A thin needle is inserted into each hair follicle. A small amount of electric current destroys the cells that grow hair. The hair is then removed with tweezers. Electrolysis can be used on all hair colors and skin types.

We have expertise in all three kinds of electrolysis:

• Galvanic: A chemical reaction destroys the follicle.
• Thermolysis: Heat destroys the follicle.
• Blend: A combination of galvanic and thermolysis is used.

During treatment: You may feel heat and mild stinging. Discomfort is usually minimal, and settings can be adjusted.

After treatment: You may have redness for about a day.

Sessions: How often and how long someone needs treatment varies greatly. It depends on the amount of hair, the size of the area being treated, the hair’s growth cycle, and sensitivity. Patients need multiple treatments, though — as often as once a week and for up to an hour. Some have up to 100 visits a year, and may need treatment for more than a year. You may not need follow-up treatments.

An intense beam of light is passed over your skin. The laser beam heats areas of high pigmentation, damaging or destroying hair follicles. Hair falls out in the days and weeks afterward, and the follicles eventually stop growing hair. Lasers can treat large areas at one time.

Laser hair removal provides permanent hair reduction, but some regrowth is possible. Our patients see about 80-90% of hair permanently removed.

Before treatment: Avoid exposing the treatment area to direct sun.

During treatment: You will wear goggles to protect your eyes from the light. The area to be treated may be shaved, and a numbing cream may be applied. You will probably feel some stinging.

After treatment: Avoid exposing your treated area to direct sun immediately afterward. Redness and swelling are common but usually last only a day or two.

Sessions: You will need multiple treatments. Hair grows in phases, and the laser affects hair only in the active growing phase. Other factors include the area being treated, skin color, and hair color and coarseness. Most patients have six to seven treatments, with four to six weeks between each one. Many have follow-up treatments every six to 12 months.

A speech-language pathologist can train you to develop authentic ways of expressing yourself. Voice training may include:

• How your voice sounds
• The rhythm of your speech
• The words and phrases you use

Communication therapy can teach you new ways to sit, stand and use your hands. If you are transitioning, training can help you overcome physical changes such as vocal instability from testosterone therapy.

Treatments: Our therapies train you to talk and act naturally without straining your vocal cords and muscles. Your new voice and traits will become second nature.

You will have a comprehensive voice and communication assessment before we recommend a training program. Your evaluation may include:

• Your medical history
• Your transition goals and how you prefer to communicate
• A stimulability test, which assesses your speech sounds
• Recording and analyzing your voice
• Looking at your voice box if:
  • Your voice sounds abnormal
  • You have a history of voice problems
  • You have risk factors such a job that requires a lot of talking

Our voice training includes:

• Pitch and tone
• Loudness
• Vocal quality
• Speaking rate
• Speech sounds
• Grammar

Our communication training includes:

• Gestures
• Facial expressions
• Body language

Sessions: You typically have a 45-minute session every week for at least six months. You also practice daily at home. How long your training lasts may depend on your vocal health, your goals and the frequency of your training.

OHSU offers vocal surgery to raise pitch. We require that patients have vocal therapy first, though. Some patients achieve their desired voice through therapy alone.

We recommend that patients seeking voice therapy to lower pitch be evaluated by a speech-language pathologist and sometimes by an ear, nose and throat specialist (otolaryngologist).

This is because our research has found that testosterone therapy isn’t fully effective for about one in five patients. These patients may have vocal fatigue or voices that are too high or soft. Testosterone therapy also doesn’t change body language and other forms of expression.