Voice feminisation: raising the pitch of the voice that is heard when you speak.
Voice feminisation is a surgical procedure that aims to permanently raise the fundamental frequency of the speaking voice by altering the vibratory characteristics of the vocal folds. It is most often performed for voice feminisation in trans women and for voice disorders such as puberphonia (mutational falsetto).
What is voice feminisation surgery?
The main factor determining whether a voice sounds deep or high is the number of times the vocal folds vibrate per second. The shorter, thinner and more taut the folds, the higher the voice sounds. Voice feminisation surgery permanently raises the fundamental frequency of the voice by altering one or more of these three variables.
The procedure comes into consideration when the desired result cannot be achieved with hormone therapy or voice therapy. The decision to operate is based on voice analysis, laryngoscopic examination and how the person uses their voice in daily life.
Who might it be suitable for?
Suitability is always determined after examination and voice analysis. In general, it is considered in the following situations:
- Trans women seeking voice feminisation
- Individuals whose voice deepened after puberty and who cannot come to terms with it
- Pitch disorders such as puberphonia (mutational falsetto)
- Cases where voice therapy has not given a sufficient result
Assessment before surgery
Before surgery, the structure of the vocal folds is examined endoscopically and an acoustic analysis of the voice is carried out. This analysis creates a baseline record so that the change after surgery can be compared objectively.
If there are problems affecting voice quality, such as reflux, vocal fold nodules or chronic laryngitis, these need to be treated first.
The recovery process
Voice rest is recommended in the first days after the procedure; how long depends on the technique the doctor has used. It can take weeks for the voice to reach its final state; the voice settles as the tissues settle and the swelling subsides.
In many cases, voice therapy after surgery is an integral part of the process. Surgery changes the pitch of the voice; therapy is what allows speech habits, intonation and resonance to adapt to the new pitch.
What you should know
Voice surgery is a field in which the outcome cannot be reduced to a single number. The pitch range that can be achieved depends on the structure of the person's larynx and is not the same for everyone. Changes in singing range can be expected, and people who use their voice professionally should discuss this in detail with the doctor at the decision stage.
No voice surgery comes with a guarantee of a particular frequency. Realistic expectations are the most important part of the process.
Frequently asked
Is the result of voice feminisation surgery permanent?
The change in pitch achieved through surgery is designed to be permanent. However, ageing, voice use habits and the health of the larynx can affect the voice over time.
Would voice therapy be enough instead of surgery?
For some people, yes. Voice therapy can bring about a marked change in pitch, resonance and speech patterns. Surgery usually comes into consideration when therapy has not given a sufficient result, or as an addition to therapy.
How long will I be unable to speak after the procedure?
The length of voice rest varies with the technique used and is determined by your doctor. Observing this period directly affects the quality of the result.
Who performs this procedure?
One of our partner doctors, Prof. Dr. Kürşat Yelken, is an ear, nose and throat and head-neck surgery specialist who completed his subspecialty training in voice disorders at the Department of Laryngology at Harvard Medical School's MEEI.