PURPOSE: Transgender and gender-diverse (TGD) people and their communication wishes are diverse and heterogeneous, so it is important to understand the situation and goals of each person individually when they arrive for professional interventions. This article describes the development and content validation of the Voice and Communication Situation Questionnaire developed with and for TGD people presumed female at birth (VCSQ METHOD: Phase 1 included a transdisciplinary literature review and an initial draft of a questionnaire designed to collect self-reports of sociocultural positioning, voice and communication function, and well-being of TGD people presumed female at birth (PFAB). Phase 2 involved collection of information and feedback on the draft questionnaire via focus groups of 31 members of the PFAB community in Germany, Sweden, and the United States. RESULTS: Revisions were based on the feedback from all focus groups and consensus within the research team. Feedback highlighted the need to develop a clear approach to introducing the questionnaire to respondents and to provide support during its completion so that self-ratings and descriptions capture the client perspective regarding categories built into the questionnaire. CONCLUSIONS: The final draft of the VCSQ