Each person’s voice has a unique characteristic. Generally, a deep, low, and strong voice indicates a male voice, while a high-pitched, small, light, and soft voice indicates a female voice. Therefore, for transgender individuals, besides gender reassignment surgery or cosmetic surgery to align their appearance with their desired gender, changing the voice to match the new gender through “voice feminization surgery” is also an important aspect that many seek. It helps boost confidence in this significant bodily transformation to be more complete.
Voice change surgery is mostly divided into 2 cases
1. Surgery to change voice from male to female (Feminization laryngoplasty)
2. Surgery to change voice from female to male (Masculinization laryngoplasty)
10 Things to Know Before Undergoing Voice Change Surgery
1. Who can undergo voice change surgery?
Transgender individuals who have decided to change themselves, whether they have undergone gender reassignment surgery or not, should be adults aged 18 years or older and must undergo a comprehensive individual evaluation before surgery.
If there are concerns about voice problems and a desire to correct them, consultation with a laryngeal specialist is recommended first to assess the cause of the voice problem and determine the appropriate treatment method, as surgery cannot fix voice problems caused by all reasons.
Some voice characteristics can be improved sufficiently through speech training alone, such as soft voice, breathy voice, or weak voice. If there are no physical or functional abnormalities of the vocal cords, breath control, training to hold and regulate air under the larynx, and exercises to gradually relax the laryngeal muscles may help strengthen the voice.
Therefore, those with voice problems who want to change their voice must undergo a detailed evaluation first so that the doctor can recommend the appropriate treatment.
For transgender men, doctors usually recommend hormone therapy instead of voice change surgery, combined with voice training by speech therapists or therapists to help change the voice to match the desired gender identity.
2. Can women with excessively high-pitched voices undergo voice change surgery to boost confidence?
In such cases, hormone therapy can help achieve a permanent voice change without surgery.
3. Can you speak immediately after surgery?
It depends on the type of surgery. Generally, if the surgery does not cause wounds on the vocal cords,
it is recommended to avoid using the voice for the first 1-2 days to reduce swelling in the surgical area. However, if the surgery involves wounds on the vocal cords, such as voice feminization surgery using endoscopic vocal cord suturing, it is advised to avoid voice use for 7-14 days after surgery and avoid coughing or clearing the throat to prevent suture tearing and bleeding in the vocal cord layers.
4. What are the results after voice change surgery?
After surgery, when starting to use the voice again, you will immediately notice a change in the voice. However, whether the voice matches the desired outcome depends on many factors. The key to a successful voice change is regular practice of proper voice techniques, maintaining vocal health, and avoiding behaviors harmful to the vocal cords.
5. Postoperative care after voice change surgery
- After surgery, when resting in the recovery room, you can eat and drink normally. The doctor may prescribe painkillers to relieve pain, which usually comes from neck or shoulder muscle soreness due to neck extension during surgery, and possibly pain at the surgical wound if there is an external incision.
- The doctor will monitor respiratory symptoms. If no complications occur within 24 hours after surgery, discharge is possible.
- Avoid coughing, sneezing, or forceful clearing of the throat to prevent vocal cord swelling.
- Avoid irritating the throat for about 2 weeks, such as eating crispy, hard, fried, or oily foods.
- Avoid using the voice for about 1 week to allow the surgical wound to heal. Communication can be done through typing or writing instead.
6. Is there a chance that the voice will change, become distorted, or different after some time post-surgery?
After surgery, the voice may become distorted due to vocal cord swelling or scarring. The voice may not reach the desired high pitch and may even revert to the original voice. Therefore, practicing proper voice techniques regularly before and after surgery is very important.
Maintaining voice quality starts with vocal cord health. Drink enough water to keep the vocal cord mucosa moist, avoid shouting, straining, or excessive and prolonged voice use, avoid any substances that irritate the vocal cords, avoid alcohol and smoking, and manage diet, weight, and exercise regularly to prevent acid reflux, which can cause frequent throat clearing and inflammation of the vocal cords.
7. Will the Adam’s apple disappear after voice change surgery in transgender women (male to female)?
Voice change surgery does not remove the Adam’s apple because the surgery does not involve removing the thyroid cartilage. The purpose of voice change surgery focuses on altering the physical characteristics of the vocal cords or adjusting the position of the thyroid cartilage. The Adam’s apple is the most prominent part of the thyroid cartilage. If reduction of the Adam’s apple size is desired, an external incision surgery can be performed to shave the cartilage to make it as smooth as possible without affecting the inside of the larynx. Regarding the external neck shape, if no hypertrophic scar forms, the Adam’s apple will appear smaller according to the amount shaved.
8. Will there be scars or stitches on the neck after voice change surgery?
If the surgery is voice change from female to male or involves adjusting the position of the thyroid cartilage, there will be scars and stitches on the front of the neck. Whether a hypertrophic scar forms depends on individual wound healing characteristics.
9. What symptoms can occur after voice change surgery?
Initially, the voice will change due to vocal cord swelling. After the wound heals, the voice may change in various ways, such as not reaching the desired pitch, unstable pitch, hoarseness, or voice breaks. If the sutures on the thyroid cartilage loosen, the voice may revert to the original. Other possible symptoms include coughing, throat irritation from anesthesia, or side effects from anesthesia such as nausea, vomiting, and headache.
10. Should the Adam’s apple be removed before undergoing voice change surgery?
The Adam’s apple should not be removed before voice change surgery because it may cause scarring on the vocal cords, making vocal cord assessment difficult, or cause skin fibrosis on the neck, complicating subsequent laryngeal surgery.
Voice change surgery can be a complex treatment process. Patients should study and understand the information carefully and consult with laryngeal specialists to choose the appropriate surgical method, prepare well before surgery, and receive systematic voice rehabilitation with therapists for optimal results that meet the patient’s needs.
