Voice Feminization Surgery (Voice Change Surgery) in Singapore: Elevate Your Feminine Expression

What is Voice Feminization Surgery?

Voice feminization surgery is a transformative procedure that aligns one’s vocal presentation with their gender identity, crucial for many in the transgender and non-binary communities. This surgery modifies vocal cords for a more feminine pitch and quality. Explore with us at Nuffield ENT how this pivotal step could be part of your journey towards vocal authenticity.

When is Voice Feminization Surgery Carried Out?

Transgender woman (assigned male at birth, transitioning to female).
Disorder of sex development (born with both male and female reproductive organs).
Medical conditions necessitating androgen (male sex hormone) therapy as part of treatment.
Ovarian cancer with tumours producing androgens.
Cis females wanting a more conventionally feminine voice.

Types of Voice Feminization Surgeries

At Nuffield ENT, we guide you to choose the most suitable procedure for your needs. Below is an overview of the various voice surgery techniques:

1. Femlar (Feminization Laryngoplasty)

A specialised surgical procedure aimed at achieving a higher, more feminine pitch by altering the vocal folds and larynx structure.

2. Wendler Glottoplasty:

This specialised technique intentionally alters the vocal cords to adjust the voice pitch upwards. The approach is focused on achieving a pitch that is perceived as more feminine.

3. Laser-Assisted Voice Adjustment (LAVA)

Utilising a CO2 laser, this method precisely modifies vocal fold tension for pitch adjustment, without removing any vocal cord tissue, focusing on fine-tuning the voice’s pitch.

4. Thyrohyoid Elevation

By shortening the vocal tract through the repositioning of the thyroid cartilage closer to the hyoid bone, this surgery tightens the vocal cords to achieve a naturally higher pitch.

5. Laser Reduction Glottoplasty (LRG)

LRG employs laser technology to carefully reduce the size of the vocal folds. The procedure is minimally invasive, typically under local anesthesia, aimed at controlled pitch and quality adjustments.

6. Anterior Glottal Web Formation

This procedure creates a web-like structure in the anterior part of the glottis to alter vibration patterns of the vocal cords for pitch adjustments. The technique is customised to meet individual patient needs for voice feminization.

7. Cricothyroid Approximation (CTA)

This technique increases tension on the vocal cords by approximating the cricoid and thyroid cartilages, aiming for a higher voice pitch. CTA is performed under local anesthesia, offering a direct approach for those seeking pitch elevation beyond non-surgical methods.

Voice Feminization Surgery Procedure

Here’s what the process entails.

Before Surgery

Schedule preoperative appointments for tests and instructions.
Receive guidance on fasting and hospital arrival times.
Attend necessary medical consultations for surgical clearance.

During Surgery

Modify vocal characteristics through incisions.
Potentially incorporate artificial vocal cords.
Ensure post-surgical care and voice therapy for optimal outcomes.

Post-Surgery Care

Post-surgery, prioritise voice rest and adhere to specific care instructions for a successful recovery.
This includes limiting verbal communication to prevent strain and potential muscle damage, warming up the voice properly before speaking, and avoiding whispery or excessively high pitches.
A 10-14 day break from vocally demanding jobs is recommended, ideally scheduling surgery when extended rest from vocal strain is feasible.
Complementary procedures include:
- Speech Therapy: Essential for refining pitch, tone, and resonance, aiding in the achievement of desired feminine voice qualities.
- Vocal Function Exercises: Assist in strengthening vocal muscles and improving vocal control, enhancing overall voice feminization outcomes.
- Resonance Training: Focuses on adjusting vocal resonance to achieve a more feminine sound, complementing surgical interventions for a comprehensive transition experience.

We understand how unnerving surgery can be – if it puts your mind at ease, our doctors are more than happy to walk you through the process in person. Leave us a message and we’ll get back to you ASAP.

Voice Feminization Surgery Benefits

Voice feminization surgery offers a range of psychological and social benefits, making it a transformative procedure for many. The primary advantages include:

Alignment with Gender Identity: The surgery adjusts the pitch and quality of the voice to reflect one’s true gender identity, playing a crucial role in the transition process for transgender women and non-binary individuals.
Enhanced Confidence and Social Interactions: By achieving a voice that matches their gender identity, individuals often experience a boost in self-esteem and feel more comfortable in social situations, leading to improved personal and professional relationships.
Mitigation of Gender Dysphoria: Changing the voice to match gender identity can significantly reduce feelings of dysphoria, as the voice is a constant aspect of how individuals present themselves to the world.
Improvement in Mental Well-Being: The congruence between voice and gender identity can lead to a substantial positive impact on mental health, fostering a sense of authenticity and reducing stress and anxiety associated with gender dysphoria.

Am I a Good Candidate For Voice Feminization Surgery?

Identifies as transgender or non-binary, seeking voice alignment with gender identity.
Experiences gender dysphoria related to voice mismatch.
Desires a voice that reflects true gender identity.
Holds realistic expectations about surgery outcomes and understands the importance of post-operative care, including voice therapy.
Commits to recovery and voice therapy sessions post-surgery.
Maintains overall good health to minimise surgical risks and support recovery.
Makes an informed decision about surgery, aware of potential risks and benefits.
Receives support from mental health and medical professionals throughout the journey.

If you find yourself resonating with these points, voice feminization surgery may be a suitable option for you. Our team at Nuffield is here to guide you through the process, from initial consultation to post-surgery recovery and beyond. Reach out to Nuffield ENT now!

Factors in Choosing Feminization Surgery

The voice feminization surgery you choose will be based on:

Your individual transition objectives
Your existing vocal tone
Factors like your anatomy, age, and general health
The proficiency and experience of your surgeon

Life After Voice Feminization Surgery (VFS)

Adapting to new voice sound and capabilities.
Ongoing voice therapy to refine pitch, tone, and resonance.
Period of self-discovery and learning to express authentically.
Increased social confidence and alignment with gender identity.
Significant emotional and psychological growth post-VFS.
Enhanced overall well-being and satisfaction with gender expression.

Voice Feminization Surgery Risks

Vocal Cord Challenges: Includes mobility issues leading to voice modulation difficulties, dysfunction, and paralysis; risks of temporary quality impact due to fluid retention (edema).
Scar Tissue Impact: Emphasises altered voice resonance and pitch from laryngeal scarring, potentially requiring postoperative adaptations.
Voice Quality and Stability: Concerns of weakness, strain, hoarseness, unnatural pitch variations, and instability (breaks, tremors), which may necessitate adjustments or further surgery.
Additional Surgical Needs: Potential for procedures like a tracheal shave for enlarged Adam’s apple and the possibility of a second surgery for unresolved issues or complications.

Voice Feminization Surgery Complications

Temporary Changes in Voice Quality: Approximately 11% of VFS cases may experience temporary alterations in voice quality, expecting full recovery within three months.
Vocal Cord Scarring: Potential long-term changes in voice quality may occur due to scarring, possibly requiring additional treatment.
Infection: Risk of infection at the surgical site or internally, which can complicate recovery and necessitate medical intervention.

Voice Feminization Surgery Costs in Singapore

Costs range from SGD 3,000 to SGD 5,000.
Additional costs may include pre-operative assessments and consultations, medications for pain management and recovery and more.
For precise details regarding additional costs and any potential subsidies or financial assistance, it’s advisable to check with the healthcare provider or surgical facility directly.

Are There Subsidies For Voice Feminization Surgery in Singapore?

Typically not covered by government schemes (e.g., CHAS, Medisave) due to cosmetic nature.
Check with your insurance provider for possible coverage.

The Team at Nuffield ENT

Specialises in voice feminization surgery with a focus on patient satisfaction.
Provides individualised care and exceptional outcomes.
Services extended to private patients and professionals, now including NHS procedures.
Led by Dr. Vyas Prasad and Dr. Rebecca Heywood, committed to exceptional care despite challenges.
Contact us to secure your appointment now.

Voice Feminization Surgery Before and After Photos

Testimonials from our patients can be accessed in person! Don’t hesitate to contact our friendly team.

FAQ

1. Does Voice Feminization Surgery Hurt?

No, the surgery itself doesn’t hurt due to anaesthesia, but post-operative soreness and discomfort are common during the recovery period.

2. Will Voice Feminization Surgery Leave Scars?

Yes, voice feminization surgery can leave scars, as it involves modifications to the vocal cords or larynx. However, surgeons aim to minimise visible scarring through careful incision placement.

3. What's the Difference Between Gender Affirming Voice Surgery and Therapy?

Gender affirming voice surgery involves medical procedures to alter the physical aspects of the voice box for a more gender-congruent sound, while voice therapy focuses on non-surgical techniques to modify pitch, resonance, and intonation through guided practice and exercises.

4. Does Voice Feminization Surgery Last?

Yes, the results of voice feminization surgery are permanent, altering vocal cord structure for a lasting change in voice pitch and quality.

5. How Long Does Voice Feminization Take?

Recovery from surgery takes a few weeks, but achieving the full effect of voice feminization, including therapy, can take several months to a year.

6. Is Voice Surgery Necessary to Transition to a Different Gender?

No. Voice surgery is not necessary for everyone transitioning to a different gender. Gender transition can involve various steps, including hormone therapy and social changes, without the need for surgical intervention to affirm one’s gender identity.

7. Is Voice Feminization Worth It?

Yes, for many, it significantly improves congruence between gender identity and voice, enhancing confidence and social interactions, making it a valuable step in their transition.

8. Does Voice Feminization Affect Singing?

Yes, it can affect singing by altering vocal range and quality; however, with proper voice therapy, many adapt and continue to sing with their new voice.

9. How Long After Voice Feminization Surgery Can I Sing Again?

Typically, you’ll need to wait 3-6 months for your vocal cords to heal.

10. Does Oestrogen Change Your Voice?

No, oestrogen does not significantly change your voice. While it can lead to some physical changes, the pitch of the voice is primarily determined by the vocal cords, which oestrogen does not substantially alter in adults.

Medical References

Gonzalez-Lopez, A., et al. (2020). Silent Speech Interfaces for Speech Restoration: A Review.

Benaroya, L., et al. (2021). Beyond Voice Identity Conversion: Manipulating Voice Attributes by Adversarial Learning of Structured Disentangled Representations.

Faundez-Zanuy, M., et al. (2022). Speaker Identification Experiments Under Gender De-Identification.

Koutsogiannaki, M., et al. (2024). Gender-ambiguous voice generation through feminine speaking style transfer in male voices.

Tian, Y., et al. (2024). Creating Personalized Synthetic Voices from Articulation Impaired Speech Using Augmented Reconstruction Loss.