Hi all,
Long-time periodic lurker, first-time poster. I had voice feminization surgery with Dr. Kim at Yeson and figured that was worth finally creating an account over. So consider this my contribution to the Yeson experience reports. Mine has most things in common with many others I've read, but I did run into a unique problem that I haven't seen anyone else write about--my tl;dr if you don't want to read the full report is this: get a blood lab done *before* you depart for Seoul (assuming you don't live near Seoul) and make sure all your levels are healthy. Particularly, confirm that your liver enzyme (AST, ALT) levels are within or close to normal ranges.
My full report:
I'm a trans woman, US citizen and resident, 27 years old, more-or-less out for a little over two years, relatively poor (paid for my surgery primarily with loads of loans/credit, some hard-won savings, and some help from friends). I have been lucky enough to have received maybe 10 or so free voice therapy sessions to help me feminize my voice, beginning in the summer of 2016. These have been hugely helpful, but didn't prove quite enough for me—perhaps with more time they would have, but I didn't want to wait years more to only possibly feel comfortable with my voice. Furthermore, the lessons made a huge improvement to my conscious, trained voice, but only mild-to-moderate improvements to my unconscious, relaxed voice, by my estimation. For multiple reasons (in great part psychosocial reasons), I found it difficult to actually use anywhere near my best voice in my daily life, and it was stressful to have to give my voice so much attention. Furthermore, I knew that even if I gave it more time and discipline, that though it would almost certainly become a lot easier, I was probably bound to slip into a strangely masculine voice here and there—perhaps while laughing or sneezing—and that it would likely be several years if ever before my voice wouldn't threaten my ability to pass and could be produced with ease/without thought. These days, I seem to pass, usually, on visual presentation alone—it's my voice that causes me trouble. Passing is important to me, and I'd like to have the ability even to go stealth if I so decide, and I'd heard such wonderful examples of the Yeson procedure, so as grateful as I have been for my speech therapy, it really became the top priority medical transition procedure for me.
I should also note that my voice therapy has focused mostly on resonance, making it the perfect complement to the VFSRAC, which only alters pitch—so if my voice sounds great when I'm able to speak again, it will still likely be in large part thanks to my lessons. If you have the means to pursue both, I would recommend doing so rather than putting all your eggs in Yeson's basket.
I flew to Seoul March 18, 2017 and had my consultation a couple days later—I believe on the 20th, in South Korean time. The consultation went well, aside from a little trouble with one of the examinations (it took me a while to be able to give them what they needed without gagging), and my conversation with Dr. Kim gave me more admiration for and comfort with the procedure than I'd previously had and a greater confidence that I'd made the right choice.
Most importantly, he corrected a misconception I'd previously had about the surgery; it had been my understanding that Yeson's voice feminization simply raised the "floor" of one's pitch range, so to speak, but didn't increase the "ceiling"—that it simply narrowed one's pitch range and made it impossible to speak in too low of a male range. So, I really believed that I was sacrificing a good chunk of my range and that I would never be able to sing as wide an array of material again (I don't sing professionally, but I do enjoy it as a personal pleasure). I'm very happy to have been wrong about that; Dr. Kim claims that the entire range is shifted upward so that one is able to reach higher pitches, as well. This was great news to me, as was learning that the procedure really is incredible and seems to create folds that are near-identical to natal female vocal folds—not only are they shortened, but they're tightened over a period of a couple months as well (apparently a key difference between Dr. Kim's procedure and Dr. Haben's, who I had also considered—reason for this is permanent rather than temporary suture). According to Dr. Kim, as long as I took care of myself and healed well, there was really no physiological reason I shouldn't be able to sound as good as any cis woman, including in my ability to sing—though he did stress the importance of mentally re-learning my new "instrument", which would take some time. This was awesome to hear, because singing aside, I thought that my voice quality, though passing, would be in some way a bit degraded. I will say that, as great as most of their voices sound, it did almost seem to me in watching YouTube before-and-afters of other Yeson patients, that many of them seemed to have trouble with higher pitches, like their voices would give out just a tad in a way that most cis women's would not, but it is very possible that Dr. Kim is being fully honest, and this is down to their need for continued mental re-training, esp. since almost all of these videos were made less than a year post-surgery. If any prior Yeson patients are reading this who had their surgery a longer while ago would like to offer any insight on this (i.e. did your upper-end and voice quality in general continue to improve after ~5 months? can you sing?), I'd really appreciate it.
Anyhow, Dr. Kim also told me, as I believe he tells most of his patients, that I had pretty significant vocal tremor, so that's something I have to really work to correct when I can speak again, to ensure the best-sounding voice. I have incomplete anterior closure and apparently use something like *15x* the energy to produce my voice that most people do (which kind of makes sense, I have a really loud voice). Working on relaxing that strain will be an important aspect of my recovery.
I'd also like to say that Dr. Kim was very sweet and seemed honest and extremely competent. He left me with a really good impression. He also speaks English, so I was able to communicate with him directly.
So that all went well, but later that evening when I was lying in my hotel bed, I got some really awful news by email; apparently my blood work had come back and liver enzyme levels were unusually high, so I wouldn't be able to have the surgery the next day as planned. Jessie instructed me to return the next morning for another blood test to see if we could go forward another day.
When I showed up the next morning, we needed up picking up a prescription instead, and I was instructed to take a couple pills three times a day and that we'd then do another blood test on Friday to see if I could still have the surgery on Monday if my levels went way down (my flight was scheduled to leave on Tuesday, so even this best-case scenario was stress-inducing). I didn't meet with Dr. Kim again that day, and Jessie was a little thin on details, though she did say the levels might be high just temporarily from going off my hormones. [A bit of an aside: Jessie is a good translator (technically her only job, as far as I know) and nice enough and very beautiful, but I found her a tad cold on the emotional side of things; this week became really anxious for me, and I found myself wishing for a little more sympathy/emotional management—there were several times where I felt she wasn't even listening very closely to me or translating what I'd said, much less consistently predicting what information I might need to hear. I don't mean to rag on her too much or portray her very negatively, but I think it's worth noting that things may have been a little easier for me had she been a bit warmer and more attentive.]
I did however receive the information that even if I wasn't able to receive the surgery that I'd owe about $800 in examination and consultation fees—so certainly have no illusions that this not very much a business first-and-foremost.
The next few days were very anxious for me; I was really worried that I might have wasted several thousand dollars and a whole lot of time for nothing, that I was doomed not to pass, and that I might have some >-bleeped-<ty disease to top it all off (google results for causes of high liver enzyme levels aren't exactly comforting). I became kind of despondent and resigned to the idea that I wouldn't have the surgery, as it seemed unlikely to me that the levels would drop enough in just a few days. I was also a little bit angry with the Yeson people that no one had recommended I have my blood work done right before flying out, as that could have saved me a lot of money and headache.
However, on Friday I was approved to go forward—just barely. We had to pursue a second doctor's opinion/permission (god was that office wait nerve wracking); my ALT levels had fallen by almost half, but they were still over 3x the upper end of the standard range. I had tested negative for Hepatitis, though, and that seemed to help. I smiled for 10 minutes straight after I got the news, and even Jessie couldn't help but mirror the smile on my face a little.
The surgery itself seemed to go well. I was so nervous going into the operating room. Dr. Kim was comforting as I lay on the table, and I pretty quickly passed out. Honestly, I'm not even sure how they administered the GA—there was no mask. I suppose it must have been through my IV, but I just hadn't expected that—and strangely, I still smelled something odd right before I lost consciousness, though.
I woke up maybe a couple hours later, felt very strange at first. Groggy, a little confused and disoriented, poor motor control, a bit unpleasant. Nurse informed me that she would bring me ice cream and water in a couple hours. So I lay there. I think I drifted in and out of sleep somewhat, I don't really remember. I was definitely kind of uncomfortable though and had the worst sore throat ever—killer every time I swallowed (that would last all day but was at least 2/3 gone by the next day and pretty much all gone by the day after that). The ice cream helped a little; it was soothing and nice. Water was kind of hard to drink. Nurse informed me that she'd bring me soup in another couple hours. GA was wearing off, and I was starting to feel more normal—didn't really feel drugged at all by the time soup came. Soup was good and not any more difficult to eat than water was to drink. I asked nurse for my phone (with pen and paper ofc) and put podcasts on, not too loud. Went back and forth between listening and falling asleep (may have grabbed phone after the ice cream actually) and going to the restroom several times for maybe 6 or so hours before I was finally discharged. Worth noting that I only slept a little the night before, so that might be why I was so tired.
I got a brief scope check of the results (which apparently looked good) and the botox injection before leaving that day (botox would apparently normally be about a week later, so it was little less than ideal, but there wasn't any choice since my flight departed next day). Btw, these are both not super fun things (scope up nose and down throat, needle to the throat while fully conscious), but also not quite as bad as they sound and you will make it.
Since the surgery, I've found that it's *really* difficult not to vocalize at all and have not managed it perfectly—though despite all the warnings, I'm not too fearful that I've screwed anything up, as nothing has caused me much pain. Still, I definitely don't mean to trivialize the warnings, and I am really trying as hard as I can. Probably the trickiest thing is that I can't clear my throat normally (for the whole 2 month healing period)—I didn't anticipate that. Instead, they teach you to to do this heavy exhale thing, which isn't nearly as effective, so it's kind of a pain and also draws a little attention. Second hardest thing is probably not being able to laugh normally. So, that's something worth noting before you go into this—it's not just talking you have to abstain from, it's *any* vocalization. So that includes little exclamations while watching movies, that includes groaning while stretching (or while anything), that includes sighing, that includes vocalized yawns and sneezes and coughs, that includes humming, etc. It's difficult to remind yourself not to say "ow" when you stub your toe, or make some sound of disapproval when you see something outrageous on the internet, or to begin to respond when your name is called. I'm not trying to scare you too badly, but just get you to understand that you vocalize more than you think, and it's so second nature that it's easy to forget occasionally. I'm about 5 days post-op now, and I've probably had very small vocal coughs about 4 or 5 times now, 4-6 half-whispers (nothing rly comes out—combination of part of my brain remembering and going ultra-soft and something physiological about my vocal folds right now, I think—still bad, I believe, and in fact whispers are supposed to be worse than normal vocalization), a little bit in the way of super-brief incorrect throat-clearing, and I'm a little worried that I've over-strained myself with too much "breath-laughing" (I don't think I've accidentally vocalized doing so yet, but I've come really close, and I wonder if it's still a bit harmful to the surgery site to do these rapid, choppy inhale/exhales). Not ideal, but I'm hoping for the best. As I'm basically trying my hardest, I figure it's likely that most patients fall a bit short of perfect in similar ways.
Aaaand I think that's about all I have to report for now. I know I really went very long—hope it wasn't *way* too thorough. I'll try to remember to post results when I'm able to speak again.
