Voice Feminisation Surgery
Voice feminisation involves the use of surgical procedures to modify the voice to sound more typically feminine. This surgery is often sought by transgender women, non-binary individuals, and others who wish to align their voice with their gender identity. While voice training and therapy are effective for many, some may choose surgery to achieve more permanent results or to enhance the outcomes of voice therapy.
Voice feminisation surgery can help individuals feel more confident in their everyday interactions, providing a voice that matches their sense of self. However, as with any surgery, it requires thorough consideration, consultation with specialists, and post-operative care to achieve the best outcomes.
If you’re considering voice feminisation surgery, understanding the options, risks, and recovery process is an important first step toward making an informed decision.
Click here for an information sheet on voice feminisation.
What makes a voice feminine?
A feminine voice is characterised by a combination of acoustic, physiological, and behavioural factors. Higher pitch is one of the most recognisable characteristics of a feminine voice. The average speaking pitch for cisgender women tends to range from about 190 to 250 Hz, while for cisgender men, it typically falls between 100 and 150 Hz. A higher pitch creates an immediate association with femininity, but alone it is not enough to fully feminise a voice. Other key factors are resonance, intonation (variations in vocal pitch), speech patterns, articulation, volume and expressiveness.
What does voice feminisation surgery aim to achieve?
Voice feminisation surgery helps achieve a more sustainable rise in vocal pitch. The fundamental frequency of the vocal cords is determined by the length, thickness and tension of the vocal cords. The thickness of the vocal cords cannot be changed after puberty so surgery aims to shorten the length of the vocal cords and increase the tension to achieve an elevation in vocal pitch that can be sustained. The other parameters important to a feminine voice are not changed with surgery but can be addressed with voice therapy. Voice therapy is therefore an essential partner to any voice feminisation procedure in order to achieve the desired result.
What training in Voice Feminisation Surgery do you have?
I was trained in voice feminisation procedures during my laryngology training and more recently, at the Grabscheid Voice and Swallowing Center, Mount Sinai Hospital, New York City. I am also an associate member of the International Association of Transvoice Surgeons.
What does Voice Feminisation Surgery involve?
I provide the following procedures for voice feminisation.
Wendler’s Glottoplasty
A glottoplasty procedure reduces the length of the vocal cords to increase pitch. The procedure involves a general anaesthetic and uses a metal tube passed through the mouth to provide a view of the vocal cords. A C02 laser is then used to remove the lining of the vocal cords at the front half and then stitches are used to join the front of the vocal cords together. This shortens the vibrating segment of the vocal cords to increase vocal pitch. The surgery is performed at The London Clinic and is typically a day-case procedure. Please click here for a downloadable patient information sheet on Wendler’s Glottoplasty.
Laser Assisted Voice Adjustment (LAVA)
Laser Assisted Voice Adjustment (LAVA) uses a C02 laser to free up the space adjacent to the vocal cords. Overtime this leads to an increase in tension on the vocal cords which elevates pitch. The procedure is performed under general anaesthetic and can be performed at the same time as a glottoplasty or in isolation. The increase in pitch following LAVA is modest and it is best used in conjunction with glottoplasty where larger pitch elevations are desired.
Laryngeal Shave (Adam’s Apple reduction)
A laryngeal shave, also known as a thyroid cartilage or Adam’s apple reduction, is a surgical procedure that reduces the prominence of the Adam’s apple to provide a more feminine appearance to the neck. The procedure is performed under general anaesthetic and involves a small incision over the neck. The procedure can be performed at the same time as a glottoplasty or in isolation.
Fees
£400* which includes consultation, pitch analysis and endoscopic assessment of vocal cords with stroboscopy.
* Hospital charges for endoscopy are not included in the fee and will be collected on the day by the hospital. For up-to-date hospital charges please contact the clinic or secretary@voicespecialist.co.uk
Costs for procedures
Fees range from £4500 – £7250 depending on what procedures are carried out. The total amount is inclusive of all surgical, anaesthetic and hospital fees on a presumed day-case basis. Two follow up consultations with endoscopy are included. The hospital fee for endoscopy is not included and will be invoiced separately.
All costs were correct at the time of writing. For confirmation of fees and to discuss further, please contact us at secretary@voicespecialist.co.uk
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FAQs
Is voice feminisation surgery available on the NHS or is it private treatment?
Voice feminisation surgery is currently only available as private treatment. The NHS does not routinely provide voice feminisation surgical procedures, as they are considered elective cosmetic procedures rather than medically necessary treatments. Patients seeking voice feminisation surgery must pursue private healthcare options, with comprehensive procedures available at our clinic ranging from £4,500 to £7,250 depending on the specific treatments required.
Is voice feminisation surgery permanent?
Yes, voice feminisation surgery provides permanent results. Procedures such as Wendler’s Glottoplasty and Laser Assisted Voice Adjustment (LAVA) create lasting structural changes to the vocal cords that cannot be reversed. The surgery permanently elevates vocal pitch by shortening the vibrating length of the vocal cords and increasing tension. Optimal outcomes are best achieved when combined with ongoing voice therapy to develop feminine speech patterns and intonation.
How long is the recovery time after voice feminisation surgery?
Recovery time following voice feminisation surgery typically takes 2 weeks or more, depending on the individual patient and specific procedures performed. During the initial recovery period, patients must observe strict voice rest to allow proper healing of the vocal cords. The recovery timeline may vary based on the patient’s overall health, adherence to post-operative care instructions, and whether multiple procedures were performed simultaneously.
Is voice feminisation surgery performed under general anaesthesia?
Yes, all voice feminisation surgical procedures are performed under general anaesthesia for patient safety and comfort. This includes Wendler’s Glottoplasty, Laser Assisted Voice Adjustment (LAVA), and laryngeal shave procedures. General anaesthesia is necessary because these procedures require precise surgical access to the vocal cords through the mouth using specialised instruments and laser technology.
Does voice feminisation surgery require an overnight hospital stay?
No, voice feminisation surgery does not usually require an overnight stay. It is typically performed as a day-case procedure at The London Clinic, allowing most patients to return home the same day after recovering from general anaesthesia. However, in some cases—such as when multiple procedures are carried out or closer post-operative monitoring is needed—an overnight stay may be recommended.