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Gender-affirming (transgender) voice therapy and surgery

About this test

Gender-affirming voice therapy and surgery help transgender and gender-diverse people adjust their voices to communication patterns that fit their gender identity. These treatments also are known as transgender voice therapy and surgery. They may be called voice feminization therapy and surgery or voice masculinization therapy and surgery.

Why it's done

People who seek gender-affirming voice care often want their voices to better fit their gender identity. The treatments may ease discomfort or distress due to differences between a person's gender identity and sex assigned at birth. That condition is called gender dysphoria. Gender-affirming voice therapy and surgery also may be done for safety reasons. Some people whose voices don't match their gender identity have concerns about possible bullying, harassment or other safety issues. Not all transgender and gender-diverse people choose to have voice therapy or surgery. Some are happy with their current voice and do not feel a need to get this treatment.

Risks and complications

Long-term voice, speech and communication changes involve using the body's ability to make sound in new ways. If not done correctly, making those changes can lead to vocal fatigue. A speech-language specialist can work with you to help avoid vocal discomfort. Gender-affirming voice surgery usually focuses only on changing pitch. For voice feminization surgery, the focus is to raise speaking pitch. The surgery also reduces the ability to make a low-pitched voice. That means the overall pitch range is smaller. The surgery reduces the voice's loudness too. That may make it hard to shout or yell. There is a risk that the surgery could cause the voice to become too high or not high enough. The voice also may become so rough, hoarse, strained or breathy as to make communication hard. The results of most voice feminization surgeries are permanent. Your healthcare team may recommend voice therapy before and after surgery. Voice masculinization surgery isn't as common as voice feminization surgery. This surgery focuses on lowering the pitch of the voice. It does this by decreasing the tension of the vocal folds. The surgery may change voice quality, and it cannot be reversed.

How to prepare

If you're considering gender-affirming voice therapy or surgery, ask your healthcare professional to refer you to a speech-language specialist. That specialist should have training in the assessment and development of communication skills in transgender and gender-diverse people. Before you start treatment, talk with the speech-language specialist about your goals. What communication behaviors do you want? If you don't have specific goals, your speech-language specialist can help you explore the options and make a plan. A voice coach or singing teacher also may play a role in helping you reach your goals. If you decide to work with this type of professional, look for one who has experience working with transgender and gender-diverse people.

Understanding your results

Finding a voice that feels true to you is an individual process. Gender-affirming voice therapy and surgery are tools you can use to help you meet the goals you have for your voice. The results of gender-affirming voice therapy and surgery depend on the treatments used. The amount of time and effort you put into voice therapy can make a difference too. Voice changes take time and commitment. Gender-affirming voice therapy requires practice and exploration. Be patient with yourself. Allow time for the changes to happen. Talk to people you trust about your experiences and feelings. Continue to work with your speech-language specialist to meet goals that reflect who you are.

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Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.

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