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Voice feminization surgery is a procedure to help transgender women (male to female) obtain a more feminine sounding voice. The goal of the surgery is to change a perceived male-sounding voice to a female sounding voice. Voice feminization surgery focus on raising the habitual speaking pitch by decreasing the ability to produce a low-pitched voice, meaning it will reduce the overall pitch range of the voice. Most trans-women choose to have a voice feminization surgery because they are not satisfied with the results of voice therapy or they want a more authentic sounding female voice.
There are several techniques to perform voice feminization surgery. The most common technique is called cricothyroid approximation, which involves elongating the vocal folds to increase vocal pitch. During this procedure, your surgeon brings the cricoid cartilage closer to the thyroid cartilage using metal plates or sutures. The cricoid cartilage is then shifted upward and backward, while the thyroid cartilage is moved downward and forward.
Another technique is called Wandler Glottoplasty. This technique connects the anterior 1/3 of your vocal folds using suture, while the remaining 2/3 act as female length vocal folds, which will yield a slightly higher voice. With this technique, no incisions are created in the neck since the entire procedure is performed through the mouth.
All techniques are performed under general anesthetic, so you will be asleep and comfortable throughout the surgery. The surgical reduction of Adam’s apple may be performed at the same time as voice feminization surgery.
Voice feminization surgery generally takes around 40 to 50 minutes to complete. The procedure is normally performed as an outpatient procedure, so you should be able to leave the hospital on the same day. However, you will need to stay in Vietnam for at least 8 to 10 days as you will have to attend follow-up checkups. During the follow-up checkups, your healing will be monitored and outer stitches will be removed.
The total recovery time until the tissue completely heals may take as long as six months. However, you should be able to return to most of your normal activities within a couple of weeks. If your job does not require the use of voice, you may be able to go back to work within one week. However, if it involves the use of voice, you need to take two weeks off work. Your surgeon will give you a recovery timeline, including the time you can go back to work and do strenuous activity.
For the first week, you may not be allowed to speak (absolute silence). It is important that you drink enough water to moisturize the vocal cords. In order to prevent acid reflux, your doctor may advise you to avoid chocolate, caffeine, peppermint, acidic foods, fatty foods, alcoholic drinks, and soda.
You will have to attend follow-up checkups at the third, sixth, and twelfth month after surgery. If you cannot travel to Vietnam for these checkups, make sure to talk to your surgeon. In most cases, you should be able to do the checkups with your local doctor back at home. Since voice feminization surgery only changes your pitch, you may still need a voice feminizing therapy to work on other vocal behaviors. The therapy will help you adapt to your new voice. It normally targets your vocal pitch, prosody, and vocal resonance. The therapy will also address speech rate, phrasing, articulation, voice quality, and nonverbal communication (such as eye contact and facial expression).
Voice feminization surgery is a safe and effective procedure. Many patients who have had the surgery are satisfied with the results. However, it does carry some risks you need to be aware of, such as reduced voice quality, negative effects on breathing and/or swallowing, reduced vocal loudness, sore throat, scarring, and infections.
If you do not want to undergo surgery to feminize your voice, voice therapy alone can be the alternative. The therapy can help you change your vocal characteristics, such as pitch and intonation, as well as nonverbal communication, such as gestures and facial expressions. A speech-language pathologist will help you learn and practice techniques to feminize your voice.
If you wanted to adapt your voice and communicate in a way that matches your gender identity, voice feminization surgery will help you achieve that. After the procedure, you can expect to have a more feminine voice with a higher pitch. It may be hard at first to maintain your new voice with loved ones or people who knew you before transitioning, and you might even fear comments about yourself or feel self-conscious about your new voice. Know that these feelings are valid and those who love you will always support you. Try to focus on enjoying what you are doing for yourself.
Whilst the information presented here has been accurately sourced and verified by a medical professional for its accuracy, it is still advised to consult with your doctor before pursuing a medical treatment at one of the listed medical providers. This content was last updated on 28/11/2020.