Harmonizing Identities: A Scoping Review on Voice and Communication Supports and Challenges for Autistic Trans and Gender Diverse Individuals.
Current speech-pathology guidance barely touches voice dysphoria for autistic trans clients—add explicit voice-affirming targets and training.
01Research in Context
What this study did
Glanville et al. (2025) read 40 papers, reports, and book chapters.
They hunted for any guidance on voice and communication support for autistic trans and gender-diverse (TGD) people.
The team mapped what speech-language pathologists (SLPs) are told to do and where the holes are.
What they found
Almost every source talked about social-chat skills.
Almost none talked about voice pitch, resonance, or gender-affirming voice work.
SLPs get no clear road map for easing voice dysphoria in autistic TGD clients.
How this fits with other research
Vassos et al. (2023) scanned 31 Autism Transitions Research Project studies and also found scant focus on equity or TGD needs.
Maingi et al. (2025) showed Indian SLPs feel lost when setting up AAC; the same "we were never trained" theme pops up for voice work.
Morris et al. (2019) listed provider knowledge gaps across all autism healthcare; Bridgette narrows the gap to one overlooked clinic room—voice therapy.
Why it matters
If you write goals for social communication but ignore voice gender cues, your client may still feel mis-gendered every time they speak.
Add one question about voice dysphoria to your intake form this week.
You will open the door to gender-affirming voice targets that most SLP protocols skip.
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02At a glance
03Original abstract
Autistic trans and gender diverse (TGD) individuals face unique voice and communication challenges compounded by minority stressors, impacting wellbeing and access to care. Speech pathologists are crucial in providing gender-affirming and neurodiversity-affirming support; however, guidance for working with this intersectional population remains limited. This scoping review mapped current knowledge on voice and communication challenges, identifies available supports, and demonstrates the limitations of existing guidance for speech pathologists. This review draws on 40 sources, including 29 peer-reviewed articles, 8 clinical guidelines, 2 books, and 1 position statement, identified through comprehensive searches of databases such as CINAHL, ERIC, Medline, APA PsycINFO, and grey literature in May 2024. Findings indicated that 96.8% of identified challenges pertained to communication, while fewer (3.2%) focused on voice-specific issues. Similarly, supports primarily addressed communication (91.3%), with 8.7% targeting voice needs. Communication challenges included barriers faced by autistic TGD individuals and those interacting with them, including healthcare professionals, peers, and family. Supports were identified as strategies and resources to enhance service delivery and client wellbeing, such as using visual aids or offering multiple communication options. However, significant gaps remain in addressing the unique voice and communication needs of this population, particularly regarding voice dysphoria, camouflaging versus identity disclosure, and communication within healthcare settings. Autistic TGD individuals represent a unique population whose needs are not sufficiently addressed by current guidance. This review highlights significant gaps in research and clinical practice and calls for improved clinical guidelines and specialized training for speech pathologists to enhance care.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.rasd.2022.102101