To Sound Like A Woman

Susan D Clark M. Phil.

Speech and Language Therapist, Speech Therapy Department, Royal Victoria Infirmary, Newcastle upon Tyne
Gendys Conference, 1998

Each area treating transsexuals has different protocols for admission to the Gender Dysphoria programme. I work at the Royal Victoria Infirmary in Newcastle upon Tyne and I shall refer only to the Northern Regional protocol.

Clients are accepted by a therapist only on referral from a psychiatrist whether the person is being managed privately or under the NHS. This allows the therapist to have relevant information about the patient and direct contact with the consultant should problems arise during the course of treatment.

On the first visit to the therapist, a case history is taken. Hearing a person's background in their own words helps to form a relationship, and to elaborate on areas pertinent to communication. A person who is not permanently cross-dressing full-time, may be accepted for treatment because this provides an opportunity to give them basic information that will allow them to practise techniques, and they will achieve results more quickly once they are cross-dressing permanently. From the outset, total commitment to therapy is essential.

So far as voice is concerned, experience shows that transsexuals fall into four categories;

  • Those where little therapy is required to achieve acceptable female voice.
  • Those who have an unrealistic self- perception of acceptable voice.
  • Those who can gain acceptable voice with considerable therapy input
  • Those where voice modification surgery is required.

The aim of therapy is to feminise the voice so that it does not attract attention. The voice should possess the correct blend of pitch, loudness and quality combined with a feminine manner. At the first or second session an audio tape is made to determine the fundamental pitch frequency. This is to show if the pitch moves into the feminine range after therapy. Transsexuals who use a fundamental frequency of 160 hz. or more are likely to be judged as female. Those with a fundamental frequency below 160 hz. are likely to be perceived as male. There are two important points to remember regarding frequency. Firstly there is an overlap between male and female frequencies - Eartha Kitt and Cher are examples of low frequencies, and secondly, some transsexuals have a large frame and would sound ridiculous with a high pitched voice.

A photograph of the client is taken at an early stage in therapy, and may be repeated at intervals to assess improvement in femininity. Recently I have started videoing transsexuals to evaluate voice and body language together.

We are all influenced by how we expect males and females to sound. A group of university students were asked for three female and three male characteristics.

For female they selected:

  • High pitch
  • Wide pitch range
  • Gentle speech

For males they selected:

  • Low pitch
  • Loud voice
  • Forceful speech

Voice changes may be accomplished in several ways:

1. Relaxation and Breathing.

It is impossible to practise voice exercises without being relaxed and using deep breathing techniques. Breathing must be from the level of the diaphragm giving maximum lung capacity. Without taking a deep breath it is impossible to do voice exercises without running out of breath when working on pitch, resonance, and intonation.

2. Pitch.

Men have a larger voice box than women with thicker, larger vocal cords, which gives a lower pitch but, as has already been noted, the pitch range of males and females overlap. Females use a wider pitch range than men and are described as being more expressive and melodious in their speech. Pitch range can be extended by singing. It may be helpful to sing along with the radio or a CD - any way that will loosen up the voice box is useful. Exercises to produce a musical note that can glide up and down on supported breath should follow, then speaking the song using the same breath technique as for singing. Each phrase should be finished with a deep breath as in singing.

Pitch can be raised by making a falsetto ('ah'), and bringing the pitch down as low as possible without breaking the voice and practice talking in a monotone on that note and gradually start to vary the pitch as you become comfortable with this pitch. This lowering the pitch can be combined by making a gargling sound which will automatically tighten up the throat, and the voice can be brought to the front of the mouth. The voice will resonate from exactly the same place with the lowest falsetto or the gargling.

However increasing pitch without a change in resonance will not produce good female voice, and special attention must be given to the way a person coughs, laughs, and clears their throat.

3. Resonance.

Resonance is perhaps the most important aspect of voice change. The aim is to develop head rather than chest resonance. This can be done by feeling vibration in the chest by humming and slowly raising the sound into the throat and into the mouth and nose. Changing resonance gives the illusion of raising the pitch. It is not where the voice is pitched, but what can be done with it. It is important not to strain the voice and damage the vocal cords. The client should start by practising for a few minutes, and build up gradually. The focus of articulation should be at the tongue tip and lips to move the emphasis away from chest resonance.

Slight breathy quality which is made by not quite bringing the vocal cords together, can feminize the voice. This requires careful monitoring so that the voice does not degenerate into a whisper that cannot be heard.

4. Intonation.

Women use a wider range of intonation patterns than men. Men use more falling than rising tones, while women use more rising tones, giving the illusion of a higher pitch, men often talk in a monotone

5. Voice Quality.

On the whole women enunciate more clearly and precisely than men. They talk slower than men, with a softer delivery which involves breathing out slowly in a controlled way, during speech. Vowel sounds tend to be longer. Male voices on the other hand, have powerful staccato attack, and men generally speak more loudly than women.

6. Vocabulary and subject matter.

The best advice is to listen to the way women speak and the vocabulary they use. Women tend to concentrate more on thoughts and feelings, while men concentrate on objects and actions. Men talk in a more direct manner. A simple illustration is to imagine someone asking a friend if they are going for a drink after work. A man might say rather abruptly "Coming down to the Pub?" using the minimum of words and concentrating on the desired action in rather an impersonal way. A woman might say " Do you feel like going for a drink tonight?" concentrating on the friend's feelings and desires, personal and not abbreviated. Women help themselves by being able to talk about their problems, and thinking about their feelings. Men are more reticent about these matters.

It is said that men speak in a more aggressive blunt authoritarian manner, but women speak with a clearer enunciation, correct grammar, politeness and tend to talk about trivial topics.

This may be changing as women are taking a more prominent position in society but these points still apply to some extent, and transsexuals must be aware of them as they must emphasise all aspects of femininity.


  • Women use more evaluative adjectives than men, e. g. 'lovely', 'delightful' but not to the extent that they might be mistaken for being "gay."
  • Women are better listeners.
  • Vocabulary is characterised by more words implying feeling and psychological state.
  • Women talk more slowly.
  • Men interrupt more than women.
  • Men talk in a more direct manner.
  • Men demonstrate a greater sense of humour in speech.
  • Men have a predominance to discuss subjects such as sport, politics, and business. Women are more concerned with people, relationships, and clothes.

The importance of non-verbal behaviour should not be forgotten. Male body language can be as big a give-away as a male sounding voice.

  • Women use more eye contact than men
  • Women nod and touch their hair and clothing more than men
  • Women smile more than men
  • Women use more gestures than men
  • Women walk with smaller strides, swing their hips and tuck their elbows in
  • Women cross their legs more than men
  • Men are more relaxed and expansive when sitting down, generally positioning their arms, and knees wide apart and holding their arms away from their bodies.
  • Men are more restless than women, exhibiting more postural shifts and foot movements.
  • Men take longer strides and walk by swinging their shoulders
  • Men put their hands in their pockets, women do not.

There are a number of minor points, such as using your female name when answering the telephone, and waiting until a salesperson is facing you before speaking in shops.

Where appearance and mannerisms are concerned, it is not how the public perceives a client but how the person perceives themself. If the transsexual is satisfied with their appearance, voice, and mannerisms, they will be a success in their preferred role.

The role of a Speech and Language Therapist is multi-focal, firstly to achieve acceptable voice and body language, secondly listen and advise about any problems that may arise to help the transsexual gain self confidence in their preferred role in society.

A transsexual sums up their change in this way:
"Opening the bottom half of a stable door with the top half already open . . . . it lets you walk into the sunshine."

Clark, S., (1998), To Sound Like A Woman, GENDYS '98, The Fifth International Gender Dysphoria Conference, Manchester, England.

Web page copyright GENDYS Network. Text copyright of the author. Last amended 22.03.02