Before Anna Kemptar knew of services offered in Duluth that could safely train people on how to match their voice to their gender identity, she started looking online for people offering advice.
"But I wasn't sure how rooted in research it was or if it was going to be safe to do," Kemptar said. "I didn't want to start down the path that would lead me to ruin."
So Kemptar, who lives and teaches in Esko, started looking up places that offered voice coaching in the area and the first call she made was to the University of Minnesota Duluth's Robert F. Pierce Speech-Language-Hearing Clinic.
"Just total dumb luck," Kemptar said. "It turns out it was the best program I could have possibly found."
For about 10 years, the UMD Speech Clinic has offered free and individualized transgender voice therapy. This past fall the clinic started offering group sessions as well for anyone who wants to work on developing their desired voice alongside others experiencing something similar.
Kemptar attended those group sessions every week.
"The really great thing about it was that it was a way for trans people to get together. Which is really rare," Kemptar said. "For people that are first starting to transition, especially male to female, it's really hard to go out in public. It's a lot more noticeable."
Ashley Weber, the clinical instructor speech language pathologist, said she hasn't heard of anywhere else in the state offering a group-based version of transgender voice therapy.
"The fact that we're offering a group network was a really big deal," Weber said. "We've found big success within the group of having peers that can support each other and give each other feedback."
The UMD clinic has received calls from people in the Twin Cities wanting to drive up for the group session. Weber said the University of Minnesota Twin Cities, which offers individualized services, is in the process of figuring out how to formulate group-based services too.
The clinic has seen up to five individuals in the group setting — which currently meets every Wednesday evening — and welcomes more participants.
"Everybody's at a different stage," Weber said. "The ages range within the group so everybody brings a different experience into it, and a lot of humor, which I love."
Most of the clients at the clinic are people transitioning from male to female. Weber said that's because once people transitioning from female to male start taking testosterone, the hormone is able to lower the pitch of their voice for them. Estrogen, however, doesn't have much of an effect on vocal quality.
During the 6-12 month process in which clients meet twice a week for individualized training, Weber and student clinicians work with individuals on gradually increasing vocal pitch, both for authenticity and safety reasons. If done too fast, people can experience vocal abuse and loss of voice, which only deepens vocal pitch.
Some clients even work on language and how they use description.
"Since expression is a huge part of our culture ... being mis-gendered through your expressions can be really damaging," Weber said. "We just want to offer individuals that voice and make sure we're affirming their gender identity."
Because insurance can be finicky when it comes to covering outpatient services, Weber said voice therapy can be a barrier for individuals already dealing with hefty medical expenses. At UMD, the clinic is able to provide the services for free largely through grants and donations.
Clients use a voice journal to track different aspects of their voice as well as their goals and progress. The journal also outlines exercises to do at home.
"These clients have been some of the hardest working clients I've ever had," Weber said. "They really have to fight for what they're doing."
While going through the training last year, Kemptar said she warmed her voice up every morning like she was taught.
"Because it's all muscles," Kemptar said. "You're just exercising your muscles. They're going to get tired, but you have to build them up to be able to get where you want."
Before starting voice therapy, Kemptar said she often found herself not using her voice because she feared it was her "giveaway."
"I felt like it was kind of a tell that I was trans," Kemptar said. "It was interfering with my enjoyment of life. So that was my motivating factor, even if it was going to be dangerous I was willing to take that risk. I am lucky that I found a healthier alternative."
One of the most rewarding parts of undergoing the voice therapy, Kemptar said, was when she listened to her final voice recording and compared it to the first one.
"It was like night and day," Kemptar said. "There were times I was in tears because she'd play back my voice, and I'm like, 'That's me?'"
Although she's done with the training, Kemptar still checks in with herself to make sure her voice is where she wants it to be.
Since the clinic started offering transgender voice therapy about a decade ago, approximately 10-15 people have gone through the training, according to a clinic secretary. Most of those clients are from more recent years.
According to Essentia spokesperson Louie St. George III, Essentia Health also has a voice therapist who offers transgender voice therapy services.