He plunged a needle filled with testosterone into his thigh each week. He changed his name to Andre and announced that he was becoming a man. His muscles grew.
In nearly every way, his new body fit him better than his old one. Then his voice deepened, as expected, and he tried to sing. He grieved for the voice he had lost, the one he had trained for six years in choruses and choirs, the voice he still heard inside his head.
Andre, who asked not to be identified by his last name, might have given up singing. His voice was too low to continue with the women’s chorus where he had sung for years. So before Andre, 36, fully transitioned, he joined the new Butterfly Music Transgender Chorus, whose founder believes it’s one of two choirs in the country open only to transgender people.
Even as the public becomes more aware of the estimated 700,000 transgender individuals in the United States, many trans men and women say they still struggle to feel accepted. For those who transition, their voices can attract attention. Singers say they are grateful to find a chorus where they can feel the support of others who understand.
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The chorus practices near Boston, which has become a center of medical care and research for the transgender community. (Because trans men and women report high rates of harassment, assault, and discrimination, the singers wanted to keep the location private.) Fenway Health , a community health center, saw 90 trans patients in 2006. Last year, 1,600 trans patients visited the center.
Last spring, Fenway Health and Sandi Hammond — a faculty member of the New School of Music in Cambridge who launched Butterfly Music — sponsored a discussion on how trans men and women can adjust their voices to match their bodies, without damaging their vocal cords, a new area of research.
Not every transgender person decides to take hormones or change his or her voice. But for those who do, new voices take time to master. Trans males who inject testosterone deepen their voices. Their pitch changes, sometimes from day to day.
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“Losing my upper range was hard,” Andre said. “It really frustrated me. It’s kind of a loss of identity a little bit because you had all these really awesome high notes and all of a sudden, they got lopped off in one fell swoop.”
Trans women who want to sound more feminine must learn to speak in a higher voice. Hormones that help their body transition — prompting breasts to grow and skin to thin — do not usually change the voice.
Many members of Butterfly Music are learning to sing with new voices. The chorus, created last fall, does not divide singers into traditional parts of soprano, alto, tenor, and bass. Instead, they choose high, medium, or low parts. Singers, whose voices may change weekly, do not have to commit to a section.
“I knew that I had to keep giving people choices,” Hammond said. “I’ve been as hands-off as I could be.”
Hammond, a singer, songwriter, and voice teacher, quit a job selling high-end rugs in 2013 after “what some people would call a midlife crisis and what some people would call a search for meaning.” She had previously watched a transgender student struggle, and she was horrified to learn that 41 percent of people who identify with a gender that differs from theirs at birth attempt suicide.
Hammond posted on a transgender Facebook page that she was considering starting a chorus. Although many gay singing groups around the country have worked to be trans-friendly, Hammond saw a need, as a voice teacher, for a transgender-only chorus. At the first rehearsal, in mid-November, 35 people showed up to sing.
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A new state law requiring insurers to pay for the same medical care for transgender patients as other patients has drawn more patients to Fenway in the past year. About 78 percent of transgender Fenway patients are taking hormones.
The clinic attracts patients from afar. Some doctors will not treat transgender patients, so they travel to Boston, driving as long as four hours, for basic medical care. Ruben Hopwood, Fenway coordinator of the trans health program, also travels around the country, training other health centers in the basics of treating transgender patients.
“It’s very difficult still in the US for people to find physicians who have any kind of training at all, on the benign end,” Hopwood said. “At its worst, they experience providers who are openly refusing to care for them.”

Speech and language pathologists are just beginning to work with the transgender population to develop their voices in their new gender. If it is not done correctly, vocal cords can be permanently damaged, said Barbara Worth, senior speech language pathologist at Beth Israel Deaconess Medical Center. Nodules can form on the vocal cords.
She’s now working with a trans woman who is 62. The larynx — the organ covering the vocal cords that is responsible for sound — is larger in men than in women.
“Particularly going from male to female, you’re trying to adapt a structure to do something that it wasn’t doing from puberty on,” Worth said.
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Butterfly Music raised $12,000 through a Kickstarter campaign this summer, partly for a pianist, regular rehearsal space, as well as sheet music, commissions for arrangements and a website.
Their first performances, this fall, are invitation-only. The chorus will sing publicly in April 2016.
Kit Johnson took testosterone as part of his transition from female to male in the past year. Johnson, a new member of the Butterfly chorus, has been grateful for Hammond’s help in training his new voice.
“One thing about my transition was I really did want a deeper masculine sounding voice,” he said. However, “just because I took hormones doesn’t mean I know how to use that voice. I don’t necessarily know how to talk with it, how to sing with it.”
Samantha Magnusson, a trans woman, enjoys the singing. But she also comes to weekly chorus practice for the chance to talk to others who have similar struggles.
“What we’re doing here is fun. Singing is fun. It will bring joy into my life. It will make me more confident in a presentation.” But that’s not the reason she joined, Magnusson said. “The reason is community.”
Kathleen Burge can be reached at kathleen.burge@globe.com. Follow her on Twitter @KathleenBurge.