Hi everyone,

I'm considering having voice surgery with Dr. Haben. In my case, I'd only want to do the Glottoplasty. I've been reading posts here about what people's experiences with him have been, and I'm not really clear on what the risks are. Some people have mentioned that their result was less than what they'd originally hoped, or that something went wrong during recovery, or that something was found that made the surgery more difficult, but most of them still seem happy with Dr. Haben. What I'm wondering is: what are the possible negative outcomes? Can you completely and permanently lose the ability to speak? Can you develop hoarseness that never goes away? Can you permanently lose the ability to talk above a certain volume? Are the possible negative outcomes worse than just not getting as high of a pitch as one would like?

I'm also wondering if the percentage of negative outcomes is worse than surgery with Yeson, or if the potential outcomes with Dr. Haben's technique are worse than those with Yeson. So far, I don't think I've read of a single person saying that surgery with Yeson made them permanently hoarse or unable to speak. Surgery with Yeson is currently out of my budget, but I am obviously willing to wait and save up if their surgery carries less risks.

Any help people can offer would be very much appreciated. At this point in my life, having a passable voice might be the difference for me between being safe in public and not being safe in public, but I want to make sure that surgery is a safe thing for me to do. I know that historically, I have been told that it wasn't, but I've been hearing that that has changed.

Quote from: ShadowCharms on October 27, 2015, 06:41:21 PM
Hi everyone,

I'm considering having voice surgery with Dr. Haben. In my case, I'd only want to do the Glottoplasty. I've been reading posts here about what people's experiences with him have been, and I'm not really clear on what the risks are. Some people have mentioned that their result was less than what they'd originally hoped, or that something went wrong during recovery, or that something was found that made the surgery more difficult, but most of them still seem happy with Dr. Haben. What I'm wondering is: what are the possible negative outcomes? Can you completely and permanently lose the ability to speak? Can you develop hoarseness that never goes away? Can you permanently lose the ability to talk above a certain volume? Are the possible negative outcomes worse than just not getting as high of a pitch as one would like?

I'm also wondering if the percentage of negative outcomes is worse than surgery with Yeson, or if the potential outcomes with Dr. Haben's technique are worse than those with Yeson. So far, I don't think I've read of a single person saying that surgery with Yeson made them permanently hoarse or unable to speak. Surgery with Yeson is currently out of my budget, but I am obviously willing to wait and save up if their surgery carries less risks.

Any help people can offer would be very much appreciated. At this point in my life, having a passable voice might be the difference for me between being safe in public and not being safe in public, but I want to make sure that surgery is a safe thing for me to do. I know that historically, I have been told that it wasn't, but I've been hearing that that has changed.

When it comes to the glottoplasty alone with Dr. Haben and Yeson I have yet to read any case where a patient came out with a voice that was hoarse, weird, too high,  unusable, etc.  The main complaints are that they saw little to no change, or not as much change as they had hoped.  Because of the large equipment, there is a slight risk for damage to your teeth.  And I've only heard of one instance where it was serious, but the girl also had a preexisting dental condition that she didn't mention to Dr. Kim.

I don't know that you will be able to find answers in terms of comparing percentages.  Yeson works on a more global level, accepting patients from all over the world and displaying more of their results on YouTube and their Facebook page.  Dr. Haben works primarily on US patients and prefers to keep things more private and lists only a few examples that he deems "average" so as not to set unrealistic expectations.   It's also hard to compare because Dr. Haben often combines his results with a CTA, something that Yeson does not do.

It's impossible to say for sure, but I would say that the odds are very good in both cases, provided you follow the after care instructions.  That being said, we know of two cases where patients of Dr. Haben had their stitches come out prematurely.   One has said that her voice is better than before, but not as good as before the stitch came out.  As for the other, I'm not sure as to the exact condition of her voice at the moment.

Both offices have contact points and would probably be able to answer your questions with greater accuracy than simply using this forum as a general survey.  Hope that helps!

The limits of the surgery at both doctors is about a 80Hz improvement at the most. It is really important you understand your voice and what the doctors offer before making the trip. In my case, I knew all the surgery would do is raise my trained voice. The option didn't exist for me with either doctor to have my chest voice in the feminine range because my male voice was so low. Ask as many questions as you want and we will try to provide the information you need to make a decision. The short answer is both doctors have a pretty good record of improving voices but both surgeries have had issues. To the best of my knowledge, nobody lost their voice as the result of the surgery. I am one of the slower ones still healing at 3 months but it wasn't Dr Haben's fault and I fully expect at 6 months the voice will be ready.

Quote from: kwala on October 27, 2015, 07:36:05 PM
When it comes to the glottoplasty alone with Dr. Haben and Yeson I have yet to read any case where a patient came out with a voice that was hoarse, weird, too high,  unusable, etc.

Well, there is this person:

https://www.susans.org/forums/index.php/topic,189270.msg1684080.html#msg1684080

Anjaq also complained about some hoarseness and other issues.

Training can "fix" those to some degree though.

My opinion is that with the voice surgery you get as much out of it as you put into it.

If you have a deep voice with resonance issues, you'll have resonance issues post op and you'll have to deal with that through training. That said, you won't have to worry about pitch, so you can concentrate more on resonance.

Remember that pitch is only one part of the puzzle.

The actual risks are miniscule. I am post op from Yeson and all I really had was a slight headache, stiffness in my neck and numbness in my tongue. All went away in relatively short order. The only things I can think of is if you have any adverse reaction to anesthesia or antibiotics there may be a problem.

I've been doing voice training now for about 8 months total (although I started over a year ago). I'm able to say short phrases with an average between 195 and 220hz, and my ability to do that seems to be gradually expanding into longer things/actual conversations. I don't personally think I would gender the way I sound as "female" when I record myself doing that, but I like the way I sound at that pitch anyway. It's kind of gender neutral, but it sounds cute, and I think I would be safe in public if I sounded like that all the time. I think the lack of "feminine" gendering is because of other qualities I'm not as good at yet. I'm getting really good at pitch and resonance, but I still talk way too fast and I don't articulate well or have any breathiness.

My voice teachers record me talking without thinking about it at the beginning of each session, and my pitch then is usually an average of around 160hz, but it sometimes goes up on it's own to an average as high as 190 for specific recordings. When I started voice training, my average was between 130hz and 140hz. I'm hoping that my post-surgery voice will have an average pitch of around 205hz when I'm talking with good resonance, but I would be ecstatic if it was higher than that.

I'm noticing that it seems like some people who have had voice surgery are able to use their voice training to raise their pitch a little bit higher than their post-surgery speaking voice. I would be excited if I could do that as well, since I intend on continuing voice training after surgery to work on other qualities and adapt to my new voice.

My main concerns center around anything that could happen which would make my voice worse than it is now, make me draw more attention than I do now, or keep me from being able to live my life. I'm particularly concerned about voice quality, because I find that I like my voice more when my quality is good but my average pitch is at between 180hz and 190hz, than when it's at 220hz with somewhat poor quality. If I could sound the way I do in my trained voice post surgery without trying, that would be good enough. Anything on top of that would be icing on the cake.

If your natural voice was 130 Hz, then it should be possible to put you at 210 Hz. Training would allow you to bump that up a little if you desire it. In my case, I could do 190 Hz before surgery but it was a falsetto and I was pushing it to hit that range. Now my trained voice is comfortable in the 190 to 210 Hz range. Your starting voice is much higher than mine was as my old trained voice was 130 - 140 Hz. Voice surgery might be a good option for you if you want it.

Hi

Quote from: ShadowCharms on October 27, 2015, 06:41:21 PM
What I'm wondering is:
1 what are the possible negative outcomes?
2 Can you completely and permanently lose the ability to speak?
3 Can you develop hoarseness that never goes away?
4 Can you permanently lose the ability to talk above a certain volume?
5 Are the possible negative outcomes worse than just not getting as high of a pitch as one would like?

1 Generally with glottoplasty the possible negative outcomes can be severe, so it is crucial to pick a surgeon that is skilled and experienced.
2 This is in principle possible. I know of one person who lost her ability to speak for over a year after a glottoplasty done, I believe in Germany or Austria. Another person I know of has ripped the suture by accident in the early post op phase and part of the tissue started to grow wildly, threatening the opening of her airways - she had a corrective surgery and has her voice back, but there was some risk that this could have lead to her loosing the voice.
3 There is definitely some risk. this depends highly on the skill and technique of the surgeon. Permanent hoarseness can happen if the "V" shape at the commissure is more U shaped due to bad scar formation or if ther are "air pockets" forming under the newly created suture. I know Dr Kim is aware of both and tries to minimize the issues with both, I cannot comment on other surgeons except the ones in Germany who seem to be rather oblivious of this issue and regularly produce results that have permanent hoarseness.
4 Glottoplasty in my opinion and from what I heard here almost always means you loose a bit of volume. At first you loose a lot but recovery from that loss is IMO rarely 100%. I believe this has partly to do with the reduced airflow during phonation, so its partly a "natural" issue - female voices usually do have less volume than male voices.
5 - see 2-4

Its hard to say if Yeson (Dr Kim) or Dr Haben has less risks because we only see limited cases and negative outcomes are less likely to be reported. I agree however that I heard no really bad outcome of Yeson yet, in one case the suture ripped because of an accident within the early healing period, in a few cases pitch changed too little or people complained about pitch changing but still sounding male - the latter needs to be adressed with therapy though, not surgery. Some people have reported breathiness and hoarseness beyond the initial healing period, but apparently for most, that disappeared within the 12 month period that Dr Kim designates as healing period. Personally, I do experience some breathiness now at month 7-8 but it is better or worse on some days or other days, worse when the pills ended etc - so I hope it will be a temporary issue. I am extremely critical about myself though - most people would not even notice that breathiness much.

QuoteAt this point in my life, having a passable voice might be the difference for me between being safe in public and not being safe in public, but I want to make sure that surgery is a safe thing for me to do. I know that historically, I have been told that it wasn't, but I've been hearing that that has changed.

That sounds like a tough situation - how come?

The basic technique of voice surgery has not changed - there still is glottoplasty and CTA just like 20 years ago, but the details in the technique and the skill of the surgeons who do it has changed - at least with some surgeons...

At this point, if I'm wearing makeup, I seem to pass reasonably well most of the time. (I wouldn't go by my profile picture. I have had a little FFS since then, and for some reason photographs tend to make me look more masculine than I do in real life.) I have lots of experiences where I go somewhere wearing a dress (like out to dinner), and no one stares at me or seems overly interested. Once I talk though, several heads around me turn to stare. The area I live in isn't particularly transphobic, but there have occasionally been hate crimes committed against different types of people. I think that if my voice matched the way I usually look, I would be able to stop worrying as much about getting attacked by someone while living my life.

I'm also quite concerned about whether my voice could keep me from getting hired somewhere if I ever lose my job. I don't think the way I look right now would be a huge problem, but the way I sound might be the thing that would keep me from getting hired.

The scariest thing is when men hit on me (which happens occasionally), and the whole time I'm waiting for them to clock me based on my voice and beat me up. I've had at least one occasion where the guy hitting on me seemed like the kind of guy who would not react well to realizing he was hitting on someone he saw "as a guy", and I was absolutely terrified that he was going to figure me out. I was so scared that I abandoned my dinner and fled to my car before he would have the chance to figure out that I was trans.

For me, being "safe" would mean not being afraid of getting attacked, denied a job, denied housing, or ending up homeless because of the way I look and sound.

Wow that sounds like a scary environment. Hate crimes and violent guys... I think if I was in that situation, I would also do my best to get the voice fixed. For me it was much less threateneing and I still did get surgery - I was just occasionally asked if I was "a guy" (by kids) or if I was "trans" (by grownups) or why my voice was so masculine. A few times people just assumed I was trans, but they were usually kind enough to just behave strangely, sometimes expressed their support but did not hate me for it. But I am in a good environment. Still these things were bad enough and restricting myself enough to get surgery, so I definitely would have done the surgery if in addition to that there would be a real danger.

However - the fear of being found out when dating a guy will probably be harder to get rid of

I got the most clocking and harassment in New York City. These days it's just more plain sexual harassment though. But in my rural small conservative town everyone treats me really nice.

I am just like you in that guys hit on me and I would always try and flee/escape the situation before I got clocked. But I think as trans women we tend to overly worry for our own safety.

In California where I live, it seems men are a lot more open to dating all kinds of women. Society as a whole is becoming less transphobic as well, which is great! During my tinder days, out of about 600-700 matches with young straight guys in my area (aged 18-30), I would say about 50% still continued talking to me after finding out I was transgender. Granted not all of them wanted to date me or hook up with me after finding out---they were probably being courteous and friendly towards me because it is the adult and human thing to do. But about half of those men who I came out to and who continued talking to me still wanted to proceed and meet up with me. So when you look at it, that's 25% of straight men out there who have no problem dating a trans woman!

My voice would give me away a lot of times also, which is why I decided to get VFS. But if you carry yourself with confidence and understanding that there are many open-minded straight men out there, life will be a lot less stressful for you!

Quote from: iKate on October 28, 2015, 04:42:49 PM
I got the most clocking and harassment in New York City. These days it's just more plain sexual harassment though. But in my rural small conservative town everyone treats me really nice.

I've found that it is probably because in liberal places like NYC, people are used to mixing with diverse and different types of groups. Most people would have probably met a trans person before, so a lot of them know what to look for in order to clock someone. As opposed to rural areas where people just quite frankly aren't completely aware that trans is even a thing, and you know, the whole "manners" thing is pretty big in conservative, rural, and southern areas.

Quote from: Roni on October 28, 2015, 05:20:59 PM
I've found that it is probably because in liberal places like NYC, people are used to mixing with diverse and different types of groups. Most people would have probably met a trans person before, so a lot of them know what to look for in order to clock someone. As opposed to rural areas where people just quite frankly aren't completely aware that trans is even a thing, and you know, the whole "manners" thing is pretty big in conservative, rural, and southern areas.

I hate to say this but the kind of people you find in big cities (if you catch my drift) don't have very tolerant attitudes to LGBT in general. Even with gay people I've seen gay guys holding hands then only to be shouted down and laughed at. Coming from the Caribbean, Jamaicans were especially bad about this as the whole Jamaican dancehall music culture is full of homophobia and transphobia where they even openly call for shooting gays. I don't really get clocked at all now but when I did it's usually a fishing expedition. Then my voice would give me away. Not now though.