The most common concern for male-to-female transgender individuals is their pitch and speaking fundamental frequency (SFF) (the average frequency produced in a connected speech sample) because they typically perceive a feminine voice as using a higher pitch. Although pitch is the not the most essential element of voice change for these individuals, it is necessary to raise the SFF to a gender appropriate pitch to help with vocal feminization. A speech-language pathologist will work with the individual to raise their pitch and provide therapeutic exercises.