Understanding Voice Lowering Surgery
The sound of your voice is an important part of who you are. It conveys your gender, age, personality, and more. For some people though, their natural voice does not match their identity or preferred method of self-expression. This distress over one's voice is called voice dysphoria.
Voice dysphoria is particularly common among transgender individuals. During puberty, hormones cause vocal changes that create typical male and female voice ranges. Transgender people who transition later in life often wish to alter their voices to better match their gender identity.
That's where voice lowering surgery comes in. Also known as vocal masculinization surgery, voice lowering surgery is a type of phonosurgery that alters the vocal cords or larynx to lower the pitch of the voice.
Who Seeks Voice Lowering Surgery?
Voice lowering surgery is pursued predominantly by transgender men seeking to develop a deeper, more masculine voice. However, it may also be an option for:
- Women with naturally high-pitched voices who want a more authoritative voice
- Performers and public speakers who want a stronger, lower vocal range
- Men with voice disorders causing abnormally high pitch
The surgery is typically sought by adults, since hormone therapy can be used to deepen voices during transgender adolescents' puberty. Voice lowering surgery is not generally recommended for children.
How Does Voice Lowering Surgery Work?
There are a few different techniques surgeons may use to lower pitch during voice lowering surgery:
1. Cricothyroid Approximation
The most common method is called cricothyroid approximation. During this procedure, the surgeon makes an incision in the larynx and stitches together the cricoid and thyroid cartilage. This places tension on the vocal cords, stretching them slightly so they vibrate at a lower frequency.
2. Vocal Fold Injection
Injectable fillers can also be used to increase the mass of the vocal folds. Greater vocal fold mass lowers the fundamental frequency. Materials like collagen, hyaluronic acid, calcium hydroxyapatite, and even one's own fat can be injected.
3. Glottoplasty
Glottoplasty reduces the vibratory surface of the vocal folds. This is done by suturing together the anterior portion of the vocal folds. With less tissue able to vibrate, the frequency produced is lowered.
4. Laryngoplasty
Laryngoplasty is the reduction of the thyroid cartilage angle to lower vocal pitch. Reshaping the thyroid cartilage changes the tension placed on the vocal ligaments.
For maximum effect, a combination of the above techniques may be used during a single operation. The surgeon will determine the best approach based on the individual goals and anatomy.
What is Recovery Like?
Voice lowering surgery is performed under general anesthesia. It typically takes one to two hours to complete.
Most people stay in the hospital overnight and are discharged the next day. Strenuous activity should be avoided for at least three weeks. Normal activity can usually be resumed after about two weeks.
After surgery, the throat is swollen and the voice will sound different until the swelling subsides. Results start to become noticeable after a few weeks, but the voice continues changing for about six months as healing progresses.
Possible side effects include temporary difficulty swallowing, changes in vocal range or quality, and rarely bleeding or infection. Voice therapy may be recommended to help the body adjust to the surgical changes.
What Results Can Be Expected?
Patients often have unrealistic expectations about the extent of change possible from voice lowering surgery. While the voice pitch is lowered significantly, the outcome still sounds natural and retains some individual character.
On average, transgender men can expect their vocal pitch to drop by 80-150 Hz through surgery. This shifts the voice out of the typical female range down into the male range. The goal is around 130 Hz after surgery.
Maximum lowering is usually achieved if the starting pitch was already contralto or alto range. Higher soprano voices have less room for downward change. Genetics also play a role.
While pitch is altered, other vocal qualities like tone and inflection are unchanged. The person's speech patterns largely stay the same.
It is important to remember that voice lowering surgery will not completely transform someone into having a voice identical to a cisgender man. The voice will sound distinctly male but retain some individuality.
Who is a Good Candidate?
Good candidates for voice lowering surgery include those who:
- Are in good general health
- Have realistic expectations for surgical results
- Have a starting voice pitch around 155-175 Hz
- Have experienced voice dysphoria for at least a year
- Have completed any desired hormone therapy
- Do not smoke, or are willing to quit smoking for at least two months pre-procedure
It is recommended to work with a voice therapist before surgery. Learning proper breath support and voice techniques can help obtain maximum benefits from the operation.
Finding a Top Surgeon
Vocal feminization procedures have been performed since the mid-1990s, but vocal masculinization surgery is a newer field. There are currently no credentials specifically for voice lowering surgery.
When choosing a surgeon, look for these qualifications:
- Board certified in otolaryngology (ENT) and fellowship trained in laryngology
- Performs at least 25 phonosurgery procedures per year
- Has experience specifically with voice masculinization
- Is familiar with transgender patients
Be sure to look at before and after recordings to get a sense of that surgeon's typical vocal outcomes.
It also helps if the surgeon has experience with a variety of voice lowering techniques, so they can customize the approach as needed. Beware any surgeon guaranteeing a certain outcome.
How Much Does Voice Surgery Cost?
Voice lowering surgery costs between $4,000 and $10,000 depending on the surgeon, methods used, and location. There may be additional costs for the operating facility fee and anesthesia.
Health insurance plans sometimes cover vocal masculinization procedures for transgender patients, depending on the specifics of the plan. Check with your insurance provider.
Otherwise, many surgeons offer third-party financing plans to pay for the procedure over time. Some advocacy groups and non-profits also provide financial assistance for voice surgery.
What to Expect from Voice Lowering Surgery
Voice altering surgery is a big decision that requires extensive research and planning. While a lowered voice can provide great confidence, the limitations must be clear.
With proper preparation and realistic expectations, voice lowering surgery can be a liberating experience. But it is just one option on the journey toward living as your true gender.
Speak in depth with your doctors and voice specialists when weighing if and when voice surgery may be right for you. Your voice is unique—make sure any changes resonate with who you genuinely are.
FAQs
How long does it take to recover from voice lowering surgery?
Most people take about 2 weeks off work or school to recover. Strenuous activity should be avoided for 3 weeks. Swelling takes 2-3 months to fully resolve. Maximum results are not apparent until 6 months after surgery.
How is voice pitch measured?
Voice pitch is measured in hertz (Hz). The average male pitch is around 120 Hz while the female range is 210 Hz. Voice lowering surgery typically drops pitch by 80-150 Hz.
Will I sound exactly like a cisgender man after voice surgery?
No, the voice will be distinctly masculine but retain some of your individual vocal characteristics. Expect a natural male-sounding voice, not a voice identical to other men.
Can voice surgery raise or lower pitch too much?
It is extremely rare for voice surgery to alter someone's pitch too drastically. Surgeons aim for an optimal male pitch range. Too much lowering can make the voice sound unnatural.
At what age can someone get voice lowering surgery?
Voice surgery is only performed on adults, not children or adolescents. Teens can deepen voices with hormone therapy during puberty. Surgery is an option if dysphoria persists after puberty.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
Add Comment