in 4 stages

Why is the feminization of the voice needed?

Throughout the journey undertaken by the transsexual women, the voice is seen as a final aspect that needs modification to obtain the definite coherence between the physical aspect and the interior personality.

The voice has a great impact in their social, professional and personal life. It could even set a border between being accepted or rejected (or discriminated) by their surroundings.

Hormone therapy has no influence on the fundamental frequency of the transgender woman (voice tone).

The voice of a transsexual woman can give her away in the most fragile moments such as sneezing or coughing, so its feminization must be deep and usually asks a lot of motivation and involvement by the patient.

Our method of working in the voice

Before the vocal exam that will be done in our clinic, there could be a possibility of sending a recorded audio or video of the voice in order to create an initial image of the patient and decide whether she is a candidate for the surgery or just needs treatment with the speech therapist.

Stage 1

The treatment starts with an appointment in the clinic, here, the anatomy of the larynx will be recorded and a complete study of the voice will be performed. This study includes:

  • A perceptual exploration.
  • An aerodynamic exploration.
  • A stroboscopic exploration of the larynx.
  • An acoustic-Spectrographic examination.

Also, the voice will be recorded while speaking (reading of a phonetically balanced text).

Stage 2

Every surgical technique to lift the vocal tone are based around three fundamental principles:

  1. Increase the tension of the vocal cords.
  2. Alter the consistency of the vocal cords.
  3. Reducing the mass of the vocal cords.

The current surgical techniques to feminize the voice are the following:

  • Shortening Vocal Cord through an endoscopy (Wendler glottoplasty).
  • LAVA (Laser Assisted Voice Adjustment) Orloff ‘s Technique).

Stage 3

Once the patient has completed the surgery of their vocal cords, and after the compulsory vocal rest, it is convenient to do speech therapy rehabilitation to strengthen what has been achieved with surgery. 

The sessions on voice feminization mainly focuses on the exercise of the following elements: The relaxation, the blow, the respiration, and the posture…

The vocal work is mainly based on singing exercises and the joint application of various voice techniques, its main objective is to consolidate all previously cited elements to obtain a female and harmonious voice.

Along with speech therapy sessions, the patient should perform a daily series of exercises at home and apply them in their daily lives. These will serve as “training” and settlement for the maintenance of the new voice. In order to obtain better results, the vocal work should be encouraged and continued.

Stage 4

After a compulsory vocal rest of 15 days, without vocal effort, the patient will return for a revision, this will include:

  • A month, a laryngoscopy will be carried out.
  • 3 months, laryngostroboscopy, acoustic analysis and spoken voice recording is performed.
  • 9 months, acoustic analysis and spoken voice recording is performed.

Conclusions of Voice Feminization

  • The feminization of the voice is currently a medical challenge, and it has an ascending demand for the transgender women.

  • There are surgical alternatives to create a larynx and a femine-looking vocal chords, this results in a higher and sharper voice tone. Furthermore, the new larynx is complemented with a change of the vocal gesture, this is obtained through postoperative speech therapy.

  • At the end of the process, the patient will obtain a confortable, stable and easy voice control; and most important, according to the external physical appearance of the patient.

  • Today, thanks to our experience and work methodology (surgery + postoperative speech therapy), we have very satisfactory objective results for our patients.