Male-to-female transsexual individuals frequently experience difficulties in increasing the fundamental frequency so that they can pass as members of the preferred gender. Female-to-male individuals may also meet with vocal problems although hormone treatment lowers fundamental frequency. The purpose of this study was to explore the transsexual individuals who, as part of their reassignment process, were referred to the voice clinic at the Sahlgrenska University Hospital in Göteborg, Sweden, between 1991 and 2002. The group comprised 22 male-to-female and 3 female-to-male transsexuals. Video recorded laryngeal examinations revealed basically normal conditions. More than half the patients showed supraglottal constriction on phonating at both habitual and preferred levels. A comparison between acoustic analyses before therapy and at follow-up visits showed increased fundamental frequencies for male-to-female individuals (p = < 0.01). Vocal fatigue was reduced. Degree of satisfaction with the post-therapy voice was not related to number of therapy sessions.