Christie Block, MA, MS, CCC-SLP, 47, is a licensed and board-certified speech/language pathologist who's also an expert in transgender voice. Block spoke with Cosmopolitan.com about what it's really like helping transgender and gender-variant people find their true voices.

I'm straight and cisgender, but I have always been interested in language and gender since my college days, when I was studying linguistics. Then when I studied speech and voice pathology, transgender voice was a natural transition. I always knew I wanted it to be part of my focus as a voice therapist.

My work with transgender and gender-variant clients is about one-third to half of my practice. I am a speech pathologist, so I specialize in people who have voice disorders and hoarseness, people who get surgery to improve their vocal quality, and I also work with a number of surgeons and doctors who address the medical aspects of the voice. I'm really like a physical therapist for the voice. People who do trans voice training usually are speech pathologists, since vocal health has to be maintained when changing the voice.

When a client first comes to me, sometimes they have an idea of how they would like to sound and sometimes they don't. They might say something like, "I like this celebrity's voice," but mostly they come in and say, "I want to fit in. I want to sound more feminine. Show me what that means physically and skill-wise with my voice." It's my role to analyze physical aspects of the voice like the shape and size of their vocal cords, as well as more gender-norm-related things like intonation (how much the vocal pitch moves, like when your voice goes up at the end of a sentence so it sounds like a question, which a lot of cisgender women do) or their word choice or how many words they speak.

They might say something like, 'I like this celebrity's voice,' but mostly they come in and say, 'I want to fit in. I want to sound more feminine.'

I don't teach most clients how to make their voice go up or sound more fitting with gender norms, but if I have a client who wants to learn how to do that, I will show them some different options and help them come up with a good combination that suits their body and their interests, and feels true to them. My work is very much about finding an individual and unique vocal identity that is often also based on the norms we see in society. I don't feel like I'm promoting stereotypes, but I am adjusting to what people want, so if someone wants to sound like a really girly girl or more like a dude, then that's the direction I go in.

With trans men, some of them are taking testosterone, which typically changes their pitch into a cisgender male vocal range. So for those men, I'll typically work on vocal resonance with them. Vocal resonance is just the way the voice reverberates in his face. Our voices sound different in an elevator versus in the shower versus in an auditorium, so it's really just how your voice fills a room, as well as the richness of the tone of the voice, which can make the voice sound more natural.

If a client also has any kind of voice problem (which can come from trying to make their voice higher or lower on their own), we do voice therapy before we do the training, so we can pick a pitch that's a good target for them and sounds natural in their body. Sometimes someone has a pitch they want to speak in, but they need to make sure their resonance is in a good place so they don't strain their voice.

In the beginning, I often tell people to just try anything, like speaking higher, speaking lower, or imitating people they know. Then once we start working together, I like them to try out their voices in their real-life situations, if it's possible for them to do so.

Most of my clients haven't tried to change their voice on their own before they come to see me, or if they have, they haven't had much luck, or they try and they feel embarrassed. Some people come when they're just exploring gender identity, or they may know what their gender identity is, but they are still unsure of what steps to take. Other people come in and they've already had hormone replacement therapy and will say very specifically, "I'm going to have gender reassignment surgery in two months and I want my voice to be good when I get there."

There's a lot more at stake for trans people who are making mistakes.

Changing your voice is like learning a language in a way, because you know you're making mistakes and hopefully everyone thinks it's endearing that you're trying, but there's a lot more at stake for trans people who are making those same mistakes. It's also often harder for people to speak in a new way with people they've known for a long time, even if they support them, because they've known you with a different voice and it can be hard for them to switch from the way they know you to speak. Sometimes they might even mock you for trying to sound differently.

Once my clients find the voice that feels comfortable to them, they're very happy people. When people sound in a way that feels more authentic and helps them with being gendered correctly, it's so helpful. They really have a sense of pride as well because it's not easy for a lot of people to do. I also make recordings of their voices as they go along so they can see the change. It's often so gradual that it's hard for them to know what they sounded like just weeks ago. When they look back and see how far they've come, that can be so rewarding. Then we often will do many tests like making a phone call to see if they're gendered correctly, or they'll give me an update about what kinds of situations have happened with them in terms of being gendered properly or not.

I tell my clients they can't expect to sound exactly like a cisgender person because it's just not realistic. Realizing that can actually bring about a form of self-acceptance, which in turn makes the world a better place filled with different kinds of voices.

This article has been edited for clarity.

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Lane Moore Sex & Relationships Editor I'm Lane Moore, sex & relationships editor at Cosmopolitan.com.

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