CHAPEL HILL, N.C. — Nicole Hatch had spent six figures on her transition from a male to a female, including flying to Thailand for sexual reassignment surgery and spending at least $20,000 on facial hair removal.
But her voice still gave her away – callers would refer to her as "sir" when she answered the phone.
So Hatch came to the University of North Carolina at Greensboro, where speech pathologists teach transgender people how to speak like the people of the sex they're becoming or have become.
"To me, there's nothing worse than seeing someone dressed as a woman, a beautiful woman," said Hatch, 57. "Then she opens her mouth and she sounds like a sailor. It's very off-putting for people."
The former Florida chiropractor took eight private classes at UNCG, learning to redirect her voice through the front of her mouth instead of her throat or chest so that she sounds more feminine. "Voice is, I would say, 50 percent of being able to pass," Hatch said.
Each semester, speech pathologists within UNCG's School of Health and Human Performance teach about eight of so transgender people in a program that began 12 years ago, says Dean Celia Hooper, who taught the transgender voice classes at UNCG for five years until she became dean in 2008.
The classes for transgender clients – people who want to live as the gender they weren't assigned at birth – are a tiny part of the work of UNCG's speech and hearing center. The classes concentrate a lot on pitch, but the clients also learn about loudness, quality of voice and movement, especially facial and hand gestures.
Women use more adjectives, and they gesture more with the hands and use their face more to express feelings, Hooper said. During one activity, clients describe the art on the walls.
"And women will say, 'that's a beautiful picture, I see a bubbling stream ...' They'll really elaborate," Hooper says. "Men will just say, 'I see a house and a car.' And then women add, 'it's just a fabulous-looking house.'"
The differences in word choice are rarely more evidence than in the how-to-give-directions project. The teacher tells clients to give directions on getting from point A to point B. Then they get handouts that compare male directions to those given by females.
Women use landmarks, while men use a compass.
A woman might say: "When you get to the red house with the blue shutters, take a right, go three miles. You'll go past the store, you'll see a cornfield. You'll see a beautiful fire station. It's new, you know, they just built it last week. Then you turn left."
A man would say: "Go west three miles, take a left at this road, go four miles, take a right."
"It's just minimal," Hooper said.
Movement is naturally constrained by what you wear. People wearing pants sit differently than those wearing skirts so clients wear different clothes in class to learn how to sit correctly.
"One thing we recommend, if you've never worn heels, probably your 40s and 50s are not a good time to start," Hooper said. "You can get cute shoes that are flat. So why be awkward and start doing that? Especially if you're large and have big bones, heels aren't for you."
Hatch says her life in the gay community – she lived as a homosexual man for about 10 years – meant she needed help only with pitch. So her eight private lessons – cancer treatments in nearby Chapel Hill prevented her from taking the classes – concentrated on moving from her natural gender-neutral voice to a more feminine one.
She learned to redirect her voice to speak from the front of her mouth, which raises the pitch.
"It's my natural voice, but I'm just using different mechanics," Hatch said. "It's probably one of the hardest things to do because it's so easy to fall back into the habit of the way you're used to speaking."
Although no one knows how many people are transgender, experts estimate the number is between .25 percent and 1 percent of the population, said Mara Keisling, executive director of the National Center for Transgender Equality.
Not all transgender people surgically change to the opposite sex, although they may live as that sex either full-time or part-time. Some can't afford the sex-change surgery, while others fear the social costs of transitioning. They are different from cross-dressers, who enjoying wearing the clothes of the opposite sex but don't want to change their sex.
Keisling attended a similar program at George Washington University. The College of Saint Rose in Albany, N.Y., has taught voice classes for transgender clients for about three years, says Jack Pickering, an associate professor at the school. Private practitioners and colleges in other countries tend to be on the forefront of such work, including in Australia, and Belgium, he said.
Clients at UNCG attend one weekly two-hour class for a semester, and some attend for two semesters.
"Mostly, their first complaint is 'my voice is too low,'" Hooper said. The voice is more of a problem for men transitioning to women than women transitioning to men because testosterone makes the voice lower naturally.
So the speech pathologists evaluate each client's voice to determine how high or low they can go and offer them a range of pitches to try to match.
"We look at voice. We look at fluency. We look at the language that they use, all the different characteristics of speech," Hooper said. "And we present to them, here's what women do, here's what men do. It's on a continuum. One speaker may sound feminine and another ... it's very subjective. So we talk about, what do you want to sound like?"
For Hatch, meeting other people like her was itself a revelation.
She credits an earlier trauma with giving her the courage to have the sex reassignment surgery in 2007. Six years earlier, while working as a man at a private hospital in Saudi Arabia, she opened a letter bomb addressed to her. Hatch lost an eye, a hand and was severely scarred on one thigh.
"I never really thought of myself as a strong person," Hatch said. "But now that I look back on what I've gone through, I think I'm a very strong person and a very courageous person for just standing up for myself and saying this is who I am and I have a right to be happy."