A co-produced, community-based voice service for trans and non-binary people:Service users’ views on terminology and pathology-based language

Manchester, UK is a city with a high percentage of people identifying as LGB+ (6.7%), and a relatively large trans population (0.3%) compared with the country as a whole (GMCA, 2023). In 2020, Indigo Gender Service a community-based provision that employs a high proportion of trans and LGB+ people was commissioned by the National Health service (NHS). In line with service improvement strategy (RCSLT, 2022; NHS National Quality Board, 2002) the Indigo Gender Service has a co-production ethos where service users’ views and feedback are central to care pathway and service design.<br/><br/>The voice and communication therapy (VCT) team provides advice and therapy to align service users’ voices, along with other aspects of communication to their authentic gender identity. This may include voice feminisation, masculinisation or neutralisation and the service is available to people with all gender identities including non-binary individuals (RCSLT, 2018).<br/><br/>As part of on-going service improvement, a service user group was held, facilitated by Speech and Language Therapists who deliver VCT. Service users’ views of terminology relating to speech and language therapy voice modification, and their understanding and use of terminology utilised by professionals were explored. Overarching terms such as ‘Gender Affirming Care’, as well as profession specific terms such as ‘VCT’ were discussed with service users. <br/><br/>Service users were highly negative about longer and more technical terminology. They preferred more straight-forward, easily understandable and non-pathologising terminology such as ‘Exploring Voice’. The findings have implications for services and Speech and Language Therapy teams providing care to trans and non-binary people.<br/><br/>References<br/><br/>Greater Manchester Combined Authority (GMCA)(2023). Census 2021 Briefing: Sexual orientation and gender identity. https://www.greatermanchester-ca.gov.uk/media/8080/census-2021-briefing_sexualorientation_finalso-002.pdf<br/><br/>National Quality Board (2022). Improving experience of care: A shared commitment for those working in health and care systems. https://www.england.nhs.uk/wp-content/uploads/2022/10/B1632-shared-commitment-for-those-working-in-health-and-care-oct2022.pdf<br/><br/>Royal College of Speech and Language Therapists (2022). The RCSLT strategic vision: 2022-2027. https://www.rcslt.org/wp-content/uploads/2023/03/RCSLT-Strategic-Vision-2022-2027.pdf<br/><br/>Royal College of Speech and Language Therapists (2018). Trans voice – guidance. https://www.rcslt.org/members/clinical-guidance/trans-and-gender-diverse-voice-and-communication/trans-voice-guidance/#section-1<br/>