Voice feminisation surgery is performed to alter the length, bulk and tension of the vocal cords to raise the pitch of the voice.
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The pitch of your voice is related to the length, bulk, and tension of your vocal cords – the longer, bulkier, and looser they are, the deeper your voice.
A person who is assigned male at birth develops a larger voice box with longer vocal cords during puberty. In addition, higher levels of testosterone make the muscle bulk within the vocal cords relatively larger in males than in females. These changes lead to a lower vocal pitch.
Voice feminisation surgery is used to raise the pitch of your voice (make it sound higher) by changing the length, size or tightness of your vocal cords so that your voice sounds more female and less male.
The pitch of your voice can affect how you’re perceived in regard to your gender.
You may wish to have voice feminisation surgery if you have a low-pitched voice because you:
are a transgender woman
have a disorder of sex differentiation
are a cisgender woman with a naturally deep voice
are receiving androgen (male sex hormone) therapy
have ovarian cancer that causes high androgen levels
At Welbeck, our specialist ENT surgeons provide voice feminisation surgery in our state-of-the-art Ear, Nose & Throat centre, where you’ll receive world-class care.
We offer appointments to paediatric patients aged 16+. For full information on our paediatrics service, please visit our main Paediatrics page.
At Welbeck, we offer 3 types of voice feminisation surgery: glottoplasty, vocal fold muscle reduction (VFMR) and cricothyroid approximation (CTA). In addition, we also perform a gender-affirming Adam’s apple reduction procedure called a laryngeal shave (sometimes referred to as a tracheal shave).
The aim of glottoplasty is to reduce the length of the vibrating segment of the cords that are involved in speech, to create a higher-pitched voice. This is the most commonly performed type of voice feminisation surgery.
The procedure is performed under general anaesthetic via the mouth with no external incisions. Using an endoscope, a CO2 laser is guided through the throat to the vocal cords. Here, the lining of the front part of the cords is removed by the laser and the sides are sutured together to shorten the length of the vocal cords.
Vocal fold muscle reduction (VFMR) is a new technique aimed at reducing the bulk of the vocal folds. As with glottoplasty, this is an endoscopic surgery using a CO2 laser, which is applied along the full length of each of the vocal cords. The laser decreases the mass of the vocal fold, while the resulting scar causes the cords to tighten, which in turn increases the pitch of the voice.
VFMR is a suitable option where a smaller pitch increase is desired or in professional voice users who don’t wish to risk the reduction of vocal volume and projection. VFMR can also be performed as a second-line surgery to further enhance the pitch after glottoplasty.
Cricothyroid approximation (CTA) increases the tension of the vocal cords to achieve a higher pitch. The procedure involves making a small incision in the neck, then bringing the cricoid and thyroid cartilage of the voice box together.
This procedure is also performed under general anaesthesia. This type of voice feminisation surgery is generally only considered in special circumstances where endoscopic surgery is not possible, or as a second-line procedure after glottoplasty to further enhance the pitch elevation.
Laryngeal shave can be performed as a standalone procedure or can be combined with voice feminisation procedures. This is a gender-affirming procedure that’s done to reduce the size and prominence of the Adam’s apple to give the neck a more feminine contour.
As with any procedure, voice feminisation surgery does carry some risks. Your consultant will discuss all of these with you before any procedure takes place.
Pitch is only one aspect that determines whether your voice is perceived to be masculine or feminine. Intonation, resonance, vocal quality and articulation are all important aspects too. Language, loudness and non-verbal communication also play a part in the social perception of a person as a female.
It’s therefore important to know that surgery must be supplemented by dedicated specialist speech therapy in order to achieve the desired voice outcome.
Before having surgery, you may wish to work with a speech-language pathologist on vocal function exercises and vocal hygiene.
Vocal exercises work to expand and contract your vocal cords so they move more easily. This can help in your recovery process post-surgery. Maintaining good vocal hygiene (staying hydrated, stopping smoking, and avoiding caffeine and alcohol) can help you keep your vocal cords as healthy as possible before surgery so you have the best chance of your procedure being successful.
It will take several weeks for your voice box to heal fully after voice feminisation surgery. Your consultant will talk you through any aftercare you need to follow.
Continuing with speech therapy after your procedure is essential for a satisfactory outcome, and it can help you adapt to your new voice. Your consultant can advise you on when it is safe to resume.
Please contact our Ear, Nose & Throat centre for pricing.
At Welbeck, our ENT surgeons are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
We accept both self-referrals and referrals from healthcare professionals for this treatment.
If you would like to schedule a consultation with a Welbeck ENT consultant, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
Not always. Many people begin with specialist voice therapy to work on pitch, resonance, intonation, and speech patterns. Surgery becomes an option if therapy alone does not achieve the desired voice outcome or if anatomical changes are needed. Your consultant will advise the best pathway for your goals.
While you’ll leave the clinic soon after the procedure, full voice recovery typically takes several weeks to months. You may need a period of vocal rest immediately after surgery and ongoing speech-therapy support before you feel confident using your new voice in all settings.
Some voice feminisation procedures raise pitch by shortening or tightening vocal cords, which can reduce your ability to produce very low voices or loud shouts. If singing or professional voice use is important to you, this will be discussed in your consultation so your surgeon and speech therapist can tailor your treatment accordingly.
Good vocal hygiene is key – stay well-hydrated, avoid smoking, limit caffeine and alcohol that dry the vocal cords, and avoid excessive voice strain or shouting. Continuing speech-therapy exercises, resting your voice when needed, and regular check-ups help preserve your results and vocal health.
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All our private ENT specialists at OneWelbeck in London are leaders in their sub-specialties, providing the highest quality treatment to ensure you receive the best available care.