It has been shown that taking androgens (testosterone) produces a reduction in the voice’s fundamental frequency 3–4 months after starting the hormone treatment. This change in voice is usually sufficient to achieve a more stereotypically masculine voice which, moreover, lasts over time even if the medication is discontinued.
A study has shown that 21% of transgender or transsexual men cannot produce a deeper voice despite taking hormones (androgens). There are also cis men who have a higher voice than would be appropriate for their body morphology. Voice masculinisation surgery is aimed at all these men.
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Who can undergo this surgery?
All trans men who, despite having undergone hormone treatment, have not achieved a deeper voice, are candidates for this surgery. But it is likewise suitable for all those men whose voice does not correspond to their body morphology. This could be as a result of vocal disorders during adolescence, a clear dissociation between body morphology and vocal tone (an excessively high-pitched, childish voice), increased stiffness of the vocal cords (sulcus, scars, post-chordectomy) or excessive tension of the vocal cords.
Surgery
The surgical technique is called Type III thyroplasty or reduction/retrusion thyroplasty. This voice masculinisation procedure aims to lower the fundamental frequency to at least below 165 Hz in order to achieve a deeper voice.
Basically, it consists of shortening the vocal cords by pulling the anterior commissure backwards (retrusion or retraction), thereby reducing the tension of the cords and increasing their density or mass. This surgery is performed under general anaesthesia through an incision in the skin of the neck.
This surgery requires absolute vocal rest for seven days, avoiding any physical exertion for at least three weeks. In addition, vocal therapy sessions will be required to consolidate what was achieved with the surgery.
Results after surgery
As for the expected result, the vocal cords will be shorter, flaccid and thicker. With regard to the voice, there is usually a decrease in the fundamental frequency. It also reduces tension and fatigue during phonation, as well as increasing comfort in vocalisation.
After surgery, post-operative speech therapy is recommended.
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