Some children and adults, due to overuse or misuse, can end up with either loss in the voice altogether or a change in their voice to a soft and husky voice. They could have nodules (like callouses) on the vocal folds which lead to further strain on the voice! If you / your child have had a change in your voice or you feel that they / you just can't seem to get the volume or projection that is needed I recommend the following:
Your GP refer you to an Ear Nose and Throat Specialist (Otolaryngologist) to either use a mirror or a fibreoptioc endoscopy to view your vocal folds
Once significant pathology has been ruled out (e.g. cancer), I recommend your GP refer you / your child to have voice therapy. During this time you will learn about environmental and lifestyle factors that contribute to voice issues; how to help your vocal folds heal; and you / your child will learn strategies to use your voice well without hurting it. **
**I do not work with professional singers and do not have experience with regards to transgender voice change.