The Year in Review Voice & Communication

Background :
The capacity to shape and adapt vocal motor behavior according to individual preferences is at the core of transaffirmative voice care, an emerging interdisciplinary field that integrates medical, psychological, communicative, and sociocultural perspectives. For transgender and gender-diverse individuals, the voice is a pivotal element in both the perception of their gender by others and their own processes of gender affirmation. The facilitation of a congruent and authentic vocal expression through individualized care is therefore essential. Contemporary approaches to vocal motor behaviour allow for its intentional modulation in accordance with personal preferences. Transaffirmative voice care increasingly strives to accommodate the unique identities of individuals, the evolving array of technical tools, and a situated understanding of the communicative contexts in which voice is embodied and expressed. This presentation seeks to deliver a comprehensive synthesis of the literature on voice and communication within trans and non-binary populations, covering developments from the 2023 EPATH conference through to 2025.
Methods:
This review included peer-reviewed journal articles, written in English and published between 2023 and 2025. Studies were eligible if they focused on the voice and communication of trans and non-binary adults. Three databases – Embase (www.embase.com), Medline (Ovid), and Scopus (www.scopus.com) - were searched on 20 June 2025, using a combination of three key concepts (voice AND communication AND trans or non-binary people). The results were limited to the publication period covered by this review. Covidence was used to manage the review process (from eliminating duplicates to extracting data from included studies). An expert in literature review methodology oversaw the process to ensure its rigor, while a subject-matter expert reviewed exclusions for accuracy.The included studies were grouped thematically. Data were presented in a narrative synthesis accompanied by graphic visualizations and tables.
Results:
A total of 352 references were found in the three databases and 167 duplicates were removed. Of the 185 references screened based on title and abstract, 59 were excluded. Assessment of the 126 full texts based on eligibility criteria led to the inclusion of 103 journal articles (23 were excluded for the following reasons: non-English language (n = 8), non-peer- reviewed journal articles (n = 14), and non-target populations (n = 1)). Eleven thematic areas were identified: autism, voice training, laryngeal surgery, assessment, epistemological reflection, professional training, technologies, general information, database, tobacco, and geographical reality. Nine of these themes included at least two studies and were therefore included in the synthesis, while themes represented by a single study were not synthesized. Recent developments in trans-affirmative vocal care (2023–2025) indicate a significant transformation in the field. Contemporary approaches increasingly prioritize care that is personalized to clients’ vocal goals and gender identity, grounded in rigorous scientific evidence, and enhanced by emerging technologies. As a key marker of identity, social recognition, and emotional well-being, the voice calls for individualized care that moves beyond binary models to embrace androgynous, fluid, or non-gendered vocal expressions. Empirical studies explore the benefits of voice therapy in supporting vocal congruence and psychosocial well-being. Some studies also describe innovations - such as machine learning–based tools, voice-centered apps and immersive virtual reality platforms – as promising avenues for enhancing therapeutic precision and engagement. Emerging frameworks further emphasize client-led goal setting and fluid trajectories over binary vocal norms. Studies also stress the need to raise awareness of vocal health professionals’ roles among both the public and patients, underscoring the importance of collaborative, well-informed care. Cross-culturalperspectives challenge Western-centric models, urging more context-sensitive practices. Moreover, research calls for inclusive, tailored care for trans and autistic individuals, centered on their lived experiences and specific needs, while highlighting the urgent need for clinical and educational frameworks that address both neurodiversity and gender diversity. Finally, it calls for enhanced training of professionals to provide trans-affirmative, reflective, and safe care.
Conclusions :
Increasingly, voice therapy and surgery are integrated into holistic care pathways. These developments collectively support a more inclusive, pluralistic, and empowering model of vocal transition. As the field evolves, it underscores the importance of agency, diversity, and ethical responsiveness in trans vocal health.