VOICE FEMINIZATION. MULTIDISCIPLINARY APPROACH IN 4 STEPS
VOICE FEMINIZATION. STEP 1: VOCAL EXAMINATION
The first step consists of a joint exploration by an otolaryngologist and a specialized speech therapist. The examination begins with a consultation where a recording of the anatomy of the larynx is performed and a complete study of the voice is performed which includes: A perceptual, aerodynamic and acoustic exploration of the voice along with a strobe scan of the larynx.
Also, a spoken voice recording (reading phonetically balanced text) will need to be performed.
After this exploration, it will be decided whether the patient is a candidate for the next step in the process of voice feminization, which is surgery. It will be taken into account for this reason, if the vocal cords are healthy and without lesions and that the fundamental frequency spoken is stereotypically masculine.
VOICE FEMINIZATION. STEP 2: SURGERY
There are several techniques of voice feminization surgery, our team has been using the technique of shortening the anterior commissure for 10 years using vocal suture and endoscopic approach. It is called Wendler’s Glotoplasty, but with personal modifications.
The procedure is performed under general anesthesia and lasts approximately 90 minutes. After surgery, it is necessary to perform an absolute vocal rest of 15 days to avoid dehiscence of the sutures. Postoperative treatment consists of antibiotic coverage for 1 week.
VOICE FEMINIZATION. STEP 3: POSTOPERATIVE LOGOPEDIA
After surgery, where we have changed the anatomy of the larynx, and the corresponding absolute vocal rest, it is necessary to perform a speech rehabilitation to strengthen what has been achieved in surgery, that is, to change the vocal gesture, vocal behavior
The speech therapy sessions for the voice feminization are mainly focused on the exercise of the following elements: relaxation, breathing, breathing, posture, intonation, …
At the beginning two weekly speech therapy sessions are advised
VOICE FEMINIZATION. STEP 4: POSTOPERATIVE REVISIONS
The ideal is to have an appointment with the otolaryngologist after one month of the surgery, where a laryngoscopy will be performed; at 3 months, to perform a laryngoestroboscopy, acoustic analysis and spoken voice recording; and at 9 months (if possible) to perform a final acoustic analysis and spoken voice recording.