When Sarah Williams walks down the street with her fitted wig, impeccable make-up and manicured fingernails, she blends in with everyone else. But when she opens her mouth to speak, she worries that her voice will give her away.
"Once I became confident in my presentation as a woman, the thing that stood in the way for me was my voice. And being authentic and being viewed in culture as a woman if I didn't have the right voice, the whole thing would just be out of sync," she said.
Biologically, Sarah is male. Once a week she goes to see Leah Helou, a speech-language pathologist who last year started the Transgender Voice Program at UPMC's Voice Center. Helou guides Sarah through vocal exercises with the goal of feminizing her deep voice.
Helou's field is a small one. In the Pittsburgh region she is the only one doing this work, and it's only been for the last year. When a person switches gender, when they have ironed out all of the other details, their voice remains.
Voice isn't, of course, just voice. Our voices are inextricably linked to who we are. It's the third print of the body—the fingerprint, the retinal print, and the vocal print. While much of it comes from our chest, lungs, vocal folds and tracts, much of it is dictated by circuitry in our brains.
Kittie Verdolini-Abbott, a professor at the University of Pittsburgh's Department of Communication Science and Disorders says that while there are three antatomical or physiological subsytems in the body for voice production, she always teaches that there is a fourth. "The other one is the brain and mind, and that includes emotions just like for any other action that we have. It's our brain and the neural functioning of the brain that ends up instructing the body what to do and when to do it," she said.