Best practice in gender-affirming voice (Ilacqua et al., 2025)

Purpose: While gender-affirming communication research is growing, most of the research has been focused on acoustic, biological, and perceptual factors related to the client. To date, little attention has been given to the clinician–client relationship. This study explored perspectives of gender-diverse individuals who received gender-affirming communication services from speech-language pathologists (SLPs). This included what made gender-diverse individuals feel protected and respected, and how inclusivity was shown during service provision.

Method: Four semistructured, virtual interviews were conducted. Data were analyzed using interpretative phenomenological analysis.

Results: Four superordinate themes with supporting subordinate themes were identified: (a) Allyship emphasized the important role the SLP had in being an ally through what clinicians did and what clinicians learned; (b) Language Matters stressed how language choices related to voice, identity, and cultural responsiveness supported the clinical relationship; (c) Holistic Care focused on if the clients felt their SLPs valued the client as a person through coaching and listening; (d) Barriers to Success emphasized both external and internal barriers to feeling supported and meeting goals related to relationships, cost, and safety.

Conclusion: SLPs can facilitate safe spaces, become allies, utilize culturally responsive language, and focus on holistic care. Future directions include further research on therapeutic relationships, an emphasis on relationship centered care, and increased opportunities and competencies surrounding diversity, equity, and inclusion for SLPs.

Supplemental Material S1. Standards for Reporting Qualitative Research (SRQR).

Ilacqua, C., Robinson, G. C., Strong, K. A., & Douglas, N. F. (2025). Best practices when delivering gender-affirming voice services: A phenomenological interpretative analysis of four semistructured client interviews. Perspectives of the ASHA Special Interest Groups. Advance online publication. https://doi.org/10.1044/2025_PERSP-24-00231