Vocal Health Tips for Gender Affirming Voice

Developing an authentic sounding voice that aligns with one’s gender expression is a goal for many patients across the gender spectrum. Whether you are looking to masculinize, feminize, or neutralize the sound of your voice, it is recommended to seek out assistance from a speech-language pathologist with a background in voice, who is also culturally competent in transgender health care.

Attempting to change your voice without professional guidance can lead to damage on the vocal folds (also known as vocal cords) and the surrounding musculature. In order to prevent injury and achieve optimal voice production, I suggest following these vocal health tips.

Tip #1 Drink lots of water

The vibrating outer tissue of the vocal cords requires hydration in order to vibrate efficiently. Vocal cords that are well-hydrated are also less likely to get hurt from extended voice use. Alcohol and caffeine are dehydrating substances which dry out the vocal cords and lead to irritation and hoarseness. If you decide to have a glass of wine or cup of coffee, just make sure to replenish with water. I recommend around 6-8 glasses of water per day.

Tip #2 Quit or reduce smoking

If you are wanting to feminize your voice, smoking will do the opposite. Smoking irritates and dehydrates your vocal cord tissues, resulting in a decrease in range and damage to the oral cavity, larynx, and respiratory system. If you smoke marijuana, consider consuming edibles as a healthier alternative for your voice.

Tip #3 Implement safe ways of coughing & throat clearing

Excessive coughing and throat clearing can lead to vocal cord damage, because when you perform these acts your vocal cords slam together. If you feel the need to cough or clear your throat, there are safe and even more feminine ways of doing so.

Coughing: Before a cough, gently hum (mmm) at your target pitch. Target pitch will vary based upon the individual, but a good starting point is the note E3 (165 Hz). This ensures that you will maintain a feminine pitch before even initiating your cough. Try to make the sound “eh-heh-eh-heh” short in duration, several in sequence. Widening the lips in a smile posture will also assist the sound coming out as lighter and brighter.

Throat clearing: Instead of clearing your throat, try taking a sip of water. If you still feel the urge to clear your throat, hum at your target pitch (mmm), gently clear your throat, and continue to hum.

In addition to vocal health, proper breath support and relaxation strategies aid in reducing muscle tension around the larynx. When the body, mind, and breath are connected, this helps facilitate an increase in range and a healthy, authentic sounding voice.

The exercises I will introduce will also have a double benefit in alleviating tension that you may feel around the time of your surgical intervention with Facialteam.

Breathing Exercise

Sit comfortably in a chair with your spine lengthened and your feet grounded to the floor. Your hips and knees should be at a 90-degree angle. Put one hand on your chest and the other on your belly. Take 3 slow deep breaths.

If you felt your shoulders or hand on your chest moving as you were breathing, this is known as chest or clavicular breathing. This can lead to muscle tension and give your voice a less powerful sound when speaking.
When doing this breathing exercise, the goal is for your hand on your chest to stay nice and steady. Your lower hand on your belly should rise and fall with your inhales and exhales.

Inhale through your nose on the count of 3. Let the air flow down expanding the belly.
Exhale through pursed lips on the count of 6. Let go of all the air and feel your hand on your belly move closer in.

Try repeating this sequence 3 times. It may also help doing this exercise while laying down.

Like the breathing exercise? Watch Facialteam’s video tutorial on relaxation breathing exercises recommend to manage nerves whenever you may need.

I hope you found these tips helpful! They can be done in preparation for facial feminization surgery or during your postop recovery. You got this!
For tips on getting moving after FFS Surgery, read our post by voice expert Christie Block on facial exercises.

About Jordan Jakomin


Adler, R. K., Hirsch, S., & Pickering, J. (2019). Voice and communication therapy for the transgender/gender diverse client: A comprehensive clinical guide (3rd ed.). San Diego, CA: Plural Publishing, Inc.

Hancock, A. B., & Siegfriedt, L. L. (2020). Transforming voice and communication with transgender and gender-diverse people: An evidenced-based process. San Diego, CA: Plural Publishing, Inc.

Verdolini, K. (2008). Lessac-Madsen Resonant Voice Therapy Clinician Manual. San Diego, CA: Plural Publishing.

Patient Relations Manager Lilia Koss, presentator of Lilia's Livestreams
About the author

Hello world! My name's Lilia Koss! With a background in humanities and diverse professional experiences, I've accumulated 11 years now working in the field of trans healthcare. Involved from the ground up when the business idea was just a seed within a clinic until it gradually transformed into the main focus of our activity. Like any startup, I have had hands in many pots: from workflows, customer journeys, social media, public relations, customer service, sales and coordination, content, web... Now life is more defined. Lately, I focus my energies on Public Relations, Social Media and copywriting of quality for our target during my day-to-day. Plus, the organization of annual educational orientation events around the world aimed at raising visibility of gender-affirming healthcare. Life is pretty complete.