Voice Feminization and Masculinization Surgery

Voice Feminization and Masculinization Surgery

Voice Feminization and Masculinization Surgery

Among the voice surgeries, pitch change surgeries, that is, the feminization or masculinzation of the voice, has an important place. Voice is a secondary sex characteristic and constitutes one of the most important parameters of communication. Voice modification should help transgender individuals to integrate into society and facilitate their daily lives in this context. The most important feature that creates the perception of gender in sound is the pitch, that is, the frequency of the voice.

Since the structures that make up the voice in men and women have different anatomical features, the male/female larynx should be considered as two different instruments. The length of the vocal cords varies between 17-23 mm in males and 12-17 mm in females. In addition, the prominence of the Adam's apple in men is due to the narrower angle of the cartilage.

Although there is no frequency level perceived as a general female voice, the adult male speech frequency range varies between 107-132 Hz on average, while it is between 189-224 Hz in females and is higher. The feminine voice is high-pitched and the masculine voice is low-pitched.

In addition to treble, breathability, sthrength, intonation, articulation-prosody, word choice, speaking rate, spoken subject, content, style and communication parameters other than speech are also important in feminine-masculine sound perception.

Although voice therapy has an important place in voice changes in transgender individuals, surgery, which is a clearer method, is applied since there can be transitions to male voices in fatigue and reflex sounds such as coughing, laughing and yawning that occur after a while. Trying to make a female voice all the time makes the larynx tired after a while and vocal cord diseases start to appear.

Phonosurgery focuses on these factors, as the soundness of the voice is related to the tension, length and mass of the vocal cords. The voice can be successfully thinned by shortening the vocal cords with microsurgery completely through the mouth without making any external incisions. Furthermore, the mass of the vocal cords can be reduced by laser. In these two methods, shortening the vocal cord or reducing its mass causes a permanent change. Thinning the voice by increasing the tension is possible through a small incision in the neck. In this method, the tension may decrease over the years and the sound may shift towards the low pitch over time. In this method, the prominence of the Adam's apple can be corrected through the same incision.

Conversion of the feminine voice to the masculine voice is possible with hormonal treatment, and surgery is not required.
Voice change surgeries can be performed not only for feminization, but also for masculinization as in "mutational falsetto".



With the adolescence period, the child's voice also changes as the larynx reaches its adult shape. “Failure to adapt” to this change causes mutational falsetto or puberphony. The resemblance of the sound to the childish sound is manifested by breaking and bifurcations in the sound. This voice disorder is usually seen in men. Although therapy has an important place in its treatment, some resistant cases require surgical treatment. In this surgery, which aims to reduce the tension of the vocal cords, the high-pitched voice shifts to more natural low tones and the result is very pleasing.



Prof. Dr. Serap Köybaşı Şanal
Tınaztepe Galen Hospital Otorhinolaryngology