Yeson voice feminization surgery

[anjaq]

Not really, but raising it "too much" will result in uncomfortable and thus hard to make it as natural habit right?

i would say a yes to it. If you overdo it, it is kind of a strain. you need to find a good way in the middle, but it may actually be helpful to do too much at first for training and kind of get used to that and then relax it a bit to a middle. Kind of like in voice excercises for inflection this is totally exxagerated in training so it settles to a natural way when dropping the excess.

I haven't yet had any formal voice coaching. Do you think this may be too soon? Should I have my vocal range tested somewhere before, is that what most people do?

Personally I would suggest you do some voice training of your own like Jenny recommended but also try and find a voice coach and do some training. They can also measure your average speaking pitch, pitch range and a ENT can also take a look at your vocal chords and make sure they are ok, which will be helpful for the decision. Voice training is needed in any case. to get resonance right and depending on how you speak now it may also be good to change the way you speak (intonation, inflection etc). If that is all good before the VFS, I think it is more likely to really be stunned by the results like one can see with Jenny. If that is not done before, I can imagine that it may not be that miracle change at first as that work will then have to be done afterwards... so maybe then one could be a bit dissapointed by pitch elevation surgery at first as the effects will only show after addintional voice coaching.

For tremor - it's not the kind that some of you experienced because of pro-longed time speaking in falsetto.

Oh, did Dr kim say that that is the cause of the trmor in most of his patients? I only suspected that it may be the cause for me but dont really know the cause. I assumed it also could be just a natural condition for me.

Mine is more like genetics - aka having it since I was born.
Tremor of my kind is hardly treatable from vocal training because it's more related to the neuron and muscles, and even brain itself. So it's not like something you could learn easily. It's possible, but only when "muscle relax" becomes the patient's reflex action according to Dr. Kim.

Hmm - ok, sounds a bit like what I am doing in voice rehab now. Try to relax relax and then tension up in a different place to make sounds. I have no idea if it will also do something against the tremor or the assymetry - the main goal is to fix the incomplete glottal closure...
So I guess for you it really is the task now to find a good voice trainer and then get working on all of these things that you learned from Dr Kim.

[AmyBerlin]

Dear Jenny,

welcome to the voice threads :-)

I haven't yet had any formal voice coaching. Do you think this may be too soon? Should I have my vocal range tested somewhere before, is that what most people do?

Well, the question is not what most people do, but the question is if it's useful. You have to know that there are several parameters to your voice that can be adjusted independently. One is pitch and range, that's what this surgery addresses. Female voices are higher in pitch than male ones, on average. So if your voice is medium or low for male standards, it'll be too low for female standards and this surgery may very well be for you. However, if your voice is high for male standards, it may be just right for female standards and you've nothing to gain from the procedure. Alexia's case goes to show that.

The other parameters are resonance/sound (the way you shape the tone your vocal cords make – there's are two distinct male and female patterns that you can switch between. That's a learning process, nothing that Yeson's surgery will fix), speech melody (women use more of it) and word choice (women phrase things differently).

So if it's pitch that's your problem, get informed, make your decision and go to Yeson :-)

Hugs,

Amy

[AmyBerlin]

Hi Alexia,

(on raising the larynx:)

Not really, but raising it "too much" will result in uncomfortable and thus hard to make it as natural habit right?

It's not uncomfortable at all, it'll be second nature in no time and will help you immensely in attaining a good and female-sounding voice.

Amy

[Jenny87]

Thanks so much Jenny, anjaq and AmyBerlin, I'm going to take your advice and go to a voice coach as soon as I can, spend some time practicing and have my pitch measured and see how things are looking by march before I commit to anything. I think I'm just a teensy bit too eager .

[anjaq]

I totally can relate to being eager to just book a ticket and go there Jenny87 - especially after listening a bit to the videos from Jenny in this thread and the others in the other threads. Its so very tempting. But for me sadly there was this dissapointment. I did my ENT appointment with pitch range and speaking pitch measurement as well as vocal chord videos and sent it all in to Yesons and they told me that they see problems there that should be fixed before I do such a surgery as they would diminish the result and increase the recovery time, so I guess it was good to do some work in advance.

[alexiakk]

Now my main concern will be whether there is a way to attain "voice feminization singing"... To me I'm a bit different. I can stand my speaking voice to be a masculine female voice (as Mariah Carey and Beyonce who have deep speaking voice) - and in fact I don't want my voice to be soft and delicate instead I admire those strong women's voices. HOWEVER, despite being a counter-tenor in full voice, I can't stand any "male-like" factors in singing voice...

I really regret letting my voice change - should've taken female hormones before it started to change 
Now if there are more advanced technologies as vocal "TRACT" space reduction I'll definitely do it lol

[Sophiabutterfly09]

I CANT WAIT lol i haven't even contacted them yet. I didn't know that your supposed to send in a voice recording beforehand. I really have a good feeling about this surgery, it has and will continue to change the lives of many transwomen YAYY!!!

[AmyBerlin]

Dear Sophia,

I didn't know that your supposed to send in a voice recording beforehand.

That makes me wonder. They didn't ask me for that...

Regards,

Amy

[Sophiabutterfly09]

Hey Amy, I would love to hear about your upcoming expierence with yeson 

[anjaq]

I dont think they request anything as you will do a thorough examination once you are there and he will judge about the possible procedures then. I did send in examination results from my examination here and he cautioned me that he can only make an uncertain judgement on that information as he did not perform the examination himself. In my case it was a video and an image with the pitch parameters. What he judged from that was that I would run into problems with the surgery due to some vocal chord issues I have and that would have to be fixed first. He also said he could not totally feminize my voice due to the original pitch being too low. That last judgement however was made on the assumption that my original voice was at F0 of 100 Hz and if he adds 75 Hz to that it still would not be in what he considers a female range wnd which is about 200 Hz. Since I do not really speak at 100 Hz anymore I would hope that this does not hold true and if it does that at least it would make it easier for me to go up a bit. There is a risk that he will not reach the 75 Hz though and that the original F0 is the important parameter, in whcih case I would fall below 175 Hz new F0 which would not be that different from now.
So I guess it is not a bad idea to do some examinations at home and do recordings (rainbow passage?) or let someone analyze the speaking voice F0 and send it to him, but he can only make a limited judgement on it. Unless something is totally wrong (or totally great) with the voice or vocal chords (as it was with me with my broken vocal chords and Alex here with her already female vocal chords), I think he will only say that things are ok and you will get the examination in Seoul.

[AmyBerlin]

Hey Sophia, Anja,

Hey Amy, I would love to hear about your upcoming expierence with yeson 

You bet you will! The thread is already there: https://www.susans.org/forums/index.php/topic,156860.0.html. But, as I said, I had to schedule for mid-April for work reasons, meaning that if you book your surgery now, without time constraints, you'll end up having an appointment earlier than mine.

That last judgement however was made on the assumption that my original voice was at F0 of 100 Hz and if he adds 75 Hz to that it still would not be in what he considers a female range wnd which is about 200 Hz.

Since pitch is logarithmic, I find it odd anyway that he's describing frequency gain linearly (+75 Hz) and not with a factor (such as ·3/2 for "a fifth higher" or ·16/9 for "a minor seventh higher").

Me, I've an F0 of 130 Hz and a lower limit of 82 Hz for the old male voice. Adding 75 Hz would yield F0=205 Hz (more than enough) and a low end of 157 Hz. In order not to have to transpose my whole repertoire, I'd need to be able to access 147 Hz though (which is the lowest note I'm using on stage). I think I should still talk to Jessie about that...

Regards,

Amy

[Jennygirl]

Hey Sophia, Anja,

You bet you will! The thread is already there: https://www.susans.org/forums/index.php/topic,156860.0.html. But, as I said, I had to schedule for mid-April for work reasons, meaning that if you book your surgery now, without time constraints, you'll end up having an appointment earlier than mine.

Since pitch is logarithmic, I find it odd anyway that he's describing frequency gain linearly (+75 Hz) and not with a factor (such as ·3/2 for "a fifth higher" or ·16/9 for "a minor seventh higher").

Me, I've an F0 of 130 Hz and a lower limit of 82 Hz for the old male voice. Adding 75 Hz would yield F0=205 Hz (more than enough) and a low end of 157 Hz. In order not to have to transpose my whole repertoire, I'd need to be able to access 147 Hz though (which is the lowest note I'm using on stage). I think I should still talk to Jessie about that...

Regards,

Amy

Amy- my pre-op voice is almost a perfect match to yours. My lower limit was the same as yours.. E2 (82hz). And my current lower limit happens to be D3 (146.8hz).

I found it odd that he used a linear scale as well. I think it more pertains to the F0 range of transposition from male to female though- it is probably just a simple average figure he uses.

It would make sense that someone with a lower starting pitch would gain less in hertz than someone with a higher starting pitch. As pitch raises, so does the amount of difference in hertz between notes (a la logarithmic - just explaining to the other folks who may be interested - I know you already understand this )

If you think of it like putting a capo on a guitar (shortening the strings like shortening vocal cords), no matter where you put the capo all strings on the guitar (aka different people's voices) get the same amount of pitch lift with the same proportion of capo position.

For example a C3 string (131hz) with capo on fret 7 would then be a G3 (196hz), a 65hz increase. Correspondingly, a D#3 string (156hz) with a capo on the same 7th fret would be a Bb3 (233hz), a 77hz increase with the same amount of pitch lift.

[Jennygirl]

It seems like he always goes for exactly 1/3 the length to be sutured unless there is something to suggest that he should go more. In my case because I had had a trach shave and due to my vocal cords being unusually long and thick, he decided to tie off closer to 1/2. Since I had a very deep perceived voice to begin with, I was not concerned about it being too much at all.

My hunch is that the more he ties off, the more volume or power is potentially lost from the voice. I know that my volume is still slightly lower now over 8 months into recovery. Whether it will be a temporary or permanent loss I don't care at all. It's never a problem. Sometimes with a night of moderate drinking I can overexert my voice though, and my voice can become incredibly limited in the upper range the next morning. When I was first recovered enough to let myself be loud again, this would happen almost nightly- and it could take up to 1.5 days to get my upper range back. That recovery time after a night of heavy voice use is diminishing more and more. Now if that happens, I am good by midday the next day.

I think of it like the relative size of a vibrating reed in a wind instrument to the body of the instrument itself. Kind of like making the mouthpiece on a saxaphone smaller. The result would be a less optimized volume level and a slightly smaller/softer sounding tone to the instrument. I don't know for sure if this relates, it's merely a thought I just had.

[alexiakk]

I recently found some interesting information about the physiological differences between males and females speaking, and feel like what Anja said to me before "But you learned how to speak in a lowered and masculine sounding voice, in part deliberately. On the upside this basically just means you have to unlearn these patterns and you will be naturally female sounding. On the downside it means that you probably still would need some voice therapy." is totally true!

Basically children use the same part of brains in speaking, but during puberty the male hormones not only affects one's larynx & vocal cords but also tell one's brain to switch "speech function" to another area in order to adapt to the heavier larynx (the processes are separate though). That's why some unique males, despite having small vocal cords, still get lower voice - hormones might not infected their cords but indeed affected their brains. As this guy: his speaking Hz is a bit above average male, but not really "that high", while he's a male soprano. That said, males naturally lose the function they "might" still be able to do post-puberty. So I really think that voice therapy might be a need for anyone regardless of the surgery, according to: http://professionalvoice.org/feminization.aspx

"A genetic female uses a different part of the brain to produce speech than a genetic male, and has a certain sing-song quality called prosody. This prosody is what the brain of someone listening to you will subconsciously process the voice as being perceived female versus a high-pitched male voice. (Visual cues are also very important, but for the purposes of this discussion, visual cues are assumed absent, such as telephone conversation). Prosody can not be changed with hormones or surgery. It must be learned, the way an actor would acquire the skills to take on another's personality of sorts. It requires a speech therapist very, very experienced in transgender voice changes, who can teach prosody. In most, it also requires years of practice to perfect and have it sound natural and effortless."

so yeah I'm gonna find the brain functionality back! 

[eh-lyssa]

I am looking into voice surgery because of difficulties in changing my pitch due to a previous injury due to a blood clot killing the nerve to my left vocal cord. Since then the nerve has healed and have regained some function but I don't have the pitch range I used to.

I saw a voice specialist (Dr Kirkham) about my injury and asked him about voice feminization surgery and he strongly advised me against it due to the restriction in your airway that results. He said any inflammation (like allergy) can result in closing off your airway much easier than without surgery.
He said he used to do voice feminization surgery but would never do it again for this reason.

Anyone who has had the surgery, have you had any issues with this?

Thanks


Alyssa

[Expressgirl]

I dont think they request anything as you will do a thorough examination once you are there and he will judge about the possible procedures then. I did send in examination results from my examination here and he cautioned me that he can only make an uncertain judgement on that information as he did not perform the examination himself. In my case it was a video and an image with the pitch parameters. What he judged from that was that I would run into problems with the surgery due to some vocal chord issues I have and that would have to be fixed first. He also said he could not totally feminize my voice due to the original pitch being too low. That last judgement however was made on the assumption that my original voice was at F0 of 100 Hz and if he adds 75 Hz to that it still would not be in what he considers a female range wnd which is about 200 Hz. Since I do not really speak at 100 Hz anymore I would hope that this does not hold true and if it does that at least it would make it easier for me to go up a bit. There is a risk that he will not reach the 75 Hz though and that the original F0 is the important parameter, in whcih case I would fall below 175 Hz new F0 which would not be that different from now.
So I guess it is not a bad idea to do some examinations at home and do recordings (rainbow passage?) or let someone analyze the speaking voice F0 and send it to him, but he can only make a limited judgement on it. Unless something is totally wrong (or totally great) with the voice or vocal chords (as it was with me with my broken vocal chords and Alex here with her already female vocal chords), I think he will only say that things are ok and you will get the examination in Seoul.

Hi,

I have also been one of the people reading over this post for quite some time. Now that I am ready to take the plunge I am getting really nervous. I am talking to Jessie about booking a date in March, but I would hate to get to Korea and be told I am unable to complete the surgery. I would hate to take the time off work, spend the money to travel to Korea with my partner and then not have the surgery (unless it is like Alexiakk's situation).  I have a very low natural voice too about 100-110 Hz, but I haven't used that voice for almost two years. When I asked Jessie if this is an issue that would prevent me from having successful results, she said no, Dr. Kim would just place the suture closer to halfway point of my vocal cords. It does not ease my concern that I can't speak with Dr. Kim until I arrive in Korea. I would like to send them the same video/pitch parameters, which you did. What did you ask your ENT to do when you wanted to send Dr. Kim your results? What vocal cord issues do you have? Is there something specific I can ask my ENT to look for?

[Jennygirl]

Alyssa- I have horrible respiratory allergies including asthma reactions to them as well. I have not had any issues at all.

Dr. Kim will not make your vocal cords too small.

I would contact him about the vocal fold paralysis, it may be something he can fix at the same time as the surgery.

[anjaq]

So, Jenny& Amy - If a 1/3 reduction in the chord length brings a 130 Hz voice to 205 Hz (+75Hz), what would it do to a 100 Hz voice? It would not go to 175 Hz but what - 160 Hz?

I would like to send them the same video/pitch parameters, which you did. What did you ask your ENT to do when you wanted to send Dr. Kim your results? What vocal cord issues do you have? Is there something specific I can ask my ENT to look for?

I have made a thread on my voice myself - https://www.susans.org/forums/index.php/topic,153931.new.html

Basically what I had done was an endocsopic video with different frequencies (I had to say "aaa"). They gave me the video on request. Also, they did a speech analysis which consisted of me reading stuff, talking, making very low up to very high tones, keep one tone as long as I could and so on. From that they determined how much air loss I have while speaking (short length of keeping a tone), what my average speaking frequency is, what my pitch range is. They diagnosed me with a double sided incomplete glottal closure, which means I have two gaps when my vocal chords are closing, which is not good as it means I have hypertension and I loose a lot of air by that, so that I cannot hold a tone for more than 9 seconds and have a breathy sound a bit. Also it means that I am straining my voice a lot just by regular conversation. In addition I have some sort of assymetric vibration. In addition to these two things, Dr Kim told me from the videos he got from me, that I also have a vocal tremor. Otherwise he confirmed the results. Since my speaking range now is about 140 Hz, he did not comment on that as this is the normal range for him to do the surgery on (130 Hz to 200 Hz increase). I wrote him only later that my original voice was at 100 Hz and then he raised some concerns about not reaching the 200 Hz. Also he said that the hypertension and tremor as well as the assymetry might affect the healing period and the pitch increase even further, so he advised more or less against it for now. I am presently working on fixing the issuew with voice training.

I am looking into voice surgery because of difficulties in changing my pitch due to a previous injury due to a blood clot killing the nerve to my left vocal cord. Since then the nerve has healed and have regained some function but I don't have the pitch range I used to.

Tell this in detail to Dr Kim and send him data. There is a chance that he can help with that, but there is also a chance that it can actually make it harder for him and you to get good results

I saw a voice specialist (Dr Kirkham) about my injury and asked him about voice feminization surgery and he strongly advised me against it due to the restriction in your airway that results. He said any inflammation (like allergy) can result in closing off your airway much easier than without surgery.
He said he used to do voice feminization surgery but would never do it again for this reason.

I am not sure this is true. I heard there is an issue with intubations as they may choose the wrong intubator in an emergency surgery. But I think most women will have a similar sized larynx opening and still breathe ok, isnt that so?

Prosody can not be changed with hormones or surgery. It must be learned, the way an actor would acquire the skills to take on another's personality of sorts. It requires a speech therapist very, very experienced in transgender voice changes, who can teach prosody. In most, it also requires years of practice to perfect and have it sound natural and effortless."
I'm gonna find the brain functionality back! 

Yes, that is important and I think it also is still part of my problems. Since I started to work on that a bit mor eagain, more people are telling my my voice is ok as it is and I should not alter pitch as it is not pitch that is important but resonance and prosody and intonation and melody and all that - basically telling me I could have a totally female voice at 140 Hz or so... I am not sure...

[Saskia]

I really wish I understood all the techy stuff you folks are talking about. I've no idea what my pitch is or anything else about my voice. Back in the 1980's I did have a visit to a speech therapist who told me my voice was within the normal female range although of course towards the deeper end, so I was of course very happy with that, and the voice I've developed now seems to be mostly OK.  I'm no longer able to speak in my old voice as I've beein using this voice for 20 plus years.
I am very worried however that for some reason Dr Kim will find something wrong and I'll not be able to have the operation, and a lot of money will have been wasted travelling to South Korea. I guess I'll have to just take the risk. But it is always at the back of my mind.

[anjaq]

As this was linked above: http://professionalvoice.org/feminization.aspx - there is a picture in there that looks like they have somehow without a suture managed to mend together the vocal chords. Apparently they are doing that wiht a laser? I have not heard of that method yet, basically a glottoplasty but not with a permanent thread that keeps them in place but with a laser scar? Is there more information on that out there? As it is scarring, I can imagine that the critical point in the commissure is not well shaped and it can be more risk of breathyness? But they say they can just advance the commisure even more and then basically reshape it.
Interesting technology...

Saskia - if your voice is in a female range and you cannot leave that range or your present voice and it worked for 20 years, why are you considering going to Dr Kim then? Is it straining the voice to use it as you do?

By the way Jenny - is it more straining to use the voice now or less than it was before to keep the same pitch? It would be a good motivator for me to put less strain on the voice after a VFS and basically not even sound that different from when I use a higher pitched voice now but doing it more effortless and without straining my voice too much when doing so...

Greeings