Brigham Young University’s speech pathology program will keep its accreditation, despite concerns about discrimination after the school canceled services for transgender clients seeking gender-affirming voice therapy.
The master’s program and speech clinic at the private religious school, owned by The Church of Jesus Christ of Latter-day Saints, first faced scrutiny earlier this year when administrators ended therapies meant to help transgender individuals match the tone and pitch of their voice to their gender identity.
The school’s leadership said in February that providing those services did not align with the faith’s policies against “social transitioning” for transgender members.
After a complaint was filed over that decision, the national Council on Academic Accreditation in Audiology and Speech-Language Pathology, or CAA, reviewed the program. It issued a letter released by the school last week with its decision to drop an investigation into BYU.
“After considering all submitted documentation, the CAA determined that, in reference to the situation the adverse information described, the program remains in compliance with CAA’s Standards for Accreditation,” the brief letter states.
The result comes after several students in the program and others in speech pathology nationwide had condemned the university for dropping transgender speech services, arguing it went against providing unbiased health care to everyone in the community. One called it an “ethical injustice.” Another said it was a “transphobic policy.”
National studies have shown that gender-affirming speech services can alleviate pain and difficulties when a person’s appearance or mannerisms don’t match their gender identity. It is considered medical care, such as other speech therapies to help with stuttering or voice disorders.
A transgender client who had been receiving the therapy at BYU and was told she was no longer welcome also spoke out.
“The program was so helpful and had been relieving a lot of my anxiety around who I am,” the client had previously said. “So to just be kicked out like this is really painful.”
Additionally, the American Speech-Language-Hearing Association, which is connected to CAA, had issued a statement back in February that said BYU’s move to drop care was “in direct opposition to practice expected” of accredited schools.
The association’s Code of Ethics that accredited universities agree to abide by states: “Individuals shall not discriminate in the delivery of professional services or in the conduct of research and scholarly activities on the basis of race, ethnicity, sex, gender identity/gender expression, sexual orientation, age, religion, national origin, disability, culture, language, or dialects.”
The association also generally advises that all students studying to become speech therapists need to experience working with all types of clients.
Faith does not expressly bar gender-affirming speech therapy
The BYU clinic, where graduate students train to work in pathology, has served transgender individuals since fall 2020 among its roughly 70 clients. Most speech therapy programs in the country offer such services.
But the university, which is church-funded, has largely unfettered religious exemptions that allow it to ignore federal laws prohibiting gender-based discrimination. Those include the ability to enforce its own preferences while recruiting and admitting students and giving out financial aid.
It also has an exemption specifically for “health and insurance benefits and services” that applies to its campus clinics. That means BYU can choose to deny care, if it wants, based on a person’s identity.
The school has also told the CAA that it is not barring transgender clients from others services, such as resolving a speech impediment, for instance — only that it is no longer providing gender-affirming therapies.
Those therapies, the school said in a letter to clinic faculty when it decided to stop the services, violate the LDS Church’s policies that guide the institution. They pointed to the faith’s handbook, which states that gender is an “eternal identity.”
While LGBTQ members are welcomed at church, the guidelines state, same-sex romantic partnerships are forbidden. And leaders are told to counsel against both sex reassignment surgery and “social transitioning” for transgender members.
Social transitioning is defined by the church as: “changing dress or grooming, or changing a name or pronouns, to present oneself as other than his or her biological sex at birth.” Those who go against that can face discipline.
BYU’s note to faculty said speech therapy to help an individual align their voice to a sex not assigned at birth would be considered by the school to be a part of transitioning. And it will not assist in that process.
But speech therapy is not expressly listed as part of the faith handbook’s description on transitioning.
And the church, for instance, does grant exceptions for transgender individuals to receive hormone therapy if it is prescribed “to ease gender dysphoria or reduce suicidal thoughts.”
In a similar way, voice therapy is used to relive gender dysphoria, when a person feels their gender identity doesn’t match their outward appearance or other characteristics. That is why many students in the program did not feel it went against church guidance.
Voice is often the first cue that a stranger may use to classify someone by gender. Some transgender individuals fear that by not “passing” as the gender they identify as, they will receive unwanted attention or be discriminated against.
The client from BYU who spoke to The Tribune previously said she is afraid to speak up in class. She doesn’t want to have people question her based on the sound of her voice.
For individuals who transition from female to male, taking testosterone will typically lower one’s voice by expanding their vocal cords. But pitch doesn’t change much for individuals who, like the client, transition from male to female. Estrogen doesn’t have the same effect and can’t reverse the thickening of one’s vocal cords, which often happens when undergoing male puberty.
This is where experts say speech therapy can help. A provider will work with a client to help them change their pitch with practice in a natural way that won’t cause damage. They also help with other language cues.
It can take anywhere from four months to two years to reach a pitch range that a person is more comfortable with. A typical female-sounding range is considered anything above 160 hertz. With some overlap, typical male-sounding voices are usually below 180 hertz.
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