Voice Masculinization Surgery - An Overview

What Is Voice Masculinization?

Higher voices are generally associated with women, and deeper voices are associated with men. But sometimes, men can have higher voices, and women can have deeper voices. The voice also plays a vital role in gender identity. For transgender, it is common to experience gender dysphoria, a condition where an individual's gender identity does not coincide with the sex assigned to them at birth. A person who identifies as a transgender man may experience dysphoria due to their feminine voice.

For many transgender, the incongruence between their voice and their gender identity can be a significant source of distress and discomfort. Voice masculinization is a way to change things like pitch, resonance, prosody, articulation, registration, characterization, musicality, interpretation, and gesture to influence listeners to perceive a more masculine or exclusively male voice. Any individual of any gender can use voice masculinization. Vocal training and speech therapy can help in getting a masculine voice, but they may not produce the desired results for everyone. In such instances, voice masculinization surgery becomes a viable option.

What Is Voice Masculinization Surgery?

Voice masculinization surgery is also called transfeminine voice surgery. It is a medical procedure performed to alter the resonance and pitch of the voice to sound more masculine. The surgery can be performed for anyone who wishes for a masculine voice. Still, it is generally performed on transgender people who want to have a deeper and more resonant voice that goes along with their gender identity.

What Are the Different Types of Voice Masculinization Surgery?

There are many surgical procedures used in voice masculinization surgery. The choice of procedure depends on anatomy, individual goals, and the surgeon's recommendation. The commonly used surgical methods include:

• Thyroid Cartilage Reduction (Chondrolaryngoplasty):

In this procedure, the Adam's apple (thyroid cartilage) is shaved down to reduce the prominence of the laryngeal prominence. Adam's apple is a characteristic feature of a male; a less prominent one will yield a more feminine voice.

• Glottoplasty:

Glottoplasty involves vocal fold modification to create a larger glottis that can produce a deeper voice. This procedure increases the fundamental pitch by shortening, tightening, and symmetrically thinning the vocal folds. All three techniques increase the vibration frequency of the vocal folds.

• Vocal Cord Shortening:

In this technique, the vocal cords are shortened by removing a small portion of the mucosal lining, which results in a lower pitch and a more masculine voice.

• Fat Injection:

Fat injections in the vocal cords are used to thicken the vocal cords, which can lower the pitch of the voice. It is a relatively easy procedure, and many patients' voice quality has significantly improved. In some cases, the patient may show improvements initially, but it may diminish over time as the body reabsorbs too much of the injected fat.

• Cricothyroid Approximation:

This procedure adjusts the vocal cord's tension and creates a lower-pitch voice. It is sometimes performed in combination with other procedures.

These procedures can be performed alone or in combination to achieve the desired voice quality. The procedure selections depend on the patient's needs and the surgeon's assessment.

What Is the Surgical Procedure for Voice Masculinization Surgery?

• Before the procedure - A clear evaluation by a team of specialists, including a speech-language pathologist, otolaryngologist, and a gender-affirming surgeon, is necessary. They check the anatomical factors, patient's vocal range, and habits.

• During the Procedure - Voice masculinization surgery is performed under general anesthesia, and the specific surgical procedure chosen will depend on the individual patient. Generally, a small cut in the throat area is made to access the vocal cords and surrounding structures. A selected technique, such as chondrolaryngoplasty, vocal cord shortening, or glottoplasty, will be performed to make changes in the vocal apparatus.

• After the Procedure - After the surgery, patients are advised to follow postoperative care carefully, which may include maintaining vocal hygiene, avoiding strenuous activities, and attending follow-up appointments with the surgical team. The patients are advised to rest their voices and may undergo speech therapy for post-operative rehabilitation. This may help the patient learn to use their new voice effectively.

What Are the Advantages of Voice Masculinization Surgery?

Voice masculinization surgery can have a great impact on the lives of transgender men. Here The advantages of this procedure are:

• One of the main advantages of voice masculinization surgery is the alignment of voices with their gender identity. Masculine voice can reduce gender dysphoria and enhance psychological well-being.

• One's gender identity can boost their self-confidence and self-esteem.

• Voice masculinization surgery can reduce or eliminate the distress caused by an incongruent voice.

• A more masculine voice in transgender men can improve effective communication in various aspects of life, including relationships, work, and social interactions.

• The quality of many individuals improves post-surgery, resulting in a more appealing and resonant tone.

What Are the Disadvantages of Voice Masculinization Surgery?

Voice masculinization surgery carries significant benefits. However, it is also important to consider certain disadvantages and potential risks:

• As with any other surgical procedure, there are potential risks, including scarring, infection, and changes in vocal quality.

• Some patients may require long preoperative voice training to enhance the surgery results. However, this voice training may be time-consuming and sometimes fails to guarantee complete satisfaction.

• In some cases, additional surgeries may be needed for desired results.

• The extent of change may vary from person to person, and the final result may not match a specific pitch or quality.

• It is an expensive surgery that may not be covered by insurance.

• Recovery can be challenging, and it may take a long time to fully adapt to the change and master the newly acquired voice.

Conclusion

Voice masculinization surgery is an important surgery for transgender men who are seeking to align their voices with their gender identity. It offers significant benefits, including improved self-confidence, enhanced communication, and a more aligned gender identity. However, not all benefited from the surgery. Choosing the right surgeon, complete preoperative training, and realistic expectations are necessary for a successful outcome.