VFSRAC (VFS) with Dr. Kim at Yeson Voice Center

[Vanessa Lopes]

Hi Kendra,

Congratulations for your VFS!

Could you please answer me some questions?

I did my VFS at Yeson on June 1, I'm starting the third month. I had some pitch increase and my vocal extension is increasing with the exercises, but the female voice perception is not increasing, people are still calling me sir. My problem, I think, is still the resonance.

How was your resonance progress in these 6 months?
Are the Yeson's exercises helping with this?

Unfortunately it is difficult to find a speech therapist who knows about the voice feminization here in Brazil. I'm trying to improve only with Yeson's exercises and with some resonance lessons that I bought from Kathe Perez on my cell phone.

Thank you!

[Kendra]

Hi Vanessa, I'm happy with my VFS so far but this is a long-haul process.  Before having this procedure I had friends expect I'd step off the plane from Korea with a completely new voice.  VFS potentially solves only one of several things that form the voice, and even that change (pitch) requires months and potentially a year to physically develop.  And then there's the brain.  Right now I'm finding my brain is holding me back... if I hear my voice crack or get hoarse that's usually because I was trying to speak at what is now too low of a pitch. 

Proof of this is when I sneeze or cough I now sound female.  But I have usually been misgendered when talking on the phone where there are no visual cues.   

I think voice exercises serve two purposes: physical (exercise) and mental (gain the correct habits).  Physical healing is measured in months, but mental changes require re-training things we developed over many years and decades.  Before starting all this I didn't realize how much gender identity in voice is similar to learning a new language. 

I pay very close attention to the way some people speak - especially professional radio announcers.  People I hear as male generally end every phrase with the same pitch and volume they were using.  People I perceive as female trail-off the end of phrases... their pitch drifts up as if it's almost a question and less of an assertion, and volume of phrases trail off without a sharp ending.  The nice part (helps build your confidence) is if you start speaking and realize you forgot to apply anything, you can still "rescue" the phrase by adding that upward-drift to the end. 

Listen to a radio station for a language you don't know and you'll immediately be able to pick out which announcers are male and which are female.  The useful part of this is with a language you don't understand, it's even easier to hear how phrases are formed for each gender without the distraction of processing what it is they are actually saying. 

VFS (if successful) helps MtF transition by enabling a higher average pitch.  I'm able to speak comfortably in a range that strained my voice before, but this isn't about averages - the goal is to form each phrase differently than before.  Requires practice and I still have a lot of work to do.

[SassyCassie]

You're absolutely right, Kendra! Pitch is only one component to the female voice. Unfortunately, thanks to nearly a century-old technology still in use, the phone kindly filters out all of that, laying bare the remnants of our male voices for all the world to hear.

I've tried to adjust my speech pattern when speaking on the phone to incorporate a more feminine variance in tone - mostly learned from observation. The resonance I can damp down to a degree but I find myself unconsciously straining those muscles when either on the phone or speaking to someone I don't really know that well. Of course, that turns my voice into a complete trainwreck but sometimes, just sometimes I can find that perfect blend of resonance and variance in pitch, and I get properly gendered over the phone.

It takes work! I don't mean that it takes practice, it still takes concentration. If I'm tired, I find myself lapsing into the old, flat, monotonous male speech patterns, albeit with a somewhat female-sounding voice.

I had a notion earlier in the week that I've been working the muscles in my throat so much in the last 18 months that I could probably crack walnuts with them at this point!

Get your beauty rest and keep at it! The only way we can get over these hurdles is to keep charging at them until they're finally behind us!

[Kendra]

I hit a goal today when my father spontaneously commented my voice sounds different. 

I had asked a few people in person and they told me my voice is better than before, but I haven't really counted that as it may be a mixture of politeness.  And a catch-22: if I am thinking about my voice when I ask that question, my speech patterns may be different than when I'm not thinking about it.

This is the first time I wasn't thinking about my voice and received a positive comment.  It's been 9 months since VFS.  Others have said recovery takes at least a half year and may require more than a year. 

I re-started vocal training a couple months ago with a new speech therapist and the results have been far better than before.  I think it's a combination of being post-VFS and finding a speech therapist I can understand.  The previous local therapist is a well-regarded scientist (has published books in speech pathology) but went way over my brain in comprehension... I found techniques the previous therapist required were baffling.  I won't go into all that here, but an analogy would be trying to parallel park your car while adjusting the spark advance and memorizing the serial number backwards before you are allowed to put your car in reverse.  My new speech therapist uses terms I can understand and treats me as just another human.  If anyone is local to the Seattle area and wants to know more about that, send me a PM.

The main breakthrough with the new speech therapist is she immediately identified I had been literally squeezing my voice with my neck and shoulder muscles... which sounded bad and caused me to tense up even more.  Relax.  She has shown me to start off with sounds and then turn that into speech.  Once I get that, do the same while looking to the left and to the right... if the sound changes too much I'm letting my neck muscles get in the way.  Good posture is essential since this musical instrument (the voice) is powered by air.  Now I have a reason to be an airhead. 

And another breakthrough.  Earlier this month for the first time, I was gendered correctly on the phone in a random setting (a phone call with someone I don't know).  In person I have never been misgendered in the past half year post-FFS but the phone is a different animal... without any visual cues it's just voice and that's where I have learned to expect failure every time.  Since that first successful call a few weeks ago I've been gendered correctly during several calls with people who don't know me.  I'm not anywhere near 100% but I can see where this is going, and with more work I think I'll finally be able to get my voice to catch up with everything else.

[Rachel]

Hi Kendra,

That is awesome news. I am very happy for you.

I am wondering if you get the same number of words per breath now as you did pre-VFS? I have notice for myself I use more air and start my air flow prior to or just at the first word in a sentence.

Thanks,
Rachel

[Donica]

Congratulations on your correct gendering on the phone Kendra! I sounds like your new voice therapist uses some of the same techniques as my voice therapist. It is Important to relax all the throat, neck and shoulder muscles. Before beginning any sound and speech exercises, she has me massage my neck and shoulder muscles and roll my head around to help relieve any tension. It's part of her vocal hygiene regimen, along with lots of water, less coffee and stop clearing my throat all the time. UGH!!!

One thing, I'm not sure what she means when she tells me to keep my voice more forward? Her explanation is making the sound come from the face and not from down in the chest. Also keeping the sinuses open during speech. What ever she is talking about, I must be doing it right.

My pitch average is around 217hz and pitch range and there proper use is good but I don't like my tone quality. She says it's not bad but I still hear him. We're working on that but I'm thinking a may still need VFS?

Anyway, I'm glad your back in therapy. I would love to hear your before and after voice. I know this is going to take a lot more work for me.

[Kendra]

Hi Rachel,
I wasn't aware of and didn't measure words per breath before VFS but I have a wider range of volume than before and my voice doesn't get tired as quickly.  I think that's due to a couple factors - the surgery may have corrected slightly asymmetric vocal chords as shown in videos taken during before/after exam in Seoul.  And from a bit of professional post-op voice training which is helping. 

Hi Donica,
With a 217 Hz average pitch you probably don't need VFS.  I think tone quality comes from many other factors, some of which are almost reflexive and involve training over time.  I also don't like my tone quality but I am finding it is improving gradually.  I'll record some before/after when I am happy with my voice, probably a few months from now when I hit the one year mark.

[jill610]

Hi Kendra,

Very happy for your success with this and of course another super helpful post. I have been waffling on this but after a year of weekly voice session I still am frustrated at the effort to keep the pitch part, the other bits seem to come naturally. I talk for a living basically and find my vocal cords get tired about halfway through the day where they did not when I spoke at my natural pitch.

Good luck and I can't wait to hear the before and after.

[Linde]

My pitch average is around 217hz and pitch range and there proper use is good but I don't like my tone quality. She says it's not bad but I still hear him. We're working on that but I'm thinking a may still need VFS?

Hi Donica, when you pitch average is 217 Hz, is that with your natural voice, or do you have to "work" to be at that average.  Could you talk like this just at any given time of the day, or do you have to 'switch' to that frequency?

As you can see from my avatar picture, I do not have any visible Adam Apple, which indicates that my voice box is similar in sie to that of a cis female.  My natural voice frequency seems to also indicate this.  I can talk all day long with an average frequency between 200 and 220 Hz, but like you, I do no really like the sound of my voice/its tone quality.
Would a language/speech therapist help with that, too, and what is with the male speech pattern?

For all my life I have tried to sound like a tough man, and now I have to unlearn all of this, and sound like a sweet old lady!

Would you please be so kind and enlighten me a little?
Thanks, and happy holidays!
Linde

[Donica]

Hi Donica, when you pitch average is 217 Hz, is that with your natural voice, or do you have to "work" to be at that average.  Could you talk like this just at any given time of the day, or do you have to 'switch' to that frequency?

As you can see from my avatar picture, I do not have any visible Adam Apple, which indicates that my voice box is similar in sie to that of a cis female.  My natural voice frequency seems to also indicate this.  I can talk all day long with an average frequency between 200 and 220 Hz, but like you, I do no really like the sound of my voice/its tone quality.
Would a language/speech therapist help with that, too, and what is with the male speech pattern?

For all my life I have tried to sound like a tough man, and now I have to unlearn all of this, and sound like a sweet old lady!

Would you please be so kind and enlighten me a little?
Thanks, and happy holidays!
Linde

Dear Dietlind! Yes, it is my natural voice now. It varies up and down occasionally but never below the high 190hz anymore. In fact, it feels wierd and forced to try to talk in a lower pitch. Currently my full range is between 184hz to as high as 319hz on occasion but most of the time, in normal conversation, the high end is more like 270 to 285hz.

Yes, most definitely I recommend finding a good voice/speech therapist. As Kendra mentioned above, not all therapist are the same. A good therapist will be able to help you reach a feminine pitch and proper speech pattern and help you to develop the tone quality. There are does and don'ts that your therapist will help you with.

Like anything else, it takes time to develop a natural feminine voice. I have been practicing YouTube videos for years and only just recently started therapy with a qualified therapist. Things are moving along much faster now. Also, the better you recording and play back device, the better.

[Linde]

Dear Dietlind! Yes, it is my natural voice now. It varies up and down occasionally but never below the high 190hz anymore. In fact, it feels wierd and forced to try to talk in a lower pitch. Currently my full range is between 184hz to as high as 319hz on occasion but most of the time, in normal conversation, the high end is more like 270 to 285hz.

Yes, most definitely I recommend finding a good voice/speech therapist. As Kendra mentioned above, not all therapist are the same. A good therapist will be able to help you reach a feminine pitch and proper speech pattern and help you to develop the tone quality. There are does and don'ts that your therapist will help you with.

Like anything else, it takes time to develop a natural feminine voice. I have been practicing YouTube videos for years and only just recently started therapy with a qualified therapist. Things are moving along much faster now. Also, the better you recording and play back device, the better.

Thanks, I better make this as anew years resolution.  Luckily, my natural voice is that high (low female range, like typical for many older women), and I never had a real low voice.  I had to stress my voice box to talk low.  I think the pitch is o problem with me, just the pattern and the way I use my voice!

Merry Christmas
Linde

[Donica]

Thanks, I better make this as anew years resolution.  Luckily, my natural voice is that high (low female range, like typical for many older women), and I never had a real low voice.  I had to stress my voice box to talk low.  I think the pitch is o problem with me, just the pattern and the way I use my voice!

Merry Christmas
Linde

I agree Dietlind. I believe the pitch range average is the least think to worry about. You may remember Dorothy from the sitcom The Golden Girls? Her pitch range average was probably more in the androgynous range at best. Still you could close your eyes and know you were listening to a cis female.

More importantly are subtle things like proper use of pitch veriation (intonation), annunciation, resonance, how well your words flow together in a sentance. Choise of words. A wider use of vocabulary, just to name a few.

It is an instrument. And like any instrument it just takes time to develop. Also like any instrument, You need a instructor/therapist to get the best out of it and to avoid any bad hapits.

[Linde]

. Choise of words. A wider use of vocabulary, just to name a few.

I think not even that should be my problem, because I learned most of my English (after the school English from Germany) from my wife, and she was a linguist and university language professor.

But with me, it is how I use the sounds that come out of my mouth.  I trained myself for many years to sound manly (because I was told that I was a man, and very likely overcompensated to make sure that nobody would have any doubt about this), and now I have real difficulties to unlearn this pattern to sound like a female. 
With other words, I have the instrument, but I have no idea how to play it! 
My therapist feels, I could become a Marlene Dietrich impersonator, because my voice is very similar to hers, and I still have that very slight German accent like she had!  But she had that female speech pattern, which I do not have, and that sucks!

[Michelle_P]

It's all paying attention to the speech therapist AND ourselves, and practice, practice, PRACTICE!

I'm convinced that the only way our feminine voice becomes our default voice is to practice and use that voice constantly.  As my speech therapist tells me, we know we have arrived when we cuss out the driver that cut us off in our feminine voice!

I've been using nothing but my feminine voice for about 18 months now, and the pitch and tensioning for the voicebox to use my head voice is finally becoming my default.  The intonation and prosody still can be a bit rough when I am distracted.  I am using far fewer contractions in my speech, and am enunciating each word more precisely, all part of the acculturated English feminine speech pattern.

It takes time to undo decades of bad habits!

[Linde]

The intonation and prosody still can be a bit rough when I am distracted.  I am using far fewer contractions in my speech, and am enunciating each word more precisely, all part of the acculturated English feminine speech pattern.

It takes time to undo decades of bad habits!

I kind of can cover this up a little with my German accent, at last I think so.  How much of this I have, I don't know.  It might be OK with me, because I was taught by a female language professional.
Everyone of my female friends tells me my speech is pretty OK and convincing, but I don't know whether it is that they want to hear me the way they think I should sound, or if I am really OK in a female speaking way!
I feel that I do not sound convincing a lot of the time.  Again, it is not my voice pitch, it is the speech pattern that I feel is not that good!

[Lexi Nexi]

What are the chances you will be perinatally mute or have a voice so messed up you can't talk? Is muteness the greatest danger besides say, an infection that kills you (any surgery really)? Could you come out with a really strange voice and they really only have so many tries to fix it before the tissue is all damaged or removed?


What's this cost in total with all the follow ups? I'm guessing air fare to Korea is less then having the surgery done in the states? Wouldn't be nice if we had insurance that actually paid for what it is supposed to? But you know if they covered this every one and their brother would be getting their voice modified to sound like they are on helium or Mr ED and back just for fun.


Sorry if some of my questions are redundant I'm legally blind and my eyes are giving my big problems today and making it hard to read (another 14,000$ procedure that insurance considers "experimental" even though it has been FDA approved for almost 30 years and has restored the eye sight of thousands of people. I have had to raise the money from charity to pay for it, air fare, hotel, food, time off work etc., six times and the foundation is not for profit so they are doing this as cheap as possible. We are the richest country in the world and I have to ask for hand out to get the basic human right of being able to see so that I may work and pay into the system. The tax revenue the country makes vs paying them Social security for their rest of their life pays for the procedure many times over so I don't understand how they can afford to NOT pay for it. That's like quitting your six figure job at work because you can't afford the gas for the hour long car ride to get there. Hey science math and critical thinking are not areas of interest to this countries education system, but good thing guns are legal how else would we shoot ourselves in the foot(feet)?


Is learning how to coach your voice that hard that this is warranted? Or are some peoples voices so deep that no amount of voice coaching would work? I wonder where I lie about 1/3 of the time when calling customer service they call me ma'am before I give my name. I was going to get this as my first surgery after laser hair but everyone tells me to do it last. Not like it matters every time I save the money up for a procedure my eyes go bad and there goes that money. How can people vote against healthcare? They must be the same people that drive around without insurance and just say, I'll just pay extra attention and limit the speeding. Are we a nation of poor risk assessors? 

[Dena]

Moving your voice into the feminine range isn't that difficult unless you have a real low voice (think Johnny Cash). In my case, the best I could do is raise my voice into the mid male range which clearly wasn't high enough to be gendered female. Without surgery, I was 130-140 HZ and I needed to at the very least have a working voice 160HZ or higher. With surgery, I moved to around 220HZ which is a pretty golden feminine pitch.

I always recommend voice therapy before surgery because it's cheap, what you learn will apply after surgery and you know what you require from surgery. If you one of the lucky ones, you will be able to  avoid surgery entirely.

[Lexxi]

Dena,

I know exactly what you're talking about when you mentioned Johnny Cash. I've spent my life being compared to him voicewise, although I think I sound more like Sam Elliott. That's something that really bothers me, because I don't think I'll ever be able to pass as a real woman no matter what steps I take.

In my fantasy riddled mind I've considered learning sign language so a voice change wouldn't be absolutely necessary. But if I did that I would never feel "complete." I then think that some women certainly have deeper voices. Susanne Pleshett immediately comes to mind. So maybe not all hope is lost after all.

[Lexi Nexi]

Dena,

I know exactly what you're talking about when you mentioned Johnny Cash. I've spent my life being compared to him voicewise, although I think I sound more like Sam Elliott. That's something that really bothers me, because I don't think I'll ever be able to pass as a real woman no matter what steps I take.

In my fantasy riddled mind I've considered learning sign language so a voice change wouldn't be absolutely necessary. But if I did that I would never feel "complete." I then think that some women certainly have deeper voices. Susanne Pleshett immediately comes to mind. So maybe not all hope is lost after all.

Can you make your voice like Elizebeth holmes (the fake billionaire theranos, steve jobs wanna be, sure she was a fraud but she changed her voice to that low voice but still sounded like a woman, even though it was lower then most women and lower then mine. Once I heard he talk normal she didn't command the authority so a lower voice is not all that bad as long as its polished and rounded off.


Dena voice surgery got you to 220 from 140 or you had to voice coach to 160 so therapy could get you to 220? I can picture a sine wave in my head but have no idea what a 220 hz voice sounds like. Are there web sites where you can measure your voice somehow? As for voice coaching do you see a SLP that is working on their masters or Phd? I tried working on mine by following youtube videos but my voice just get crackly. Back in my male days if I was excited or in a good mood or doing my sales voice people would make fun of me and say I sounded like a girl. Maybe that's what throws off the reps that call me ma'am when I call customer service so many years of doing a phone voice I just start doing it when ever I pick up the phone. I wonder how many hours or words I spent just spewing BS over the phone?

To me my voice sounds low but when I play it back on a tape recorder (tape...heh I'm dating myself, I mean on the home motion picture machine) my voice sounds higher and I was quite embarrassed and used to try to talk in a barratone voice when I was being recorded. That works great considering people ears are what hears what and not the tape somehow making me sound higher.


I always wondered what makes voices sound higher and lower. Contrapoints on youtube is 6'4" and her male voice isn't that low and her female voice is acceptable. I notice she has no adams apple like myself, but shes also a foot taller. Maybe the adams apple/ hyoid process gives that extra volume? If I had a high pitched voice I would be all set as far as confidence goes, maybe someday. The only time I get comments is sometimes in the morning when Im tired people say "speak up/raise your tone, you sound like a guy".


Dena what does 220 sound like, no I don't know what middle c cut in half sounds like, maybe a celebrity that talks at 220? So are males sub 200hz? Dunno maybe I do have a male voice but I just talk in a fem way. I know I don't have a lisp or gay voice, but I do enunciate and speak out properly. Sometimes a gay voice is all you need to pass as female.

[Lexi Nexi]

Dena,

I know exactly what you're talking about when you mentioned Johnny Cash. I've spent my life being compared to him voicewise, although I think I sound more like Sam Elliott. That's something that really bothers me, because I don't think I'll ever be able to pass as a real woman no matter what steps I take.

In my fantasy riddled mind I've considered learning sign language so a voice change wouldn't be absolutely necessary. But if I did that I would never feel "complete." I then think that some women certainly have deeper voices. Susanne Pleshett immediately comes to mind. So maybe not all hope is lost after all.

Woa 5 20 19 did you just start hrt yesterday? Congrats the next two years are going to be like nothing you think, no matter how many hours you spend on these boards. The first step seems so esy now, but I remember the day I wrote "What do you need to see the doctor for?"
HRT - I wrote in little letters then turned the paper upside down and gave it to the nurse quickly. haha makes me laugh now.