Vocal Feminization: Surgery

Experimental and risky

There are several surgical methods of vocal cord alterations being performed.

I do not recommend existing voice surgery techniques based on results I've heard. To date, I have met or spoken to 14 people in person who have had vocal cord surgery. Of these, 12 have what I consider poor results. Two have acceptable results, and of these two, one has very good results.

How unacceptable?

One woman I know sounds like slightly deeper version Minnie Mouse, or maybe Michael Jackson. On the other end of the spectrum are two women who sound like a hoarse Bea Arthur, or Marge Simpson's sisters Selma and Patty. Most don't sound much different than before surgery.

Katherine writes:

I, too, looked into "voice surgery", just before my SRS two years ago.  After speaking on the phone to about 6 people who had had it done, I was scared off it forever. They all had the weirdest, squeakiest voices, and one said that after about half the day, her voice would give out altogether. AND all told me that they could no longer sing -- the end of the subject for me! I'd as soon give up singing as most men would give up their penises.

JulieAnne is an ENT (ear, nose and, throat) surgeon who writes:

Differences in the way people heal will affect the eventual outcome and this is something the surgeon often has no control over. I hope any surgeon would discuss this with their patient so they can make an intelligent decision about proceeding with this type of surgery.

A reader sent this comment in June 2005:

Hello again, I wanted to send you a short note to "follow-up" with my experience with voice surgery, as you had an entire page dedicated to it.  After having the CTA surgery July 2004 in Portland, I can confidently say it isn't in any way a cure-all procedure.  My voice was not masculine to begin with, but it was at a level (I thought) sounded like a 16 year old feminine gay guy.  CTA helped me a very small bit, especially being able to raise my voice to someone across the room or laugh, but it wasn't a miracle.  Along with changing my speech patterns I was able to improve a great deal on my voice.  So what many people have said about voice surgery still remains true ;^). Hopefully someday they'll come out with something better surgery-wise!  

I do not believe this surgery has an acceptable success rate given the costs, risks, and the permanence of poor results I've heard.

This surgery is not a quick fix for a non-passing voice. You will not go from male to female from this procedure. It must be combined with voice therapy pre-surgically and post-surgically in order to optimize the results. Even then, it's likely that your voice will sound unnaturally high and thin in most cases. On the other hand, your voice can sound raspy like a bad smoker.

Voice surgery can only raise pitch and does little to nothing to your resonance. As I and others discuss, resonance is the key to feminizing your voice.

It's cheaper, easier, and less risky to practice. This allows you to maintain your range, and practicing is 100% reversible. Plus, you'll need to practice anyway, even if you do get surgery.

Don't take my word...

If you are still considering this surgery, I suggest you personally speak with at least three women who have done it. That should be enough to change your mind.

Patient first-hand experiences

The following posts were culled from various transgender newsgroups.

Melissa wrote a detailed article on her voice surgery experiences.

My Voice Surgery Experience

Now that I'm feeling better and starting to be able to hear the results of my voice surgery more clearly, I'd like to tell the story and recommend the doctor, surgical center and voice therapist to any of you who might be interested in voice surgery. These are all very good people! I'll include the details and phone numbers at the end of this article.

As most of you know, who have ever been around many M-F Transsexuals or talked to them on the phone, the voice is one of the greatest obstacles we all face. Someone can be the nicest looking woman in the world and if people hear a male voice, or even one that doesn't sound quite like a woman, it's all over and they get to be called "sir" no matter what they look like!

I've heard a very small minority who have managed to do an excellent job with solving this problem but in most of the cases I've heard, it hasn't worked out very well with practice and speech help alone.

Computers are a wonderful tool. Here's an example of what can be done with a fax modem:

I read an article a few years ago about the voice surgery done by Dr. Meyer, a plastic surgeon in Beverly Hills. But I knew there was no way I could afford $6000 for that, plus the trip out there! As much money as I was able to save for transition, before being discovered and eventually getting fired, it was still just not in the budget.

So last year, I started a long search locally. I got the fax numbers of almost all the local plastic surgeons and faxed them that article and a letter inquiring as to whether they could do that type of surgery. I was turned down by all. But some of them did tell me this was not the type of surgery a plastic surgeon would normally do and suggested checking with Otolaryngologists ( ENT's; Ear Nose & Throat doctors ) So I made a list of almost all the ENT's fax numbers in this area and did the same with them. Almost all of them sent back letters declining and said that they didn't know anyone in this area who had ever done such surgery. But one day I received a letter back from a doctor Michael Tralla, who said he might be able to help, and to please call him & talk. I did and he said that he would try to find out more about what this Dr. Meyer was doing to see if it could be done. He would call him. I asked what would make Dr. Meyer necessarily tell him what he was doing and how. He said that all doctors are bound, by the codes of medical ethics, to help each other, even to the point of inviting others to observe their work and showing them how it is done. If Dr. Meyer did not cooperate, he would be considered a pariah in the medical community. I had doubts but wished him luck with it. He said to get back with him in 3-4 weeks.

After about a month had gone by, I contacted him again and asked how it had worked out with Dr. Meyer. It turned out that a Beverly Hills plastic surgeon does not have to worry much about being considered a pariah among his medical peers. He had apparently stonewalled on the cooperation, which I suspected he might from the beginning.

But Dr. Tralla said he still thought he could help me and to make an appointment to see him. He examined my sinuses and throat and put an optical probe down through my nose to look at my vocal cords. He told me that he felt that he had figured out what Dr. Meyer had been doing and that it was not such an uncommon procedure among ENT's. ( Reconstructive Laryngoplasty ) He had done similar procedures successfully with other people before, for other problems, and had even given a woman back her voice who had lost it earlier due to disease. It was a matter of adjusting the structure of the area around the vocal cords and the pitch could be changed. He said he could not absolutely guarantee me success but that he would guarantee me no harm to my voice, and that it could be reversed if I later changed my mind. ( No way! But it was certainly an ethical guarantee to make. ) This was also the time to talk about whether I would need a tracheal shave to take care of my Adam's Apple. I suspected I didn't because mine is smaller than those of some women I've seen and Dr. Tralla confirmed this. But it's a good idea to discuss this early on because it might harm the results to attempt it after the voice adjustment.

Dr. Tralla said he would be able to do the surgery for $2000. It did not turn out to be an office procedure, so this did not include the costs of the place to do it and a surgical assistant to help him. The surgery was to be done with me awake under a local anesthetic ( I had to be awake to talk so my voice could be adjusted properly ) so there was no additional fee for an anesthesiologist. Instead of using a hospital for day surgery and incurring all the extra expenses associated with that, I contacted Lakewood Surgical Center and because they said my insurance would probably not pay for this procedure ( I'm going to submit the bills and fight them if they won't! ) , I got a price in advance for how much I'd have to pay them; $438. The surgical assistant's fee was 12% of Dr. Tralla's fee, or $240. That brought the total to $2678. Still quite a bit less than Beverly Hills, even if I had lived in California!

We scheduled the surgery for 7:30 AM on January 17th. I was told to be there an hour early for prep. The people at Lakewood Surgical Center were super nice to me from the start. The only kink we ran into was over my blood pressure medicine. I usually take it around 10:00 AM and PM each day and after food because otherwise it can cause a sore colon. The surgery was only supposed to last an hour, to an hour and a half maximum. So they told me I could wait and take it after the surgery. Unfortunately that didn't work out too well and caused them a little scare.

In the prep. room they started an IV in the back of my hand about 15 minutes before the surgery was to begin. This proved to be a more difficult task than ever before. I used to have great big excellent veins for such purposes but it looks like 2 1/2 years on Estinyl must have changed that. My skin has become softer and smoother and the big veins have all but disappeared. It took the nurse about 10 minutes to find a good enough place to stick me. I have to give her a lot of credit for only having to do it once, despite this!

Then they wheeled me into the operating room. They must have put some good stuff in that IV because my anxiety level was very low. I was also extremely happy that this was finally getting done because I considered it one of my last prerequisites to going full time as a woman. I was smiling all over the place and if the doctor hadn't known why, he might have thought I was crazy.

They got me all strapped down to the table and, like I said, the drugs must have been pretty good because I don't even remember the local anesthetic he did as hurting! In fact I don't remember the local at all. < smile > They began the surgery and started opening up a hole in my throat and separating the tissue and muscles so they could get into the area they needed to. The procedure wound up taking longer because of some complications. It turns out that as a person gets older, the wind pipe begins to harden or calcify. Dr. Tralla needed to put some sutures into place there, to hold his work in place so it could heal. But he couldn't get sutures in because the cartilage had calcified. So he had to break out the drill and drill some holes for the sutures. Another problem was that because of my size, they had to bend my head back at a more extreme angle than usual and hold it there to reach the area they needed to reach. It was difficult to get my head back far enough and it had to be pushed back by pressure on the bottom of my jaw. ( It felt like somebody's elbow! )

So there I was with my head pushed back and Dr. Tralla drilling holes in my wind pipe and it slowly started to hurt. It wasn't supposed to hurt and hadn't before that, but some pain started from about where he was drilling the holes on the left side and crept up under my jaw and over into my ear on that side. It was also taking longer than expected and the blood pressure monitor said that mine was starting to go up, probably because of the pain. I started to complain about the pain and get a little nervous. I broke out in a major sweat from it. It wasn't really serious pain, just enough to cause me to sweat a lot and moan a little. It was a little scary but I certainly didn't want them to stop the surgery so I knew I had to just hang in there. But the blood pressure started to go too high so they had to get some liquid medicine under my tongue to bring it back down. When he began drilling on the other side the same pain started creeping over there and after awhile it was really hurting. This pain went away as soon as the surgery was over, but because of the complications the surgery wound up taking 3 hours altogether.

About two thirds of the way through, Dr. Tralla reached the point of being able to adjust my voice and it was like a miracle! He asked me to count up and as I did, my voice started changing in pitch! It was so great to hear! When it got to a certain pitch, they said OK and stopped it there. Everyone I have talked to since agrees that in my case, they managed to raise the pitch about an octave, which was perfect! We've done some comparisons since the surgery and my pitch range now closely matches Jennifer's ( my wife ) and Linda's ( my therapist )! In fact I think I can even go about one note above Linda's!

Of course I still need voice therapy to learn how to modulate that pitch and speak like a woman does, but no matter how I tried ( over a couple of years! ) I could not get it right before and now it's only a matter of some work and practice. No problemo!

After the surgery was done and they wrapped it up and were ready to wheel me to the recovery area, someone commented that I had really been through a ringer. I agreed. Then someone said that; "now at least the voice matches the face". I got all watery hearing that and as they wheeled me out of the operating room, the realization of what had just been done struck me and got really moved and cried a little bit from the overwhelming happiness and relief !

The doctor ordered an EKG before getting dressed again, to make sure in my case that the pain experience hadn't been caused by a heart problem and the blood pressure. It came out normal. And the nurse who ran it gave me a copy and showed me that she had put "female" on the EKG print-out because that's the way she thought of me. I got all watery again!

Why couldn't everyone in the world be as nice and accepting as these people?!

We figured later that the pain had been caused by a combination of the drilling and having my head pushed back so far so tightly. Probably just pulling on some nerves made them sore. It went away as soon as the surgery was over and they let me relax and tilt my head back down again.

Over all, the people at Lakewood Surgical Center were super nice to me, as was Dr. Tralla. He's a really sincere, kind guy!

Last week ( February 13th ) I began seeing a voice therapist, Kathy Maes, who works with the Denver Center for the Performing Arts and is a really good teacher. She showed me some exercises and I experienced a marked improvement just from that one lesson so far. Now it's only a matter of some time and work.

  • Lakewood Surgical Center: (303) 234-0445
  • Michael Tralla, MD
  • 3550 Lutheran Parkway, Suite 102B
  • Wheatridge, CO 80033
  • 303-425-0449

Voice surgery follow-ups

Some of you may remember my posting before about the voice surgery I had back in January ( 95 ). To the best of my understanding, it was the same kind done by that Dr. Meyer in Beverly Hills but I had it done for a lot less ( around $2700 instead of around $10k ) by Dr. Tralla here in Denver. This is a follow up and a request for additional information from others of you out there who may have had other options like this done.

One problem I had was that I was Dr. Tralla's first try at this. I was about to go full time, I'm 6' tall and large boned, had a pretty deep voice before, and *desperately* needed something done! So he had no experience with how far to go with it and he seemed concerned about the possibility that a TS might change their mind later and wanted to be conservative about how much he changed it.

" You can't always get what you want. But if you try sometime, you get what you need." - The Rolling Stones

The surgery did give me what I need to sound fairly convincing in public, with the visual clues added, which is *much* better than I started out with. Before, my voice would have given me away instantly. But on the phone I still get called "sir" most of the time, which is very annoying and I have to keep correcting people. ( "I'm not sir, I'm ma'am") One funny incident happened this summer when I had called a guy one of the neighbors recommended, to cut down a tree in our front yard. He came to the door the next day to give me an estimate and took one look at me when I opened the door and said; "I talked to your husband on the phone yesterday about cutting down the tree". So in public, I'm doing a fairly convincing job. Jennifer & I have been married 11+ years now and so far since I've been full time, there's been one time when someone asked me if we were sisters, and another time when someone asked me if she was my daughter. :-)

As far as with the surgery, one of the problems I experienced was that because of my age ( 47 ) the wind pipe has calcified and hardened like it does when people get older. So it was hard for the Dr. to get the sutures into it right. ( I mentioned this in my original article ) After he did the adjustments, it sounded pretty good for awhile ( maybe 1 month ) but then dropped down in pitch about half of what we'd gained from the surgery. ( Why does life always seem like that?! 2 steps forward, one step back! ) He said it was apparently from the scar tissue stretching later. These are the things we learn from experience and the problems associated with being the first on your block.

Dr. Tralla just got back from a convention in New Orleans and told me that apparently none of the other ENT's have a clue about how to solve this kind of problem either. Very few doctors in the country are doing this kind of thing at all! At least with an ENT like him, he's done similar types of things on other people for other problems.

He said there are basically 2 options he could try to get me the results I want with. One is injecting cortisone into my vocal cords, which will have some results and should shrink the muscle tissue and raise the pitch some. It's the lowest cost try for under about $1k. ( is that kind of thing permanent? )

The other would be laser surgery to thin the cords, which he says will not only surely raise the pitch more but also give a breathier quality, which would really help me because of my size and formerly deep voice. That's around $2k.

Epilogue:

I had the laser thinning done by Dr. Tralla in December 1995. He also injected some cortisone into the vocal cords but I don't know how much that really helped. The thinning helped raise the pitch and make my voice sound breathier like he suggested it might. It was worth doing. I feel like it's reached the point of diminishing returns now where I have what I need but not absolutely what I wanted. By working and practicing, I've gotten to the point where a don't get sirred that much on the phone much any more. Also changing my first name from Robin to Melissa will also help that, giving further clues to people on the other end who can't see me. I don't know what the other surgeons doing these procedures are getting, to compare them to Dr. Tralla but I think he's a kind and competent doctor for doing this. I probably would have had better results if I hadn't been so big to begin with.

I have a wav sound file of my voice before these 2 surgeries and can make another one of after, if anyone's interested in comparing. The differences are quite remarkable when compared directly like that. I'm not sure if this newsgroup allows posting of files though. Let me know.

April 8th 1997: I've learned how to use my voice much better now and get called "ma'am" about 90% of the time now on the phone. Changing the first name to Melissa definitely helped on the phone too and people have to be real dim to call me "sir" on the phone with both combined. I often hang up and refuse to do business with sales people who call & want to sell me something but persist in doing that even after they're told. I'd definitely recommend changing to a distinctly, unmistakably female sounding name for that reason.


Jerrie writes:

I had voice surgery last October with Dr's M[eltzer] & C[ohen] also. My experience with them has made my voice just a little better than it was before. Like you, I too, had a very bad experience with a trach shave although the doctor that operated on me did not detach the vocal chords, he completely removed that anchoring point for them. I was laft with a raspy and hoarse voice. Dr's M & C had to do a lot of experimenting with other throats before they felt confidant that they could do me right. They had worked on others before me and tried to perfect the technique they were using to reattach the chords. My throat was in horrible shape because of blatant malpractices from the other Dr. My trachea was broke from the top all the way to the base of my throat. They had to place a metal plate in my throat to keep the trachea from moving and they had to place three separate sutures in the vocal chords and secure them to the plate. My voice is a LOT better than it was before but it will never be the same as it was on that horrible day three years ago on the 20th. I have been contemplating going back to them and having some fine tuning done but at the moment I am not sure that I would like to have my throat opened up another time.

I had a lot of swelling from the surgery but right after they took me back to the short stay room, I had a coughing jag that was caused by one of the sutures touching slightly on the chords and aggravating them in the jag. Two days later at the post op exam by Dr. C, he discovered that the chords were hemorrhaging slightly because of coughing. I had a very hard time talking after I was given the ok to resume doing so. My voice was also rather weak but it became stronger as it was used. I have never had the wonderful sounds coming out of my throat like I did while they were operating and stretching them. But I do have more projection than I did before. All in all, I would rate the surgery as a success due to the fact that I can still talk. I think that I need to find a speech pathologist to help me further tune my voice without having to resort to more surgery. One day when the demands of my job are not so great I will do so. I hope that this has answered your questions. Take care of the voice. It is the only one that you have regardless of anything else.

Thank you for posting your message about your voice surgery and the results. Like you, I too have had voice surgery done although mine was more in an attempt to repair some MAJOR damage that had been done to my throat in 1994 by a doctor that did a tracheal shave on me. The results of that surgery left me with a near complete loss of my voice. The topical results of the surgery were nearly perfect but when I would try to talk, I would be able to gasp out what I was saying very hoarsely and gravelly. When I confronted the doctor that did the surgery about why my voice was not back to normal, I was told "I did not work in the INSIDE!" which was not what I had asked. If I had been more alert to things, I would have gone to another doctor right away and had it checked. But, alas, I felt that I had to trust the doctor with him saying that it would come back. A year after the surgery, it was still in the same shape except that I was losing the ability to speak at all. I hated to talk because the sound of my voice was very harsh to my ears. I started looking to see if I could find someone who would be able to fix it and raise the pitch to a more feminine pitch. I found one in the least likely people- Dr. Toby Meltzer. I found out about it when I went to Portland to have my SRS. The two weeks that I was there pre- and post-op, I was able to get information from him that he and another surgeon did vocal chord work. When I scheduled my labiaplasty before I left, I scheduled with him to also do the corrective surgery on my voice. I was ecstatic about the prospect of being able to get my voice back but even better than it was before. As the time approached for my return, he requested some x-rays (cat-scan) of my vocal chord area so that they could make some plans about what to do. The ENT that did the tests prior to the cat scan took one look in my throat with the scope and just about freaked. He then made an appointment so that I could get the cat scan. I had them done and had the results sent to Dr. Meltzer. I was then asked to see the ENT on my arrival for an evaluation of the surgical area. The testing they did then confirmed a lot of fears that I had had since I had the surgery on the trachea done. My vocal chords had been very seriously damaged by the quack (by this time I felt that way about him) and all they were doing was flopping around in my throat when I talked. I could not hit any high pitched sounds at all due to the fact that not only did he shave the trachea down, he removed TOO much cartilage and broke into the throat and tried to make it look ok. The anchoring point for the vocal chords in the front of the throat was totally removed which caused the floppy chords. Needless to say, I was devastated by the news and even more so when they told me that there would be no way possible to do the surgery. The technique they used would have no effect at all and would be a waste of time and money. I cried for hours afterward and I think I fell asleep crying that night.

I had my labiaplasty done and went home the following weekend very depressed.

But six months later I received a phone call from a friend who had gone to see Dr. Meltzer for her pre-consultation for her SRS. When he found out that she knew me, he asked her to get in touch with me and for me to call him. It seems that he had had a couple of other patients with nearly the same problem that I had but not as severe as mine was. He was able to get their voices fixed and pitched higher into the female range. I was once again ecstatic about the news. I made and appointment to have the surgery done after I finally got to talk to Dr. Meltzer.

My surgery was scheduled for Oct. 1, 1996 but that was the time frame that he decided to leave the University where he had been working and they had been trying to rescheduled everyone for later dates. Because I already had the time off from work and my airline tickets, I could not reschedule for any later than that week. They had wanted me to come two weeks later but they were able to reschedule me for the 2nd of Oct. instead. I have a friend in the Portland area and I was asked to stay with her during my stay there.  Because they already knew what was to be expected with the voice problems, I did not have to go for an evaluation prior to the surgery like the previous time. I was scheduled for the first procedure of the morning and had to be there at 6:00 am. Once into the pre-pre-op room I was given an IV and waited for around 45 minutes to be taken to pre-op. I was then given a sedative and when it was working they took me into the OR. I was shifted to the table and the ENT began the preparatory work. it only took a couple of minutes to do that and by that time Dr. Meltzer made his appearance and the work began.  Once they were able to open the skin of my throat, the first problem appeared: My trachea was broke from the top of my throat all the way to the base. It had been done by the quack when he did his "work". It was then decided that they had to enter the throat below the vocal chords rather than above as they had hoped. The upper area was too severely damaged to be of any use. They had to place 3 sutures into the vocal chords near the front with enough tail so that they could do their adjusting. To tune the chords, they had to pull the sutures tight and had me talk while the did so. It was such a strange feeling. I felt no pain but yet I could feel the pulling on the back of my throat. Once they figured out where the correct pitch was, they had to figure out how to anchor the sutures so that they would remain taut. That was corrected when they place a metal plate across the break in the trachea and they fastened the sutures around it and then screwed it into place. But before they did the final anchoring they did another adjustment to fine tune it. Everything was tightened and secured into place. The ENT was relieved of his part of the surgery and Dr. Meltzer proceeded to finish closing up my throat.Once all that was done I was transferred back into the pre-op room so that I could recover somewhat before being transferred back to the short stay room.

Before leaving the operating room, I was told to keep from talking at all (voice rest they called it) [which is hard for me sometimes because I have to talk for a living]. Once dismissed from the hospital, I was taken back to my friends house so that I could start my recuperation and healing. I was supposed to not use my voice for at least ten days and after that was finished to be careful for about 2 months with what I did with it.

When I was able to use my voice again, the level of my speaking was very soft due to the fact that the chords were still swollen. As the swelling decreased and it became easier to talk, I was able to sound a bit more like my old self again. I am able to hit a few higher pitches but not really as I would liked to have been able to.

It has been 7 months since the surgery and a lot has changed with my voice. I can do more with it than I had previously but over all my results are fair. But that has a lot to do with the fact that I had very severe damage to begin with. I am fairly soft voiced now and I have a very breathy quality to my speech. I cannot raise my voice loud enough to shout without completely losing it. But I can be heard in my normal speaking voice within 15 feet, which is more than before. I have been told that my voice is pleasant to listen to and at times it is very sultry. Dr. Meltzer said that some further tuning might need to be done but I am not sure that I would like to go through all that again. Who knows at this moment? Not I.  At the moment, I cannot afford another surgical event for a while and if I did I would more than likely leave my vocal chords alone and work on something that I really need to get done-- my facial features. I can handle the voice for now but I feel that my face needs a lot more feminization done than I have done.

I am sorry this was so long. I hope that others can find a doctor better than I did to begin with and avoid the many problems that I have suffered with during my transition. Good luck to you all. If any feel like replying please do so in the group. I have changed my email address to an incorrect one to avoid the spam mail that I had been getting when it was listed right. I apologize for that.


Amanda writes:

Has anyone else had voice surgery with Dr. Meltzer and Dr. Cohen in Portland? I had the surgery 9 days ago and I still have quite a bit of swelling. It looks as if I swallowed a golf ball and it got stuck in my throat. It's not really sore anymore though. Tomorrow is my official day to begin speaking again. However, I did try some brief and gentle testing of my vocal range today and there appears to be no improvement in the range or speaking pitch. Also, my voice is hoarse and weak. Presumably, all of this will improve in the coming weeks.

My situation is complicated by the fact that my vocal chords had become partly detached (due to a trach shave I had 1 1/2 yrs ago) and they had to be re-attached by the doctors using pins. I guess I'm being impatient but I'm wondering how long after surgery have others gotten their voice back to normal, and how much improvement did you observe?


Rosalind writes:

Did I have voice pitch surgery? No. My voice is marginal for passing, like most transsexuals' voices at best are. And I do find it very important. However, with the current state of the art, the risk involved in voice surgery is not slight, and the results are often disappointing. It is weighing importance, gains and risks against each other.


Bethanne writes

I had the conventional type of voice surgery done in April 1996 by Dr Pincus in Marina Del Rey, CA. This procedure "tilted" the voice box, stretching the vocal cords and making it easier to speak in the upper ranges of their ability. This is the same method being used by Dr Menard and Dr Toby Meltzer (srs surgeons).

Dr Pincus has since added the laser to this surgery...after he stretches the vocal cords, he hits the cords with the laser and sutures two of them together where they attach to the side of the voice box....shortening both of them and increasing the tension on them.

I wouldn't do this surgery unless it included the laser. My results were pretty typical...not that much improvement.

This does cost about $5000...so I would give Dr Pincus a call in Marina Del Rey and talk to him about it.


Pitch-Raising Surgery in Fourteen Male-to-Female Transsexuals
Isabelle Wagner, MD; Claude Fugain, MD; Lucile Monneron-Girard; Bernard Cordier, MD; Frédéric Chabolle, MD

http://www.laryngoscope.com/article.asp?ISSN=0023-852X&amp;VOL=113&amp;ISS=7&amp;PAGE=1157


Teri is the only person I've heard who I thought had excellent results. I did not hear her voice before surgery.

I had the voice surgery you spoke of done in late October of 1996, by Doctors Toby Meltzer and Dr. Coen in Portland OR. The results are wonderful, but the healing time to achieve a "natural" voice is MONTHS not weeks.

I have a friend who also had this procedure done and she is still healing and somewhat "scratchy" after 2 1/2 months. It really was for me, about 3 months before I felt really good about my voice. It starts out very weak and gradually gains strength over time.

You will lose 100% of your lower voice range, so any ideas you have of maybe still having your old voice to fall back on, are only dreams. I love the fact I don't have to worry about my voice "slipping" I am always addressed as miss, and now even on the phone! It has been wonderful, but plan on giving yourself some extra healing time.

Recommendation

I do not recommend surgery except as a last resort. To help you avoid the risk and expense of surgery, I now offer a video program for Finding Your Female Voice as well as personalized voice consultations.

Papers and presentations

Brown M, Perry A, Cheesman AD, Pring T (2000). Pitch change in male-to-female transsexuals: Has phonosurgery a role to play? International Journal of Language and Communication Disorders, 35, 129-136.

de Jong, F (2003, September). Surgical raise of vocal pitch in male to female transsexuals. Paper presented at the XVIII Biennial Symposium of the Harry Benjamin International Gender Dysphoria Association, Gent, Belgium.

Donald PJ (1982). Voice change surgery in the transsexual. Head and Neck Surgery, 13, 246-250.

Gross M (1999). Pitch-raising surgery in male-to-female transsexuals. Journal of Voice, 4, 433-437.

Isshiki N, Taira T, Tanabe M. (1983). Surgical alteration of the vocal pitch. Journal of Otolaryngology, 12, 335-340.

Kunachak S, Prakunhungsit S, Sujjala K (2000) Thyroid cartilage and vocal fold reduction: a new phonosurgical method for male-to-female transsexuals. Annals of Otology, Rhinology, and Laryngology, 109, 1082-1085.

HF Mahieu, HK Schutte New surgical techniques for voice improvement. European Archives of Oto-Rhino-Laryngology, 1989

HF Mahieu, T Norbart, F Snel - Laryngeal framework surgery for voice improvement. Rev Laryngol Otol Rhinol (Bord), 1996

Neumann K, Welzel C, Berghaus A (2002). Cricothyroidopexy in Male-to-female-Transsexuals – Modification of Thyroplasty Type IV. International Journal of Transgenderism, 6(3). Retrieved December 30, 2003 from http://www.symposion.com/ijt/ijtvo06no03_03.htm

Oates J, Dacakis G (1983). Speech pathology considerations in the management of transsexualism: A review. British Journal of Disorders of Communication, 18, 139-151.

Pincus SJ (1997). Voice surgery. Paper presented at the Second International Congress on Sex and Gender Issues, Philadelphia.

Sataloff RT, Spiegel JR, Carrol LM, Heuer RJ (1992). Male soprano voice: A rare complication of thyroidectomy. Laryngoscope, 102, 90-93.

Wagner I, Fugain ., Monneron-Girard L, Cordier B, Chabolle F. (2003). Pitch-raising surgery in fourteen male-to-female transsexuals. Laryngoscope, 113, 1157-1165.

Wolfe V, Ratusnik D, Smith F, Northrop G (1990). Intonation and fundamental frequency in male-to-female transsexuals. Journal of Speech and Hearing Disorders, 55, 43-50.

CY Yang, AD Palmer, KD Murray, TR Meltzer, JI … - Cricothyroid approximation to elevate vocal pitch in male-to-female transsexuals: results of surgery …The Annals of otology, rhinology, and laryngology, 2002