Yeson voice feminization surgery

[Rose35]

I am new here and trying to get a grip on a vocal surgery that really works. The type of surgery I am looking is the Feminization laryngoplasty with thyrohyoid elevation which seems to have the best results. I know you said you do not like Dr Thomas procedure so do know of other doctors in the states that do theses surgeries?

Thank you Rose

[Jennygirl]

I am new here and trying to get a grip on a vocal surgery that really works. The type of surgery I am looking is the Feminization laryngoplasty with thyrohyoid elevation which seems to have the best results. I know you said you do not like Dr Thomas procedure so do know of other doctors in the states that do theses surgeries?

Thank you Rose

Yeah I mean to each her own but the feminization laryngoplasty seemed like some of the worst results to me. Most I the samples came out sounding a bit rough or restricted. And there is the risk that you will permanently sound like that or end up sounding like an ex smoker cancer patient.

No there are no docs in the states that do VFSAAC (vocal fold shortening and advancement of the anterior commissure) it's a procedure that is currently unique to Yeson.

[Lena from Kiev]

there are no docs in the states that do VFSAAC (vocal fold shortening and advancement of the anterior commissure) it's a procedure that is currently unique to Yeson.

I don't know about USA, but Yeson is not unique. On May 15, 2012 a surgeon in Kiev for $2500 did exactly this and tracheal shave for Victoria from Kharkov (she is currently in Chonburi recovering from SRS). On June 25, 2013 another surgeon in Moscow did the same (also with tracheal shave) for $2000 for Sasha from Moscow. Those surgeons haven't support structure in place for English-speaking patients and have less experience with this surgery, but it's not that diffucult for an ENT (ear-nose-throat) surgeon.

Jenny wrote that the "before" female voice sample she recorded for the clinic was not the best she could do - she didn't manage to alter resonance sufficiently during that recording, but she could for the "after" sample. Have this in mind while listening to samples. Jenny got how to alter resonance, for many MtF it's not as easy. Jenny is right that if a MtF undergoes this surgery but doesn't manage to alter resonance then her voice is perceived as high-pitched male voice.

What resonance is and how to alter it:
http://groups.yahoo.com/group/voicets/message/9179
(in order to read that message, you need at first to sign up for an yahooID if you haven't one, then to join the voicets group).

[Jennygirl]

I don't know about USA, but Yeson is not unique. On May 15, 2012 a surgeon in Kiev for $2500 did exactly this and tracheal shave for Victoria from Kharkov (she is currently in Chonburi recovering from SRS). On June 25, 2013 another surgeon in Moscow did the same (also with tracheal shave) for $2000 for Sasha from Moscow. Those surgeons haven't support structure in place for English-speaking patients and have less experience with this surgery, but it's not that diffucult for an ENT (ear-nose-throat) surgeon.

Jenny wrote that the "before" female voice sample she recorded for the clinic was not the best she could do - she didn't manage to alter resonance sufficiently during that recording, but she could for the "after" sample. Have this in mind while listening to samples. Jenny got how to alter resonance, for many MtF it's not as easy. Jenny is right that if a MtF undergoes this surgery but doesn't manage to alter resonance then her voice is perceived as high-pitched male voice.

What resonance is and how to alter it:
http://groups.yahoo.com/group/voicets/message/9179
(in order to read that message, you need at first to sign up for an yahooID if you haven't one, then to join the voicets group).

I would think after a while that other ENT surgeons across the world will learn how to do this surgery in a similar way, because it is the least invasive way to modify the pitch of a voice that currently exists- as long as they are performing it with no incision. I would be interested to know if the surgeons you mention did it sans-incision. Since they also had trach shave, I would assume that is a definite no.

Everything you say about resonance is true, except I disagree that it is as hard as you make it sound. With a few simple exercises it is possible to give your throat the right shape for proper resonance. The hardest part, in my opinion, is trying to modify pitch and resonance at the same time. To me that was kind of like patting my head with one hand and rubbing my belly with the other. Modifying resonance alone is not hard. And if it is difficult for a person, I feel like any competent voice therapist would be able to show them how with a few productive sessions. At the same time, it is true- it is ultimately up to the patient to incorporate this through their own motivation. Yeson also provides vocal exercises which help improve resonance. I have yet to start these exercises, my 2 month post-op date is in 6 days and that is when I will begin!

I sincerely hope that Yeson is not the only one to provide this surgery in the future. I could not recommend any other voice procedure to someone... It would be great if Dr. Kim would teach other surgeons the details on what he does to minimize risk and maximize his results... The TS community would benefit greatly from his experience if he were to share it. Maybe someday he will. In the meantime, perhaps other surgeons will start trying versions of their own.

[Jennygirl]

In other news, I have 6 days until full recovery! I feel like I am already ready to start the exercises, though.

I'm consistently blown away with how well I pass now in all situations. Last night I told a guy who was hanging out with my group of friends that I am transgendered. He has been hanging out with us for about a week and has interacted with me several times, and talked for about an hour before I decided to tell him randomly. He was in absolute disbelief when I told him, and had all the classic signs of questioning his own sexuality in response to me still being pre-op (he said he has had a huge attraction for me which I did sense almost immediately). Passing like that is absolutely a new experience that I never really expected to have (I always had a hope, though). I am beginning to just trust that I pass when interacting with people without always wondering whether they are reading me, and that is the real kicker- my mindset.

Ever since the results have been in (I would say over the past 2 weeks or so), I have been super relaxed about further surgeries. I had this laundry list that I am now erasing stuff because it is no longer important to me, which feels a-m-a-z-i-n-g. I think that the new voice has a LOT to do with it, because that is what has made the biggest difference in my ability to pass when interacting with people.

I can definitely see why some say that VFS is right up there with SRS.

Anyway, I have been becoming more and more comfortable with the new sound as well as the limited lower range. When I try to say something in a low range (150-160hz) it just sounds silly.. It sounds just like a girl trying to do a low voice I've also been humming a few notes here and there and my chest voice range is climbing up and up and up... The lines between chest & falsetto are blurring into something much more female and that gets me SO EXCITED to start singing!!

Well that's about it, just thought I would do a little update for y'all

And happy 4th of July for the U.S. readers!  

[Lena from Kiev]

I would be interested to know if the surgeons you mention did it sans-incision.

They did the incision only for concurrent tracheal shave (thyroid cartilage reduction). The stitch on vocal folds can be applied only from inside, no sense for incision for it. That's two separate surgeries, just performed by the same surgeon during the same general anesthesia.

Since they also had trach shave

Because patients requested it.

Everything you say about resonance is true, except I disagree that it is as hard as you make it sound.

And if it is difficult for a person, I feel like any competent voice therapist would be able to show them how with a few productive sessions.

Most voice therapists also don't understand what resonance is and what it depends on, yours too, as evidenced by you mentioning "size of voice box". Larynx (called also "voice box") size cannot be altered voluntarily. What you managed to learn to change is larynx position and thus vocal tract length (from vocal folds to lips).

[barbie]

According to newspaper reports here in S. Korea in 2011, Dr. Kim tried to transfer his technique to some Russian surgeons.

barbie~~

[Jennygirl]

Most voice therapists also don't understand what resonance is and what it depends on, yours too, as evidenced by you mentioning "size of voice box". Larynx (called also "voice box") size cannot be altered voluntarily. What you managed to learn to change is larynx position and thus vocal tract length (from vocal folds to lips).

Well I feel like you're just picking my words apart for some reason, but I'll entertain your critique anyway.

Imagine a trombone, where the diameter of the tube stays the same just like our vocal tract. When the slide moves in and out, the total size of the resonating chamber is modified by changing the length from the vibrating element (the lips touching the mouthpiece) to the exit of the sound vibrations at the horn. In our case, it would be the length from our vocal chords and our mouth. Same concept.

Either way, you are absolutely changing the size of the resonating chamber by modifying the length. And I find it hard to believe that a voice therapist specializing in voice feminization would not know how important resonance is in finding a female voice. That's one of the main points to any voice feminization any way you do it.

According to newspaper reports here in S. Korea in 2011, Dr. Kim tried to transfer his technique to some Russian surgeons.

barbie~~

Well there you have it, it's probably only a matter of time before this procedure hits the rest of the world

[Jennygirl]

Also, the only voice therapy I have done is Kathe Perez' mp3 tutorials. There is an entire chapter dedicated to resonance.

One of the things I found extremely helpful was putting a finger on my adams apple to make sure I am keeping it in the "up" position, slowly letting go of it, and checking it to make sure I hadn't slipped. After a few weeks of practicing this in the car, I had an "ah-ha" moment and it sort of clicked. I've read about many similar experiences with people practicing their feminine voice. At some point, your muscles just "get it" and you honestly have a hard time un-getting it.

[Jennygirl]

Well I decided to start vocal exercises a day early... But since Korea is also a day early I think I'm gonna be a-ok

I also decided that I would keep track of my progress and recovery stats in a spreadsheet. I figured it might be interesting for those who wonder how my regular speaking voice stacks up compared to when I am reading the rainbow passage in a semi-animated reading tone like the one in my 1 month post op recording. I've noticed a large difference in vocal patterns when reading the passage and when I am talking during normal conversation. I've even heard this mentioned on Kathe Perez' instructional mp3's (reading sounds different from conversing). Eventually I would love to have the two line up in terms of pitch and dynamic capability.

So all in all, I do NOT think that rainbow passage is a very good judge of a voice's actual fundamental frequency. For me, sometimes my natural (actual conversation) speech dips down to the 180's during certain parts of the day when I'm feeling a little worn out from talking a lot. Other times, I am right on the money around 205-210. But really, I hardly ever get any higher than that unless I make a conscious effort to go there. I'm perfectly fine with it though because the average female range is 190-250hz- and a lot of my cis female friends are actually 160-180hz fundamental frequency. Buuut, their resonance is quite a bit different so it just kind of "works" for them. I've been saving working on my resonance any further until I started vocal exercises, but I was already pretty pleased with it to begin with. Some of the exercises also work on resonance, so I may be fine with just that

My recovery spreadsheet / doc
http://tinyurl.com/jgvoicerecovery

The recovery curriculum (I will do this twice per day)


And a voice sample from just a moment ago
http://vocaroo.com/i/s1JXQYauh779

I dunno if you will hear much of a change in my voice through the mic and recording, but I definitely notice a difference in terms of projection and "power" behind my ability to phonate and clearly talk to people without them having to lean in. Also, I haven't started singing yet but I will soon- when I feel like I have more control over my pitch. Starting the vocal exercises tonight showed me how I really do have a ways to go with regaining control over the mid range pitches. But I am not worried about it, even after a few frequency sweeps it is already coming back to me... Gawd it has been such a long time since I have tested my voice like this!! It feels great!!! Like doing vocal pushups

I hope you enjoy the voice sample I just made. I decided to just throw something together without really thinking about it. Maybe it will paint a better picture of what my voice normally sounds like.

Much love,
~Jenny

[Carrie Liz]

You sound absolutely fantastic!

And yeah, I can hear that you're still working on regaining control of the pitch, but regardless of that, it sounds 100% female, to the point where I'd have no doubt whatsoever on your gender if I was just listening to it from some random person and trying to determine whether they were male or female on their voice alone.

I can't wait to hear you sing! That's like the #1 thing that I'm curious (and concerned) about with this surgery, since I'm a huge singer myself.

[Jennygirl]

You sound absolutely fantastic!

And yeah, I can hear that you're still working on regaining control of the pitch, but regardless of that, it sounds 100% female, to the point where I'd have no doubt whatsoever on your gender if I was just listening to it from some random person and trying to determine whether they were male or female on their voice alone.

I can't wait to hear you sing! That's like the #1 thing that I'm curious (and concerned) about with this surgery, since I'm a huge singer myself.


(Side note: I'm curious, what software are you using to analyze the pitches?)

Thanks Carrie!! I really appreciate the kind and honest words that it does still need work. Even though my voice does pass and it's made me the happiest I've been during the whole transition process out of ANYTHING so far (well besides maybe the acceptance of my mother), it is still a work in progress and I do wish to make it better.

I used to be a huge singer, too... so I am equally excited about that part!

Thanks again!

[Carlita]

Thanks Carrie!! I really appreciate the kind and honest words that it does still need work. Even though my voice does pass and it's made me the happiest I've been during the whole transition process out of ANYTHING so far (well besides maybe the acceptance of my mother), it is still a work in progress and I do wish to make it better.

I used to be a huge singer, too... so I am equally excited about that part!

Thanks again!

Yeah ... I'm waiting for the singing too!

I totally agree with all the compliments about your voice, which just seems to get better by the day. And one thing you said in the recording really hit a chord (no pun intended!) with me ... It was when you said that the surgery helped you relax. that was exactly what the best MTF voice therapist in the UK said to me a few years ago. She'd always been opposed to vocal surgery, thinking it was too risky and the results didn't justify it. But now, she said, she felt much more confident in telling her patients they should consider it as an option. And the main benefit, she said, was that it helped them relax. They weren't having to consciously maintain a feminine voice, or worry about slipping back into a male one. They just spoke in the female range, because that was now their natural range - and the only range they had - so they stopped worrying.

It absolutely confirmed my personal view that the ideal aim for any MTF is not to be able to pass as female. it's to be unable to pass as male.

[Jennygirl]

They weren't having to consciously maintain a feminine voice, or worry about slipping back into a male one. They just spoke in the female range, because that was now their natural range - and the only range they had - so they stopped worrying.

It absolutely confirmed my personal view that the ideal aim for any MTF is not to be able to pass as female. it's to be unable to pass as male.

Yes yes and yes! That's exactly how I feel and why I did the surgery in the first place. My fear of slipping back into a male range kept me from EVER getting to used my female voice in a public setting even amongst friends (especially amongst friends). I just could not break free. I felt awkward about it and it was a vicious cycle.

Your personal view about being unable to pass as male is dead on, though. That sums it up right there I keep thinking that I might be able to pass as male visually, but now with the voice surgery I am fairly certain that it's impossible in any situation where I would actually have to interact with someone. My male voice just isn't there at all anymore, and it never will be.

[Jamie D]

And a voice sample from just a moment ago
http://vocaroo.com/i/s1JXQYauh779

Jenny - it's just perfect!

[abbyt89]

Ahhhh your voice sounds amazing!!!

I'm so so so happy for you! And thank you for posting such a detailed log of your journey. I'm counting down the days until I have my surgery at Yeson. December can't come soon enough!

[Jennygirl]

Ahhhh thank you Jamie and Abby

Today was a great day. I sat next to and spoke with a cis female with two toddlers on the plane on the way back to LA for about 30 minutes when for some reason I felt very comfortable around her and decided to tell her that I was trans. Part of me was just curious how well my voice was passing in person. Well, she was completely shocked and had no idea. I dunno why I was so surprised I guess, but being so proximally close to someone does make a difference if you ask me. Anyway I knew by the look on her face that she wasn't just being nice by saying she hadn't noticed. We talked and talked, and it turns out she has a close friend that is MtF, and her brother (who was sitting adjacent the isle) was gay.

Her kids were NUTS. I mean NUTS I tell you. Screaming, nearly kicking me in the face, and just going generally ape. Then she gave them Coca Cola. I was like. WTF lady!! If I wouldn't have had such wonderful conversations with her it would have turned a very pleasurable flight into the most miserable flight possible! Instead of getting mad about the disturbance, I was laughing right along with her. It was great

I'm still doing the vocal exercises and already noticing more control- almost immediately. The first few times I did the exercises there was a huge gap in my pitch when doing sweeps low to high or high to low. It's already evening out a lot. Can't wait to be a couple months more along.

Thanks again for the kind words on the most recent recording. I will have my first "sit down and talk" video in the next couple of days. Yeson wants me to do a 2 month post op interview and answer some questions about the surgery in video form. It will be my first time posting a video like that ever! I hope I'm not nervous!

[barbie]

I hope I'm not nervous!

Indeed. I think you do not need to be nervous on your voice any more. Your voice is not only feminine, but beautiful and your pronunciation is accurate. Maybe you can apply for a radio host woman.

barbie~~

[TamaraElle]

Hi Jennygirl, My name is Ella. I live in London. I had voice feminization surgery at yeson a week after you had yours. I actually saw you and your friend on your last visit to the clinic. I think that was the time I had my operation. May 22. Ive been following your progress here. And amazingly feel the same as you do. Unfortunately, I have not been as detailed as you've been in documenting your progress. I only have my voice recorded on my mobile. Can you please give me the application or software that actually gives  frequency/ pitch measurement?  I would also like to see how my pitch is doing in terms of numbers. Ive been meeting with my speech therapist here in London who wasn't keen for me to have the operation when I was contemplating on it but now she was convinced that the operation was worth it. I am meeting her every month for post surgery speech therapy. which I believe is really valuable to keep voice control and pitch maintenance. I have yet to email Jessie of Yeson regarding my progress and send her my 2nd month post op voice after July 22.
I'll be looking forward to your reply and really happy that we had this life changing operation.

[Lena from Kiev]

Ive been meeting with my speech therapist here in London

Ella, did you speech therapist explain to you how to change resonance?