Vocal Surgery

[Riven]

I've noticed not a lot of trans women go for vocal surgery and instead go for vocal therapy. Why is this? From what I've read the results are very satisfactory and some even call it a complete miracle for passing. Can anybody tell me something about it that I'm not reading or hearing about elsewhere? Thanks.

[mmmmm]

Some are able to develop fantastic voice with only training/therapy. While some other people have different voices, and all the therapy in the world won't be enough for them to have completely "passable" voice. And some people strain their voice constantly if they use their trained "pitched" voice. So surgery can be a solution for them. Sadly surgery alone won't do much. It will raise base speaking pitch, remove the access to lower tones, and higher tones will be easier to access (not neccessarily). Male speaking voice will still sound male after surgery, just a little higher. Everything else still needs to be done with training.

Think of it as a helpful tool if you have a specific pitch-related problem while speaking with your trained voice. It's not a shortcut for feminine voice. Training is the essential part.

[Dena]

I have used a raised voice all my transitioned life but in updating my image I found I can't hit the range I need for a proper voice. If I could, I would't bother with surgery. What I have learned is the surgery can provide you pitch but your voice will sound flat and machine/male like without knowing how to use it. First men speak in something called a chest voice and women use a mouth voices. You need to learn how to do this no matter which path you take. Next comes inflection, adding breath to the voice, a higher delivery rate and cleaning up your language/male habits. If you do this work before surgery, you may not need surgery. What you learn before surgery will allow you to use the post surgical voice much faster. If somebody thinks all they need is the surgery, they will be in for a nasty surprise unless their voice is very feminine before the surgery.

[leacobb]

I have always thought about having this done because i have always struggled with my voice.. and i did go to the hospital to enquire about it. But they did tell me that there was a massive risk.. and the risk is not speaking again because they could damage the vocal cords..  but i did enquire about this 5 years ago and i dont know how much things have improved since...

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[Dena]

One doctor has a poor track record but Dr Kim and Dr Haben have a good track record. Of the two, I am going to use Haben because he is much more open about his procedure and has a much faster recovery period. Haven has been doing the surgery for 10 years but I don't know how long Dr Kim has been doing it.

[Riven]

I've been looking up results of vocal surgery and some of them are nothing short of incredible. I'm doing it whether I need it or not.

[Rejennyrated]

I've been looking up results of vocal surgery and some of them are nothing short of incredible. I'm doing it whether I need it or not.

Speaking as someone who is currently training for medicine can I just sound a small note of caution. I'm going to play devils advocate because I think its very important not to get carried away.

The old adage that if it isnt broken you shouldnt fix it is just as applicable to medicine as to anything else...

Your enthusiasm and trust in the medical profession is commendable but I would advise that you weigh carefully the risks and rewards and bear in mind that the people who post on the internet may be the extreme results. I personally know three women who had this surgery and actually ended up pretty unchanged - and in one case, to my ears actually slightly worse sounding, although of course I would never tell her that to her face because I wouldnt want to upset her. Unfortunately for her two or three years later I honestly think she ended up sounding like an effeminate man with laryngitis, which is a real shame.

Now I'm not saying you shouldn't explore this option, but I am suugesting that it is always a good idea to carefully weigh the risks and reward in your own individual case. If your voice is a major problem to you then go for it, if not then be careful because it would be a shame to go through that sort of major surgery only to be disappointed.

[iKate]

Voice surgery isn't magic. I was operated on my Dr Kim last week and it was explained to me that the whole thing is a process. You still need to train your voice and they are emphasizing the training as part of the total voice rehab for voice feminization.

The surgery will help with pitch but resonance and prosody tends to keep even a high pitched voice male.

That said I chose it because I see that there could be a good benefit. It will help me pass with less effort, voice wise. However that doesn't mean NO effort. The recovery is a whole year long almost and you have to get botox and take clonazepam.

[Dena]

I don't recommend voice surgery unless you need it. Both a surgical voice and therapy voice use the mouth voice all the time and a male doesn't do that by default. If a therapy voice works, there is no need for the surgery. In my case, I was cursed with an extremely low male voice and even with my attempt to bring it up, I don't have a usable voice in the feminine range. I didn't know it but everybody around me was very nice and didn't tell me about my voice. It took a sweet but loud mouth neighbor and 5 calls to a product support number to drive the point home. Modern tools and information allowed me to explore my voice and discover the problem. In the future I want to go somewhat stealth and I can't have my voice outing me overtime I open my mouth.

If you listened to all of the voice samples, some sounded like a male talking with a very high voice. We made suggestions to correct the issue and the speaker took our suggestions producing a feminine voice. 50% of the voice is the surgery and 50% is the work you put into the voice eliminating male pattern and adopting female patterns.

With the surgery I will have, my chest voice (what men use) will be in the range of the falsetto I am currently using so without training, I would still sound Gender Ambiguous at best which would be rewarded with a Sir. Strange as it may sound, I don't mind still having this range because I would like to play with singing the lower range might be useful. Years of using the mouth voice have the process locked in so it's simple for me to take advantage of what the surgery offers. Will I be able to properly use the new voice at first, no. You have to learn how to talk all over again meaning you sound pretty bad for at least a couple of months.

Go to therapy and find the limits of your current voice. Should you have issues like many of us have, consider surgery carefully. On the other hand, there are some really good therapy voices on the internet and I hope you are blessed with one of them.

I had a very good teacher in speech therapy years ago and with what I learned on the internet, I can answer most any questions you might have about voices. My desire would be to keep you away from surgery but should I find you have a problem like mine. I would recommend surgery. Feel free to ask for my help.

[RosaDaniella]

I've talked with my doctors and psychologist about this and they /highly/ suggested me /not/ to consider vocal surgery, the vocal chord is still a very new thing to have surgery on and is an extremely delicate instrument.

She even told me about multiple girls who went and ended up with a lower voice than before or complete loss of speech, needless to say, surgery should be a last resort something of the vocal speech training isn't working.

[Dena]

I've talked with my doctors and psychologist about this and they /highly/ suggested me /not/ to consider vocal surgery, the vocal chord is still a very new thing to have surgery on and is an extremely delicate instrument.

From what I have dug up the surgery has been done for 20 years and Haben has been doing it for 10 years.

She even told me about multiple girls who went and ended up with a lower voice than before or complete loss of speech, needless to say, surgery should be a last resort something of the vocal speech training isn't working.

There is a doctor I would not trust doing voice alteration. Some of his work is good but most scares me. His procedure is far more complex that of Dr Kim or Dr Haben. Had that doctor been my only option, I would live with the voice I have now and avoid the risk of surgery.
The same training used in speech training needs to be applied to a surgical voice as well. If you voice works with out surgery, there is no point in getting surgery. My voice is not capable of generating the pitch to push it into the female range so my options are a male voice or surgery.

[kittenpower]

I've talked with my doctors and psychologist about this and they /highly/ suggested me /not/ to consider vocal surgery, the vocal chord is still a very new thing to have surgery on and is an extremely delicate instrument.

She even told me about multiple girls who went and ended up with a lower voice than before or complete loss of speech, needless to say, surgery should be a last resort something of the vocal speech training isn't working.

I think that most trans women are able to achieve a female voice without surgery. And aside from the risks involved with VFS, I've also read that it is not always permanent. 

[Dena]

I think that most trans women are able to achieve a female voice without surgery. And aside from the risks involved with VFS, I've also read that it is not always permanent.

Interesting statment! I did a little looking and I now understand. The process Dr Haben uses is permanent and not reversible. Other doctors don't fuse the unused length of the vocal cords and only tie them together. This allows for reversing the surgery. Should the material holding the cords together fail, the old voice will return. There is much mystery behind Dr kim's procedure so I am not going to judge what will happen with his surgery. In short, if the procedure can be reversed, it may also fail.

[bibilinda]

I've noticed not a lot of trans women go for vocal surgery and instead go for vocal therapy. Why is this? From what I've read the results are very satisfactory and some even call it a complete miracle for passing. Can anybody tell me something about it that I'm not reading or hearing about elsewhere? Thanks.

1st, thanks for starting such an interesting and thought-provoking thread. As usual, an underrated one response-wise because it is less shallow than many others.

2nd, the simplest response to the question is: THE PRICE. Everyone can afford vocal therapy. NOT everyone has about $9K US ready to spend for surgery with Dr. Kim (I have no idea what Dr. Haben's fees are but I guess it must be a similar price for a similar job).

3d, the risk-reward ratio for voice therapy is much better than that of surgery. Basically, voice therapy can frustrate you, but very rarely will you damage your voice permanently, and you definitely will not spend thousands of dollars on something that may or may not work for you.

So, as usual, IT IS THE MONEY what really makes the difference. Those with the money for it, will go for everything if they need to: FFS, VFS, BA, liposculpture, electrolysis all over the body, hair transplants, even extreme surgery like rib removal, and, ultimately, SRS. If you accumulate all that, it can easily add up to $100 to 200K US and I am not exaggerating. If I had the money, I would go for full FFS at the very least, and of course, SRS is mandatory as well. Just my two cents. I know there are some countries, specially in north Europe, Canada and the US to some extent, that would cover part or even all expenses, specially for SRS, but applying and getting approved for it is not as easy as it may sound, and it can lead to a big frustration feeling.

So, for those who CAN pay for it and are aware of the REAL benefits and risks, from sources other than the doctor's web site, You Tube channel or any other self-advertised source (where OBVIOUSLY the examples will always be their best patients, they will NEVER EVER use their botch jobs for advertising their services), I say go for it, you only live once!!!

Cheers

Bibi B.

[Dena]

With airline tickets added in, I am going to lay down about $7,000 US for Dr Haban and I will receive the lower cost package. The more expensive package would be close to what Dr Kim chargers.
Even if you have the surgery you still need therapy before or after the surgery in order to use the voice correctly. I recommend voice therapy before surgery so the surgeon will know where your mouth voice is and then will know how much to raise the pitch.

[Dena]

You are right about the mouth voice thing. To get a female resonance, one has to switch the resonance from chest or throat, to the face mask.

But that's only one of two main things, the other one, a super-important one at it, is the size of the throat. I can speak with face resonance easily. But so far I haven't discovered how others have been successful at reducing the size of their throat through their neck muscles to decrease or even totally eliminate the male resonance (male overtones) that are logically produced by a larger throat size.

In October last year, my BF got for me the Kathe Perez voice feminisation three-mp3 method. The most crucial one is the 2nd, the one about resonance.

Now, in her advertising web page and tons of other ones on the web that lead to that one, Kathe Perez claims this, for the 2nd mp3:

Fundamentals of Your Feminine Voice II:
Feminine Resonance

We'll teach you:

A simple "throat size adjustment" technique that gives you perfect feminine resonance.

I have listened to the 2nd mp3 over and over and over, and I still haven't found any explanation of such advertised technique. Bottom line, I have no idea whatsoever on how to narrow my throat size to a female-like size, to get rid of the unwanted male overtones.

So, Dena, did you ever learn that during your voice therapy years? If so, please do tell!!! I would be very interested in hearing about it!

Cheers

Bibi B.

The only thing I can think of is false advertising. There is only one thing we have control over to do that and that is the mouth voice where we tighten the muscles above the larynx to somewhat reduce the size of the cavity. In the mouth you have a bit of control with tongue placement but for the most part we are pretty well stuck with what we have. There is a surgeon who rebuilds the larynx and that would accomplish changing the resonance but his results are pretty hit and miss. On the other hand, Karen Carpenter sings with the Chest Voice and base notes still sound pretty good.

Now I found a web page that give a pretty good example of what's behind therapy and I have it book marked for reference http://www.nyspeechandvoicelab.net/transgender/voice-feminization/

On the other hand, with the right voice, therapy can produce amazing results as seen in  this video

I think the voice in the video was using the Falsetto range and in my voice that give me between 30 and 40 hz improvement in pitch which still isn't enough to move me into the feminine range. I would sure like to find some magic solution to this problem but I don't think it exist.

[Dena]

For the most part i can judge my voice because I have learned to ignore the things that get on my nerves but you should really have others evaluate your voice and accept their judgement. The problem is we hear our voice through our skull and that sound good. When we record our voice, all the speech patterns are there but they sound wrong.

You say the pitch is right. Do you know what your pitch is?

As for best students, I am sure that is the case and I would fail here course because the top range of my Falsetto is 230 Hz. To be able to use it I have to stay around 170hz  which is pretty low. As I move up in pitch, I lose inflection and my voice goes flat.

In the surgery section, we record voices and pass them around for review. That is an option if you want other opinions.

[Katiepie]

I had decided to do a small recording of my voice this morning, and oh my god.. when I heard it, I couldn't stand it at all. It's deep, and nasal sounding, and slightly muffled due to a salivary gland overproduction of saliva.
Though for the majority of my life over the phone I've hardly ever got sir'd, only other than friends and family know me, but with Bill collectors (even when using my biological name, and all that junk) would always ma'am me at the end of the conversation, solicitors would always ma'am me, even the credit unions and banks that I would call to get information on my account, would do the same.
Got to the point to where it frustrated me, and I would correct them, or yell at them cause it got annoying... but I guess the tables have turned.

I suppose if I can get past despising my voice, and keep recording and training it based on how I talk on the phone, I may be ahead of the curve for training.

Kate <3

[Dena]

OK this is the 1st time I've shared my voice on here. I just recorded this.
http://vocaroo.com/i/s00WjbcosZ1n

I am not trying to do my "best trained voice", I am just reading something randomly, the way I speak in public, which is a bit monotone but I am sure it is in the female range. Problem is, I have undesired overtones I just can't get rid of. According to Pratt, the average pitch is 207 Hz, that is, a G#3, which proves that it is in the correct range. Of course I can speak higher than that but I would sound even more fake. Pitch is no problem for me really, since my break notes into falsetto are around F#4, G4 and G#4, so it is there where my voice really gets weird.

I have to get used to the fact we have people here from all over the world and the accent caused me to replay the voice several times. The voice isn't bad and mine may end up lower after surgery but there are two things I can hear. The mono tone prevents you from mixing the higher notes in that will give a clear female ring to the voice and the voice is hard because there is no breath in it. To add breath, just allow a little more air to pass through the vocal cords when speaking. As this can make you voice overly sexy, strike a balance between softness and over sexy. You are correct in not pushing for a higher pitch. If you are a larger woman, the pitch you have would work well with you body size. We have a GG that rents from us and her voice is lower with more bass than yours.
Now if you are angry with somebody and you want to make your point stick, drop the breath and use the voice like it currently is.
This is more or less the same issue with the surgical voice in that the pitch is high enough but breath and inflection are need to really set the voice off. 

[bibilinda]

I've learned my lesson: Don't upload audio files and then share them with everybody.

I accept that the now-deleted recording of my voice was a half-hearted-at-best effort. But it was genuine, because I speak like that in public, to sound real as opposed to fake. I make no effort to speak like that, and I can do it for hours and hours, not just a few minutes. Yet, that seemingly very-poor voice in your opinion, is good enough for me to pass voice wise, at least in person. On the phone, I have to do just a bit more effort to pass, but I don't like to force myself.

All people I talk to understand me perfectly well, THE FIRST TIME. Including my BF from UK, who has a beautiful natural English accent. Just an observation.

Criticism is always appreciated though. But I WILL NOT record something forcing myself, like so many people do, as in how I speak when I do voice practice, just to get a good "review" from somebody who is probably an American that maybe speaks only American-accented English (100% of the very harsh criticisms of my accent and voice --oh and my "larger size" now, as well lol-- come from such people) and most probably doesn't have full command of another language. I am a professional translator and I have full command of English and my other language. So yes I have an accent because I speak both languages on a daily basis and sadly I may have a speech impediment for it. But again, no one needs that I repeat myself several times, just to understand me.

Good luck with your surgery.

I have to get used to the fact we have people here from all over the world and the accent caused me to replay the voice several times. The voice isn't bad and mine may end up lower after surgery but there are two things I can hear. The mono tone prevents you from mixing the higher notes in that will give a clear female ring to the voice and the voice is hard because there is no breath in it. To add breath, just allow a little more air to pass through the vocal cords when speaking. As this can make you voice overly sexy, strike a balance between softness and over sexy. You are correct in not pushing for a higher pitch. If you are a larger woman, the pitch you have would work well with you body size. We have a GG that rents from us and her voice is lower with more bass than yours.
Now if you are angry with somebody and you want to make your point stick, drop the breath and use the voice like it currently is.
This is more or less the same issue with the surgical voice in that the pitch is high enough but breath and inflection are need to really set the voice off.