas of gender expression

Gender is an integral part of our identity, and we are socialized to interact with the world within the context of normative binary understandings of gender and gender expression that intersect with other (also limiting) axes of identity (e.g., race/ethnicity, sexuality, and so on). Considering the impacts of attempting to exist within these often-limiting notions of gender, I turn to the work of sociologist Erving Goffman (1963) who discussed stigma.

There is stigma that comes from both intentionally and unintentionally breaking outside of normative gender narratives. Consider the cis woman who speaks loudly and with confidence about their beliefs and opinions. Or the cis man who speaks gently and with lots of expression in their voice. Or any trans person who identifies with a gender other than what they were assigned at birth. Consider further the trans woman who doesn’t wear makeup. Or the trans man who doesn’t pursue hormone therapy or surgical transitions. Or the female-assigned nonbinary person who chooses to express their gender in more feminine ways. Or the intersex person who is born outside of the imposed sex binary. And all these people have multiple interlocking identities which will further impact the way they experience any stigma. As I consider the aforementioned people, I witness Erving’s understanding of “stigma symbols,” which mark a person as not normal or even ‘human’ when considered alongside normative constructions of gender. I write all of this not to pathologize gender non-conforming persons but instead to recognize the stigma that can come from existing within this gendered world. The act of stigmatizing is the problem, not the stigmatized person.

Of great importance to what might surround a person coming to gender affirming voicework, Erving wrote that “a discrepancy may exist between an individual’s virtual and actual identity” (1963, p. 30). This relates to ‘gender dysphoria,’ an experience that many, although certainly not all, trans and nonbinary individuals might have (American Psychiatric Association, 2019). According to the American Psychiatric Association (2019), gender dysphoria “involves a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify” (para. 1). Erving (1963) went on to express that “[t]his discrepancy, when known about or apparent, spoils [the stigmatized person’s] identity; it has the effect of cutting [them] off from society and from [themself] so that [they stand] as a discredited person facing an unaccepting world” (p. 30). Within this world, we learn how we must exist in order to be accepted, whether partially or fully. We are taught to behave, to be compliant and unspoiled, to move, to think, to voice in ‘normal’ ways.

Although my personal work expanded into something much bigger than my voice, I entered the waters of this work first due to experiencing a disconnect between my voice and gender as I came into my own gender as a nonbinary, agender person. I often experience tension when a listener hears my voice and automatically assigns it as belonging to a woman. This led to a desire for a speaking voice that would be perceived in a more androgynous-something-outside-of-man-and-woman kind of way – something that would not as easily lead to female perceptions of gender and that would hold my gender in all the ways it shifts. My voice was one of many other stigmas, including my sometimes feminine, sometimes masculine clothing choices, shaved head hair style, body type, and so on.

Considering stigma, Erving (1963) emphasized how a stigmatized person must learn how to navigate their stigma by developing various strategies. These strategies can include removing or compensating for the stigma in their lives, understanding the stigma as a learning experience, or even hiding their stigma. This last response to stigma, in particular, can lead to a kind of emotional turmoil (e.g., depression, isolation, and anxiety). My own journey within this work has led to the realization that I’ve hidden a lot of myself not only from my Self but from the broader world.

As mentioned earlier, I’ve come to understand that authenticity is integral to gender affirming voicework, specifically a focus on returning to the authenticity of the inner child within us who existed prior to the learning of gender took hold. That is, it involves accessing the child that existed prior to being stigmatized into removing, compensating, or hiding gender and/or gender expression. Consider the child who flops their body in any which way they please. Or the child who cries and screams and yells and belts loudly because they haven’t learned not to. Very young children often move and voice without care regarding how they’re perceived. They often emote without filtering themselves. I personally believe that accessing this childlike authenticity is one of the most important aspects of what gender affirming voicework might be. My understanding of this work is that it involves accessing and embodying expressions of gender which come directly from this inner childlike authenticity – less from outside societal forces that impose filters on who we must be in order to be accepted as ‘real’ and ‘valid.’ This feels connected to ideas of the Self that I described earlier; however, again, I am grappling with the inadequacies of language and my own evolving understandings.

Erving Goffman’s work and conversations with colleagues have led me to further queer my understanding of gender affirming voicework into something more complex, specifically with sitting at the intersections of how this work can encourage, in some ways, the removal, compensation, or hiding of gender stigmas while also encouraging a returning to authentic ways of being. For example, I wanted to access a voice that didn’t as easily mark me as female. This can perhaps be understood as wanting to remove my stigma to be more ‘normal.’ I need to stress that I don’t believe there is anything wrong with this if it is an authentic representation of gender. That expressed, removing stigma to fit into gendered norms may very well be a tool for survival when considering the violence that many trans and nonbinary persons experience, particularly trans women and nonbinary, male-assigned people of color (Human Rights Campaign, 2018). For me, I’ve grown to understand that a fluid, queer voice is an important articulation of my gender, both for myself and in navigating this world. These physical changes to my voice have been situated alongside returning to my own authenticity while also accepting that, as a nonbinary person, I will likely always be read within a binary by those who do not personally know me. I believe that it is important as professionals that we support those who seek therapy in realizing their own ever-evolving understandings of themselves. So often, trans and nonbinary people are policed and told what is real and valid about their bodies and genders, even told what they can and cannot do with their bodies due to barriers that are in place for different kinds of gender affirming medical treatments. This is incredibly damaging and invalidating. We, as therapists, have an important role in this.

Relatedly, I’ve further come to understand stigma and the navigation of stigma to be a kind of trauma; albeit not the kind of trauma we typically consider in therapeutic work. It is the trauma from years and years of microaggressions which can implicitly or explicitly position our gender and gender expressions as unacceptable or abnormal. Kevin L. Nadal (2018) has situated microaggressions as part of a systemic traumatizing of people. In a personal memoir by genderqueer author Jacob Tobia (2019), gender socialization is positioned as a trauma and emotional abuse that must be coped with. Jacob further described how growing up involved navigating the trauma of needing to let go of certain aspects of their gender and gender expression or face rejection. Both the letting go and the rejection is traumatizing. Jacob painfully conveyed this, saying:

Jacob importantly marked gender socialization to be trauma, and this idea resonates with me when I’ve considered my own childhood and even adult experiences surrounding my gender. This trauma doesn’t necessarily go away – we just find different ways of navigating it.

In my understanding, gender affirming voicework comes down to two parts that perhaps occur concurrently as they become relevant to an individual’s needs – accessing and embodying affirming and authentic expressions and healing from gender-based trauma. More specifically, I understand the work to involve accessing the inner childlike Self within a person. This Self authentically bares itself to the world without care to the way stigma might slap them squarely in the face – it’s the part that moves, thinks, and voices in ways that are affirming. Simultaneously, I understand this work to emphasize creating a healing space to navigate the impacts of traumatic gender socialization, especially as we understand how deeply the voice is connected to our body, gender, identity, and emotional world. While this work is likely more pertinent to trans and nonbinary individuals whose gender and expressions are often deeply stigmatized, I suggest that most if not all people – whether trans, nonbinary, or cis – are in some capacity impacted by gender-based stigma. This suggests that gender affirming voicework is a space not only for trans and nonbinary individuals but all wishing to more authentically exist within their gender.

Bringing in the music

Knowledge regarding vocal pedagogy and vocal function can be integrated with knowledge from the field of speech–language pathology. Reflecting on the literature and my experiences as a practiced singer, it became clear that many of the areas that speech–language pathologists focus on overlap with that of singers and voice teachers. Of the greatest significance to my own vocal situation, we as singers work with pitch, creating different vocal qualities by working with our resonance. Further, we also work with other areas that are explored within speech therapy, including articulation, vocal strength, nonverbal communication or body language, and what might be more broadly understood as vocal expression. Resonance and pitch are two of the most important parameters of gendered vocal expression (Shelagh Davies & Joshua Goldberg, 2006; Shelagh Davies, Viktória G. Papp, & Christella Antoni, 2015; James Hillenbrand & Michael Clark, 2009; Marylou Pausewang Gelfer & Quinn Bennett, 2013; Verena Skuk & Stefan Schweinberger, 2014).

I’ve grown to appreciate the voice as the unique, queer instrument that it is, with its shape malleable and shifting. For example, the body of a cello overall stays the same shape over time, whereas the vocal tract (i.e., resonating chamber, oral cavity/mouth, pharynx/throat, and nasal passages) is constantly shifting to create differently sized spaces for different vowels through the movement of the articulators (i.e., lips, tongue, teeth, jaw, and soft palate). These differently sized spaces create opportunities to either amplify or dampen certain bands of frequencies (i.e., the overtones of any given pitch). Formant frequencies are frequently discussed within speech–language pathology literature and refer to the various frequencies that are amplified within the vocal tract for various vowels (Johan Sundberg, 2006). Vowels have specific formant frequency patterns that make each vowel identifiable from the next (National Center for Voice and Speech, 2018). Although not a completely correct metaphor, but one that is perhaps helpful for understanding this, the vowels that we speak/sing are almost like individual instruments in that we are often able to identify an instrument (e.g., flute, clarinet, cello, etc.) based upon the timbre/resonance that we hear. Understanding this vocally, the format frequency patterns of an “ee” and “oo” makes those two vowels distinguishable between each other. This is also related to how we’re able to recognize singers/speakers based on just their voices.

Alongside the ways the articulators form specific vowels, the size of the vocal tract itself (outside of what the articulators are doing) influences which frequencies resonate better than others (John Sundberg, 2006). The longer the vocal tract, the lower the formant frequencies as there is more space for those frequencies to resonate (Jo-Anne Bachorowski & Michael J. Owren, 1999). We can physically raise or lower our larynx through the way we voice, thereby shortening or lengthening the vocal tract, creating smaller and larger spaces, impacting the quality of the voice. Relating all of this back to speech therapy, singers will (un)knowingly engage in formant tuning (i.e., shifting the articulators of the voice to create small changes to the space within the vocal tract without compromising the clarity or integrity of the vowel itself) (Adam Kirkpatrick, 2009; John Nix, 2004; Johan Sundberg, 2006). This is also called vowel modification, and the aim of this is to get the pitch being sung or one of its harmonics to clearly resonate within the vocal tract. Changing which harmonics are amplified affects the quality of the sound and how that sound is perceived. It is noted that when higher frequencies are enhanced, and lower frequencies are dampened, the tone is brighter (Adam Kirkpatrick, 2009). Further, with warmer, richer tones, the vocal tract is strengthening the lower frequencies and dampening the higher ones.

All this expressed, it is clear that singers can have a complex understanding of the voice, particularly of working with pitch and resonance, and both of which are significant when considering gender-based vocal work. It is important to note that many singers do not experience their voices within the more technical acoustic-based language mentioned above, but rather in terms of felt experience. Engaging with a deep understanding of the way the voice functions is important for gender affirming voicework. This knowledge has been very helpful to not only providing me with a more in-depth understanding of the voice but also a richer and deeper relationship with my own voice. Further, it has assisted me in considering how a person might work with pitch and resonance when singing to access a more affirming voice at any given moment.

Gender affirming voicework

I will now share my ideas of what a gender affirming voicework session might be pulling from my queer autoethnographic research (2019) and my own experiences of solo voicework sessions, working with a former voice teacher, experiencing Alexander Technique lessons (refer to footnote 1), and engaging in full and adapted GIM music therapy sessions. I will further integrate understandings I’ve gained since beginning to work in the capacity of a music therapist alongside others who wish to access and embody affirming gender expressions. While I’ve found that a typical session pattern is helpful to providing structure and with getting more engaged with the work, my understanding of that pattern has shifted from what is represented in my queer autoethnography. There, I separated out the body, the voice, and the emotional Self; I framed this pattern to be beginning with the breath and body then moving into the voice and then sometimes ending with more emotionally saturated experiences. This framework occurred partly because my brain likes organization, logic, and reason. However, the reality is that these categories were not experienced in isolation from each other, but instead in messy overlaps. Further, my distinctions between them have, at times, been incorrect. There’s been a need to queer and unsettle the fixed categories that I’ve created, recognizing that the breath, body, voice, and emotions are a gestalt of whole experience. While attempting to move beyond and between these categories, I’m finding that they are, at times, still helpful for articulating my ideas of gender affirming voicework. As such, I still work with some of them in describing what this work might be. I’m now understanding that the pattern of a session might just be that we always begin with getting into an in-the-moment mindset that promotes authenticity. From there, the work might go in many different directions that overlap and intersect as they become relevant to experience.

I believe that an important beginning to this work is to spend time getting physically, emotionally, and mentally connected with our authentic expressions. I’ve found that listening to a steady, relaxing piece of music while in a seated or lying position has been helpful. Here, the focus has been first on getting in tune with the breath, paying attention to how we’re breathing and the space we’re physically taking up while encouraging deep, full, relaxed breathing. The focus is on how breathing feels within our entire body, and it then sometimes shifts to a progressive muscle relaxation in attempts to connect deeper to our physical bodies, allowing unnecessary tension to be released. After this, I’ve sometimes shifted into free movement and stretching to further connect with my own body and release tension; however, this might be different for others depending on their comfort and physical capabilities. I understand this tuning in to be an important part of this work. Tuning in perhaps allows for more possibilities of engaging with our inner authenticity and to stay in the here-and-now.

From here, I think the work can go into a variety of different experiences, including but certainly not limited to movement-based work, imagery work, vocal exercises, song-based work, vocal improvisations, working with the CoreTone, and other chanting/toning experiences. Each of these experiences might have different purposes; that is, they might be focused on vocal function, emotions/identity, or a combination of the two (and others) as they are relevant to the needs of a person. In no particular order, below are examples of what some of these experiences might be.

More movement- and body-based work might be focused on the way we relate to our bodies, move about a room, and take up physical space, with the aim being to shift into authentic and affirming ways of being with and moving our bodies. This kind of work might also include working with what I’m coming to understand as gender imagery – images, sounds, experiences, and ideas that are reflective of inner child-like authenticity as it relates to gender. As an example, I understand some of my own gender imagery to be that of the ocean because of the way it represents the fluidity, expansiveness, and becomingness of my gender. Gender imagery could be integrated into acting exercises such as Michael Chekhov’s Imaginary Body exercise (2002). This exercise involves an actor imagining every aspect of a character (in this case, the gender imagery), stepping into the body of that person – from how they walk to how they wear their coat to how they wear their boots to how they talk. It’s about taking the actor’s body and filling it into the body of the character. Outside of movement- and body-based experiences, I think imagery might also play an important role in supporting other kinds of emotion-/identity-based work (e.g., using the imagery as a focus for improvisation with the aim to connect with gender identity) and with vocal function work (e.g., using the imagery to access what that imagery might sound like within the voice).

Somewhat relatedly, in discussing gender affirming voicework, I’ve recently shifted to statements about both accessing and embodying affirming gender expressions. This language is intentional and articulates a difference between recognizing affirming expressions within ourselves and actually embodying them within our day-to-day life. For example, the ocean is intertwined with my own identity. There is an important difference between the experience of recognizing (i.e., accessing) myself as the ocean and embodying myself physically, emotionally, and cognitively as the ocean. For me, the idea of stepping into my own ocean imagery is a powerful and even terrifying experience. Being able to identify the ocean as an expression of myself – to look out at that body of ocean, so to speak – is not the same as entering the water and experiencing myself viscerally. This distinction feels important for what gender affirming voicework might be.

Returning to the different kinds of experiences within this work, voicing experiences supported by the piano might arise in different kinds of ways. For example, in my own experiences I’ve come to understand a difference between voice-lesson-like exercise-based work and more improvisational in-the-moment kind of work. I’ve teased these out for the purposes of explanation, but these are loose categories that are actually quite messy in reality. Further, both are important for what gender affirming voicework might be; however, I’ve personally been shifting more toward in-the-moment ways of working.

Voice-lesson-like work might include warming up the voice in the kinds of ways you might in a practice or choral setting, using a variety of melodic patterns, modulating up and down while working with technique to support sound within the voice as it moves about and creating physical changes as they relate to the gendered vocal parameters. These exercises might then shift into speaking at the end of the pattern in attempts to integrate speech and song. For example, singing a five-note pattern of 5–4–3–2–1 on “ee” and shifting into speaking the phrase “easy is this sound” at the end. While I did find this helpful, I personally had difficulties with connecting my speech and singing in this way, which I partly attribute to the fact that my voice was attempting to navigate an exercise that was outside the context of my everyday speaking experiences. Working with more ‘performed speech’ (such as the speech at the end of vocal exercises) might shift us out of our natural voice and into something with exaggerated or unnatural expression. This does not get at our day-to-day typical organic speech; however, it does involve engaging with technique which is important. More voice-lesson-like work might also involve working with technique or expanding range while singing a song, changing the key of that song. For me, this kind of work involved attempting to consistently access across my voice a certain kind of timbre and vocal sound that I connected with. Voice-lesson-like work is important in considering gender affirming voicework, and because of this, I’m trying to find ways of integrating it into more in-the-moment ways of working.

More in-the-moment work might involve making music around different ‘givens’ of improvisation (Tony Wigram, 2004). This might include warming up by exploring different parts of the voice, working with a specific technique/idea throughout an improvisation (e.g., diaphragmatic breathing, tracking resonance on the palate while shifting notes, feeling a wide open space within the mouth, accessing a sound that feels like ‘me,’ expressing an intense emotion that is currently being experienced within the work, etc.), and so on. This work might also include working with the CoreTone exercise as described by Sanne Storm (2013) and variations of it. I went beyond the specific exercise to instead allow the CoreTone to become the ‘given’ of a toning experience or improvisation, with the understanding that that note could move and change into something else as it needs to. Working with the CoreTone might also shift into working more directly with speech melodies – not just one singular note but a phrase of notes coming directly out of natural speech or poetry readings. These speech melodies could then become the givens of further toning or improvisational experiences. I connect this more in-the-moment way of working with the kind of radical listening described earlier – where the focus is on attending to where a person is and where they want to be, to where they want to grow within the music and their voice.

Noting the differences between voice-lesson-like and more in-the-moment work, I experience the latter as drastically different from the former in that it is focused on being in-the-moment with personal experience and doesn’t invoke a ‘perfection/performance’ mindset for me. It also allows for more directly and intentionally working with the liminal space between speech/song, where there’s little distinction between one and the other. As mentioned above, I’ve gradually shifted toward placing more emphasis on in-the-moment ways of working.

This relates to an approach called Conversation Training Therapy (CTT) (Jackie Gartner-Schmidt, Shirley Gherson, Edie R. Hapner, Jennifer Muckala, Douglas Roth, Sarah Schneider, & Amanda Gillespie, 2016) within speech–language pathology that I’ve very recently been introduced to. This is a novel approach which aims to address how many individuals receiving speech therapy services often experience challenges in transferring techniques (which are worked on within exercises) into their natural conversation. The co-developers of this approach (Jackie and Amanda of the previously cited article) attribute this to the traditional hierarchical speech therapy programs that only engage in conversations after first working with vowels/consonants, then nonsense words, then small words, and so on until in full dialogue. They propose an approach which begins with conversationally-based work from the very beginning, and although this approach has not been directly integrated into speech-language pathology literature regarding trans and nonbinary voices, there are important overlaps to be recognized with gender affirming voicework (e.g., traditional hierarchical speech therapy as voice-lesson-like exercise-based work and conversationally-driven work as more in-the-moment improvisational). In fact, a person I’ve been working with has identified the in-the-moment aspects of gender affirming voicework as a “bridge” between vocal technique and everyday speech.

All of this expressed, gender affirming voicework is in its infancy with many possibilities of the work still to be realized. I cannot speak for others who might experience this kind of work, but profound personal growth has come out of my engagement with accessing and embodying authentic gender expressions alongside deep personal work and an exploration of what gender affirming voicework might be. I strongly believe that it has been the culmination of the various types of experiences I have engaged in over the past two-plus years that have provided the space for me to grow holistically and to become more in tune with my own experiences on multiple levels. I am a work in progress with definite room for ongoing improvement, but I’ve found a groundedness within myself that has been missing for a long while.

Training

Prior to attempting gender affirming voicework, I strongly believe that training is essential. I have been immersed in these ideas and this process for over two years and have primarily worked only with myself. Only recently have I begun to work alongside others, offering discounted sessions to those who seek to access and embody affirming gender expressions. These sessions are discounted first and foremost because this is an emerging method, and it is very much in a process of becoming as I learn alongside those I work with. Secondly, these sessions will likely continue to be discounted as much as possible in efforts to make them accessible to trans and nonbinary people, in particular.⁷ My personal explorations of accessing and embodying affirming gender expressions have been deeply informative to my understanding of gender affirming voicework.

I do not feel that this work is something you can just read about and do. I believe that it requires an in-depth exploration of speech-language pathology literature surrounding trans and nonbinary voices; an engagement with related voicework music therapy methods (such as Lisa’s Embodied VoiceWork method); an intimate knowledge of healthy vocal use and vocal pedagogy; training around working with imagery in informed and deep ways (such as GIM); an in-depth understanding of trauma-informed work and the ways it could inform understandings of trans and nonbinary experiences; continued learning surrounding trans and nonbinary healthcare and culture; and a deep interrogation and addressing of personal values and biases surrounding gender and other cultural axes of identity.

I am not an expert by any means, and personally think that words like ‘expert’ too easily impose hierarchies and reduce the possibilities for the ‘expert’ to continue to expand. I have so much growing yet to do and intend to pursue training and/or personal work with Lisa Sokolov for Embodied VoiceWork, potentially some GIM training, and other trainings/education around vocal health and function, while continuing to immerse myself in trans and nonbinary culture, spend time with my own voice and body, and continuously work to live with more cultural humility. Despite feeling intimately informed with regards to this work, there is so much more I want to learn.

As I have begun to work alongside others, I have been very thoughtful about what kinds of work I can safely support as I draw upon the current knowledge and training that I do have. For example, I am not working with imagery in the deep ways that I’ve personally experienced as a client because I have not been trained in GIM. That’s not to suggest that all imagery is off-limits, I have just been hesitant given the intensity of my own imagery experiences. While I imagine integrating adaptations of GIM into gender affirming voicework, this is not something that I currently feel able to safely support.

Beginning thoughts on complexities of power and trust

In my queer autoethnographic research, I reflected on issues of positionality (and thereby power and privilege) regarding my experiences of Alexander Technique. Although I found the tenets of Alexander Technique to be helpful, I experienced a lot of discomfort in attempting to give the weight of my body to the teacher who was touching me. I barely knew this person, and I didn’t know their perspective on trans and nonbinary individuals. Further, the gender of this person also influenced the way I experienced these lessons. I recognized from these experiences that my positionality was important in engaging in gender affirming voicework with others. As a music therapist, my embodiment, values, and sociocultural location will impact the ways I relate to others and how they relate to me. Trust and safety feel integral to sharing intimate parts of oneself with another person. Power and privilege seem connected with trust, especially when considering work with a teacher, helper, or therapist. That person sits within a privileged position, and a relationship with them is uniquely experienced dependent upon the interactions of other aspects of identities (e.g., gender, sexuality, race, and so on) between both the helper and the helped. I personally did not experience maliciousness or a misuse of power with this Alexander Technique teacher; however, giving them the weight of my leg/arm/etc. required a certain level of trust and safety that just wasn’t there. These ideas are important when considering gender affirming voicework within the context of therapeutic relationship.

As I have more recently begun to work in the capacity of a music therapist, I have attempted to further examine issues of power and privilege. In particular, I have recognized the importance of leaving room for a holistic and eclectic space where the work can ‘become’ what it needs to be for that particular individual—that is, it can address vocal function, emotions/identity, and/or any intersection of those areas as they become relevant to a person. I believe that it is so important that I do not push the work into one direction but instead allow the person I’m working with to articulate/realize the kind of work they want to pursue. That expressed, in introducing gender affirming voicework to those I work alongside, I’ve described the method as a holistic one which can fluidly intersect and overlap with different needs as those needs becomes salient. I further emphasize that even if we find that our work tends to be focused more on vocal function, this doesn’t mean that we can’t bring in emotion-/identity-based at any point. This is in efforts to keep the therapeutic process queer—to keep it un-fixed, flexible, and adaptable to the needs of a person.

In beginning to work with others, I have been energized by how gender affirming voicework, when approached with a queer thought process, can more individually address a person’s concerns leading to many different kinds of work even as it’s the same method. For example, I work with one person who does not wish to change their physical voice but instead the way they relate to it in efforts to experience their voice in affirming ways (i.e., emotion/identity-based work). I work with another person who is working on creating physical changes to their voice to access something affirming (i.e., vocal function). I also work with a person who wishes to more directly work with both these areas. This kind of flexibility excites me because while there is this grounded tenet of accessing and embodying something affirming, what the work looks like and is experienced as can be as fluid as the person.

Within this work, I have further attempted to queer my own role as a music therapist by interrogating the balance between working with vocal function and emotions/identity within gender affirming voicework. In other words, what’s my role in both a) assisting people with fitting into these normative expectations of gender and expression (e.g., helping a trans woman to access a more feminine sounding voice) and b) challenging normative expectations of gender and expression (e.g., encouraging a person to authentically voice however they want to voice even if it means they are not perceived as how they identify). My role in that is complex because those two areas could perhaps be experienced as at odds with each other. I don’t think either area is good or bad-they just are. That expressed, I do think it’s important to somehow interrogate in this work whether someone is seeking work focused on vocal function because they feel the pressure to perform gender in a certain way or whether they are seeking that work because it is an actual articulation of their gender in this moment. As I’ve written above, I personally believe that accessing a child-like authenticity is perhaps the most important aspect of gender affirming voicework. This has led me to attempting to take up a role where I aim to emphasize voicing in authentic ways and to sit in a curious space to continuously ask: Does that feel authentic for you in this moment? Does that feel like you? Further, within our voicework, I encourage the person to consider similar questions as they attempt to access something that is affirming for them. From here, authenticity is emphasized.

Further attempting to queer my role as a music therapist, I’ve also considered questions such as: What is my role in supporting a person to voice in healthy ways while also encouraging them to access something that is affirming? This calls into question understandings of health and who is defining health. These are important because definitions of health could perhaps be another form of stigmatizing or limiting (e.g., if I were to tell a person that what is affirming for them is not healthy). Because of this, I’ve instead been asking myself and the person I’m working with questions like: Is this affirming sound sustainable—i.e., will this sound cause potential vocal damage in the long-term? Do you feel able to sustain this sound without it hurting or causing fatigue? And, if the sound might cause long-term damage or doesn’t appear sustainable, how can we access this sound in a more sustainable way? This both interrogates the purpose of voicing in healthy ways and further brings the person I’m working with into defining health.

Although these are certainly not the only issues that might arise when considering power and privilege in therapeutic relationship, they are issues that have specifically emerged as I’ve begun to work alongside others who aim to access and embody more affirming gender expressions. I continue to be humbled by how much I still have to learn about gender affirming voicework.

Conclusion

In attempts to invite you into a dialogue with what I’ve expressed in this article, I wish to voice a set of questions that arose throughout my queer autoethnographic research and current clinical work. This is in hopes that we might query these together through further exploration.

These questions hold so many possibilities of breathing new life into the air.

In this article, I have attempted to condense the complexity of my thoughts and experiences into a brief introduction/overview which explores relevant literature, possible ways of working within a session, training that might be needed, and questions/issues to be explored. For a more detailed and nuanced account of what gender affirming voicework could be, I again encourage you to refer to my full thesis (Gumble, 2019). I understand gender affirming voicework to be a work in progress, and there’s no great way of ending a story that’s in the process of becoming something else. However, I will end with a quote that perhaps captures the possibilities of this work in some miniscule way. I hope you are left with the wonder, excitement, and passion with which I am currently filled.