Susan's Place Transgender Resources

Hello everyone!

So I am in the process of pursuing vocal feminization surgery, but I am feeling a little lost and frustrated with the process.

I went to Dr. Mark Courey in NYC (which my insurance conveniently covers), and he said I needed the obligatory 3 sessions of Vocal Coaching/Therapy, which I welcomed. After I did those sessions, I saw him again, and he seemed frustrated with me, and I was a little confused.

During my first session with him, he told me he didn't think I needed surgery, which, to some degree, I could understand; my voice isn't the deepest in the world. It's in the androgynous zone, I would say, with some giveaway that I was AMAB. I don't get misgendered much in person, but I think that's because my appearance helps signal my gender more clearly. On the phone/mic, however, I have been misgendered a good amount. I was an avid DND and Video gamer, and whenever I went on voice, I would get misgendered a lot (playing video games, I would often be called slurs, so much fun) and all that has led me to avoid wanting to play with others. I've also had a bad experience with my ex, telling me the reason he didn't want me to meet his family was that my voice clocked me.

Needless to say, I have a complicated relationship with my voice, and I thought this surgery would help alleviate some of that pain.

During my second session, seeing the doctor, he seemed annoyed with me. He said something along the lines of "pitch before tone" or maybe it was the reverse, or maybe it wasn't tone but another word. To be honest, I am still kind of confused by all the lingo, as I've never really been introduced to it before this experience. The voice therapist said I had vocal fry, which contributed to my issues, but that's something I worked on with her as much as I could.

He asked to touch my throat, and he pushed really hard on either side of it with his fingers, I think, commenting that it felt tight and that I needed to learn to loosen it.

Dr. Courey felt that even with the surgery, my results wouldn't be great because I haven't made enough progress with the vocal training. I think his basic point was that the vocal therapy is more important than the actual surgery, and the surgery won't give me improvement if I don't work on my vocal fry or something along those lines, perhaps? He also said that it will be easier to achieve my goals with the voice I have now instead of getting an entirely new voice and having to train it from that point.

But I did everything the voice therapist told me to do, and I did the practices between sessions. One of the reasons why I wanted to get the surgery was because I don't always want to have to put effort into how I talk; I just want to talk and feel natural, but he made it seem like that's exactly what I have to do to change my voice, even with surgery.

The part that confuses me is that I've seen so many before-and-afters of trans women, and their results sound great. I get that voice training therapy is a part of that, but to me it doesn't seem to me as if I get the surgery, I won't get a good result from it at all. I guess I just want feedback and advice from those who have been through it.

Another thing I should mention is that he brought up a patient he gave the surgery, and they were not pleased with the results. He referred to her as an 'older big lady,' and that someone like that can only expect results to be so good. He also implied it was her fault for not having good results because she didn't take the vocal coaching seriously, so I felt like a lot of his frustration came from his experience with those types of patients (which I felt he was worried I was going to be one of).

Any insight, advice, or suggestions would be deeply appreciated. My voice has been a major struggle for me and something I feel has really held me back and caused me to miss out in a lot of situations and I want to do everything I can do to work on improving it.

Persephone

My understanding is that vocal surgery is mainly about increasing the pitch of your voice. If you have a broad range and can hit higher pitches and sustain them naturally then vocal surgery will probably have limited benefit but a number of potential risks or downsides.

I have been looking into starting voice training but by all accounts the process can take from 6 months to a year or more. 3 sessions doesn't seem like a long enough time to explore your ability. A feminine voice is much more to do with resonance, intonation and language, even mannerisms come into play. There are many women who have deeper voices but who you never think are male. I would give the training at least a year before resorting to surgery which may have limited benefit. For a fraction of the cost of vocal surgery you could have a well respected vocal therapist coaching you though it.

My top range with eee and tee vowel sounds hit 230 - 240 sustained so I think that is more than sufficient to work with but anything around 200 is also fine. Plus you can train your voice to hit those levels too if you cannot do it now. Download the free Voice Tools app for your phone and measure your pitch with those sounds if you are 200 plus, my opinion is don't bother with the surgery.

I'm no expert mind!

Hope that helps in some way.

Sarah xx

I find the whole thing totally confusing to be honest. I'm trying to feminise my voice myself and can get way up in pitch, but that doesn't really help much as voice weight and resonance are allegedly more important. The worst thing I find is that I've no clue as to if I'm doing ok or not so might just give up for now. Surgery helps although not a replacement for therapy as far as I've researched. I think you need both. The problem with surgery is the time out after where you basically cant talk and must rest your voice.

I agree with your doctor.

A feminine voice is much more than your pitch of your voice!

Traditionally women have not been able to speak their mind, being in positions of less power.
It was important for them to say what they were supposed to say, while being able to clearly indicate what they really felt at the same time!

This is typically done using longer sentences and modulating your voice to give your speech added meaning.

If I take the time to do that, properly modulating my voice and using appropriate mannerisms, I clearly come off as female.  I've asked for the rest room location at Walmart Customer Service and been directed to the ladies room.

Sorry, but there is no quick and easy surgical procedure to do that.  But, I had professional speech therapy  that made my voice quite feminine.  I had the pitch correct before, as well as good enunciation, but the modulaton and inflection I can impart to my speech make a big difference.
                                                                                                                                                                                                                                 
Marion

I have not had vocal surgery, but I volunteered as a community mentor for a transgender speech therapy class for three years. Resonance, pitch, and modulation are just a few of the factors to consider. Most of the clients who went through the class didn't have noticeable results until they had attended at least six to eight sessions. Voice training can result in dramatic changes, but it takes time, patience, and dedication.

Voice training may not work for everyone, but voice surgery is not to be taken lightly. While some people have beautiful outcomes, it is also possible that surgery results in a less pleasing voice. Voice surgery is not a magic bullet, it won't change a tenor into a soprano overnight. For most people, voice surgery should be a last resort, only used when training does not produce acceptable results.

Please, do not rush into this. Take some time to research the different surgeries available, their range of outcomes, and their success vs failure rates. Make an informed decision.

Love always -- Jessica Rose

Prostrate surgery became much less dangerous in the mid 2000s with the adoption of the da Vinci surgical system.  Lives were ruined as men who needed diapers had their social lives wrecked. 

Nowadays, it is common to watch monitor prostrate cancer in older men instead of operating, as the cancer is slow growing.  The advances in surgery have not made it a "safe option."

I went through a little more than six months of voice therapy through the VA. I learned a lot, but was unable to finish the course because the politicians canceled the service.

My voice was never very deep, but over 14 years in the Army, I learned how to bark orders. That became my normal way of speaking. When I started voice therapy, I had to unlearn those habits and focus on speaking differently.

When speaking to a group or shouting, the sound comes from your chest. Women speak from their mouths. You can raise the pitch of your voice, but without correcting for forward resonance, you could end up sounding like a cartoon character. Regardless of pitch, speaking from your mouth rather than your chest softens the voice's texture, making it sound more feminine.

There are plenty of women with deeper voices. It is the sound of their voice (softness) that makes it unmistakably feminine. I agree with the others that you should look into therapy sessions and work on better controlling your voice first.

I believe that is what the surgeon is looking for as well. The surgery will tighten things up to change the sound, but you will still need to develop the muscles that control the voice to make it a success. I think the surgeon understands this and does not want you to be so disappointed that you give up and feel it was a failure.

The more you practice, the more it will become second nature. TransVoiceLessons on YouTube has some good explanations and exercises, but it is more helpful to have a coach who can hear what you are doing and understands what needs to be corrected.

Hang in there.

I think Awkwafina has a feminine voice, despite being low and raspy.
What do you think?
https://youtu.be/xEGfcZhoSdY

I read the original post again.

A key concept is feminine intonation.  The only way to get that is to put in the work and practice.
This is an important concept with learning to play golf.  It takes a lot of practice to hit that little white ball!
Unless you are a gifted athlete who spent a ton of time learning a similar skill, like hitting a hockey puck.

I think the hardest thing is its easy to keep practicing and feel like you're making progress, but its very difficult to know if you actually are. Its almost impossible to hear your own voice and know if it sounds right in my experience. The worry is pushing in one direction only to realise thats completely wrong and are developing a bad habit. Apps help demonstrate what to do and can measure frequency, but cant tell you if its sounding right so to speak.

I was doing telephone customer service at work so I got a lot of feedback.
Now I go to the golf course and interact one on one with an obvious female presentation.

I recently helped a guy with the mental side of his golfing game
He considers me female.  Last time we played he complemented me on helping him play his best round ever!

Oh my goodness, I didn't think I would get so many responses! I want to thank everyone who did respond. I don't get online as often, so I'm still reading through them all, and I deeply appreciate the advice and resources!

I have no issue with doing more vocal training before surgery, but I live in Staten Island, so getting to the Upper East Side every few weeks has been hard, and right now it's the only option I have that's covered by insurance. I wish they did remote sessions!

Anyway, thanks again so much!

Training is best done in short frequent sessions.  A couple 15 minute practice sessions is better than one longer one per day.  If you only practice once per week it is unlikely  you will put in enough repetitions to re-train your brain.  As a stroke survivor I've had to fix a lot of stuff with physical and occupational therapy.

The most girly skill I learned in school was learning to touch type.  That class was mostly girls.
It was a huge advantage when I took computer science classes as I could effortlessly type while thinking of something else!

Quote from: Aether Princess on June 05, 2026, 04:06:40 AMOh my goodness, I didn't think I would get so many responses! I want to thank everyone who did respond. I don't get online as often, so I'm still reading through them all, and I deeply appreciate the advice and resources!

I have no issue with doing more vocal training before surgery, but I live in Staten Island, so getting to the Upper East Side every few weeks has been hard, and right now it's the only option I have that's covered by insurance. I wish they did remote sessions!

Anyway, thanks again so much!

I don't know what I'm learn voice lessons cost,  but you download a recorded training series for under $200