Why you might need? Voice Feminisation
The female voice has a higher pitch compared to the male voice. Pitch however, is only one aspect that determines whether voice is perceived to be masculine or feminine. Intonation, resonance, vocal quality and articulation are all important aspects. Language, loudness and non-verbal communication also play a part in the social perception of a person as a female. It is important therefore to appreciate that surgery must be supplemented by dedicated specialist speech therapy in order to achieve the desired voice outcome.
During puberty, an assigned male at birth develops a larger larynx (voice box) with longer vocal cords (14mm in males vs 10 mm in females). In addition, the effect of testosterone makes the muscle bulk within the vocal cords relatively larger in males. The longer, bulkier vocal cords vibrate at a lower fundamental frequency (pitch). The average speaking pitch of adult males is approximately 107 to 120 Hz, while for females it is 189 to 224 Hz. Voice pitch over 165Hz is generally perceived as female.
The pitch of the vocal cords (as with strings in a musical instrument) is related to their length, bulk and tension. Surgical pitch increase can be achieved by changing these parameters. The bulk of the vocal cords can’t be reduced once a person is beyond puberty, so surgery will aim to either shorten the cords (glottoplasty) or increase their tension (cricothyroid approximation).
The aim of this procedure is to adjust the relative length of the “speaking” vocal cords. Women's vocal cords are shorter than in men. Glottoplasty reduces the length of the vibrating segment of the cords, leading to a higher pitched voice.
The procedure is performed via the mouth with no external wounds or scars. Using the CO2 laser, the lining of the front part of the cords are removed and the two sides are sutured together
Cricothyroid approximation (CTA):
This procedure increases the tension of the vocal cords, in the same way guitar strings are tightened, leading to an increase in pitch. The procedure involves placing permanent tightening sutures between the two encasing cartilages of the voice box. Your doctor will go through this in detail during your consultation. In general, CTA will be considered if a glottoplasty has failed to achieve enough voice pitch elevation.
Laryngeal shave (Adam’s Apple reduction):
This procedure aims to give a feminine contour to the neck. Here, the prominence of the “Adam's Apple” is shaved off the voice box. This can be performed as a standalone procedure or combined with glottoplasty or cricothyroid approximation.