Purpose This study analyzed information shared through journal reflections of a client and a student clinician participating in The College of Saint Rose Transgender Voice and Communication Program related to the application and implications of Acoustic Assumptions. This research note was generated by a client, a student clinician, and certified speech-language pathologists. Method This single-case study focused on an eclectic approach to gender-affirmative voice services that addressed factors related to resonance commonly explored with transgender clients. A first-person account of reactions to therapy served as the foundation for journal reflections made by the client and the student clinician. Therefore, first-person language appears in the journal entries to detail our perspectives of this clinical experience. Results Providing gender-affirmative voice services in a holistic manner helped the client align her communication with her gender identity. Creating a client-specific conceptual framework that prioritized elements of cognitive–linguistic therapy, education, and counseling supported the client as the resonance challenges frequently experienced by transgender and gender-nonconforming individuals outlined in Acoustic Assumptions were explored. Limitations regarding the clinical application of this highly individualized approach to resonance are acknowledged. The findings from this study may not generalize to entire clinical populations, given the format of the research design. Conclusions We found this therapeutic approach helped the client develop a personalized understanding of the resonance challenges she was experiencing (see below for a more detailed discussion of those challenges). And she was able to deepen her ability to produce voice with forward resonance, an acoustic parameter that researchers have found many listeners to associate with “femininity” and that, in this case, aligned with the client's perception of femininity. Techniques used and observations on them may be useful for future work in gender-affirmative voice services.