Transgender Voice Problems

What is it?
Sometimes individuals’ gender identity does not match their natural manner of speech.  The voice is the sound produced during speech, and the fundamental frequency of that sound is the natural, comfortable pitch created.  Whether gender neutral or transitioning either male-to-female or female-to-male, the pitch may sound different from the identified gender.  Additionally, the patterns of intonation and stress made during speech, called prosody, have a significant effect on the perception of vocal gender, as do certain communication mannerisms.  Each of these aspects of speech are essential to a voice that best fits one’s gender identity and are typically unaffected by hormone replacement therapy.  We understand the challenges of voice transition, so have developed a program to help these patients.

How is it treated?
Many individuals benefit significantly and sufficiently by working with our speech pathologists alone.  Our therapists have a particularly knowledge base and interest in improving prosody and mannerisms, while trying to subtly adjust pitch to be in a comfortable, but more appropriate pitch range.

Pitch can only be completely natural by alterations made surgically to “reset” the fundamental frequency.

  • Pitch can be elevated by a number of techniques, called feminization laryngoplasty, but the one typically employed by our surgeons is an endoscopic, same-day procedure that shortens the length of the vocal folds and elevates pitch.  This has been quite successful and avoids an external incision.
  • If a prominent laryngeal cartilage (Adam’s apple) is affecting patients transitioning from male-to-female, this can be reduced through a very small incision and performed at the same time as the pitch-raising surgery.
  • Further more subtle elevations in pitch can be performed using laser treatments to the vocal folds that can be done with topical anesthesia only.
  • Pitch can be lowered by “relaxing” the cartilage back, which reduced the tension of the vocal folds.  This is also done as a same day surgery, but it done through a small neck incision.

There are often many questions about therapeutic and surgical management of transgender voice care, including cost, travel, logistics, and surgical specifics.  If you live in our region, call to make an appointment, which is billed through insurance, to further discuss these specifics.  If outside of our region or country, please contact us via email or phone so that we can reach out to you directly and ensure your questions are answered before making the commitment to travel to our center for a consultation.

Learn more by clicking here, then scrolling down and clicking on the “Transgender Voice” pamphlet