As a practice, we see clients between 9 am and 7 pm Central time Monday - Friday, and 10 am - 4 pm on Saturdays. Each clinician sets their own hours, and appointment scheduling is subject to availability. Here is each clinician's typical availability as of June 2024. All times are in Central time:

It's your choice. For voice or swallowing rehabilitation, we will make a personalized recommendation. For voice transitioning, we have no prescribed frequency. Most clients reduce how often they see us as they progress. Past clients, on average: 2x weekly 12% weekly 55% every other week 21% every three weeks 8% less often than every three weeks 5%

This varies greatly, and depends on you personally. For voice and swallowing therapy, we average 4-6 sessions, but it will depend on your specific needs. For gender affirming voice care, some people only need one session for validation that their voice passes, or to fine tune their voice. Other people need time to explore their voice before even fully understanding what they want to sound like, or want singing voice lessons or to work on other professional voice skills after they transition their voice. Past clients, for comparison: 40% 1-5 sessions 29% 6-15 sessions 15% 16-25 sessions 16% 26+ sessions When you're happy with your voice, we're happy, and you graduate yourself!

This varies greatly, and depends on you personally. Some people only need one session for validation that their voice passes, or to fine tune their voice. Other people need time to explore their voice before even fully understanding what they want to sound like, or want singing voice lessons. When you're happy with your voice, we're happy, and you graduate yourself. ​​ How long from start to finish: <1 - 3 months 54% 4 - 6 months 15% 7 - 9 months 15% 10 - 12 months 5% > 12 months 10%

Your personal goals and situation will ultimately determine your timeline, but we have seen overall trends in different gender groups. For those not familiar with statistical terminology, the median is the middle value in a sorted list of numbers. For example, the median of 1-3 would be 2. Interquartile range (IRQ) measures how spread out data is, and tells us the range in the middle of the set of scores. The higher IQR for gender diverse people is because our gender diverse clients sometimes have more complex goals, such as being able to fluidly shift between different voice gender recipes. Observations from past clients: Trans feminine: median 10 sessions, IQR 18 sessions Trans masculine: median 5 sessions, IQR 6 sessions Non-binary: median 7 sessions, IQR 8 sessions Gender diverse: 7 sessions, IQR 20 sessions

Yes! We like to describe our voice care as gender AND identity affirming, because it's really about what vocal self-expression fits you, not the stereotype of what voice matches your gender. There are seventeen different variables that contribute to listener perception of voice sex and gender. By choosing for yourself how you want to modulate whichever of these variables you want to shift, you find YOUR unique voice. We present each new concept as genderless as they are- here is the range, and now that you can control this new vocal knob, what amount fits you? Anyone who doesn't feel like their voice fits them can go through this process. And you don't have to know ahead of time what voice you want- you learn that in our process.

Sometimes! Every plan is different. We are in network with BCBS, Oscar Healthcare, and Medicare, and can provide a super bill you can submit to insurance to request out of network benefits. We also can explain how to request a single provider agreement with other insurances, such as United, Aetna, or Cigna, so you can see us at your in network rate). When choosing your plan, look to see if there are any exclusions for speech therapy or gender affirming care. Look closely at what the detailed benefit plan says about what diagnoses they allow speech therapy for. Plans that will only cover speech therapy after an accident or illness, or for developmental disabilities, are unlikely to cover gender affirming voice care. HMO plans that do cover gender affirming voice care are likely to restrict sessions, require referrals and pre-authorizations, and cause long delays waiting for approval.

Voice therapy is necessary to achieve the best vocal outcomes. However, we all deserve bodily autonomy, and voice therapy may not be the right choice for your particular circumstances. If that is your choice, and you give informed consent, we will write a supportive letter on your behalf. You may still be required to participate in voice therapy though, as most surgeons require pre-operative voice therapy for the following reasons: All surgeries have risks, and surgeons don't want to expose you to unnecessary risk. Since most people transition their voice without surgery, otolaryngologists know that by requiring voice training first, they give you the best chance to avoid those risks. How you use your voice after surgery impacts both your short term and long term vocal outcomes. Without complete vocal rest followed by slowly adding gently voice sounds then speech after surgery, you risk delaying how long it takes to get to a good vocal quality, and can irreversibly harm your voice. Complete vocal rest can be difficult without first learning techniques to clear mucus without coughing or clearing your throat. Pre-operative voice therapy teaches techniques that help you care for and use your new voice in a sustainable way that improves vocal quality and ease. Even if you do not vocalize now for dysphoria reasons, the educational components of voice therapy can be helpful to prepare you for post-surgery complete vocal rest and gentle voicing. Pitch is only one component of a complete voice transition, as testosterone impacts other acoustic perceptual vocal characteristics including resonance, tone, and speaking patterns. Additionally, some voice surgeries only temporarily raise pitch. That is why research consistently shows that people who choose surgery achieve the most complete voice transition by combining it with voice therapy. Please ask to work with Tallulah or Zoe if you need a letter and/or gender affirming voice surgery adjacent voice therapy.

We are in network with BCBS, Oscar Healthcare, and Medicare insurance. We also accept FSA/HSA cards and credit cards. ​ Upon request, we are able to provide a superbill for submitting to insurance.