Find Your Voice: Gender Affirming Voice Surgery

Gender affirming voice surgery, otherwise known as vocal feminization surgery (VFS) or more specifically Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) is a surgical procedure designed to alter the pitch, resonance, and quality of a person’s voice to align with their gender identity. For many transgender individuals, their voice can be a significant source of discomfort and dysphoria. At our ENT practice, we offer VFSRAC as part of our commitment to providing compassionate care and support for all patients seeking gender affirming surgeries.

How is Gender Affirming Voice Surgery Performed?
Your provider will first evaluate your vocal range and quality before the procedure to determine the optimal pitch for your voice and discuss your goals and expectations for the outcome of the procedure.

Unlike other forms of voice feminization surgery, VFSRAC involves a unique surgical concept and procedure. During the surgery, advanced micro-endoscopic instruments are used to remove 1/3 of the vocal fold membrane and internal tissue without the need for a skin incision. The new structures are then sutured tightly with permanent suture material at two precisely calculated locations of the vocal fold surgical site.

The surgical site is very small, only about 3-5mm in size, and the knots are tied using the smallest permanent thread available. One of the key elements of a successful VFSRAC result is the use of permanent suture material which can induce progressive thinning of the vocal fold mass to achieve a higher fundamental frequency and keep the result permanent. Overall, VFSRAC is a highly effective and safe surgical technique for achieving voice feminization and is considered to be the gold standard in voice feminization surgery.

Transgender Care
Our doctors are highly trained and experienced in providing medical services to transgender patients, and we take great care to ensure that our patients receive compassionate and personalized care. We understand that undergoing transoral tracheal shave surgery is a crucial step for many transgender individuals in affirming their gender identity and achieving a more congruent physical appearance. Therefore, we approach our patients’ concerns and goals with empathy, and we are committed to supporting them throughout their surgical journey.

In addition to empathy, our doctors have a deep understanding of the unique healthcare needs and challenges faced by transgender individuals. We have experience working with patients who are undergoing hormone therapy, gender confirmation surgery, and other related procedures, and we are aware of the potential psychological and social factors that may affect transgender patients, such as gender dysphoria and discrimination. We are committed to providing appropriate referrals and support to our patients, as needed.

The VFSRAC approach is unique in its endoscopic modification of the size, length, and thickness of male vocal folds to achieve female characteristics, without requiring any skin incision. This sets it apart from other VFS techniques, which only shorten the vocal folds without addressing thickness, size, or airflow. By optimizing airflow and addressing all other vocal fold characteristics, including suture technique, the VFSRAC approach achieves a natural-sounding increase in pitch with minimal damage to vocal fold tissue and the larynx.

Recovery
After Gender Affirming Voice Surgery, patients can expect to experience some discomfort, swelling, and hoarseness for a few days to a few weeks. Your surgeon may recommend voice rest for the first few days, during which the patient should avoid speaking or whispering to allow the vocal cords to heal properly. The patient may also be prescribed pain medication and/or anti-inflammatory medication to manage discomfort and swelling.

The length of time required to achieve a fully feminized voice pitch after undergoing VFSRAC surgery typically ranges from 6 to 12 months. However, this timeframe can vary depending on various factors, including the patient’s age, recovery capacity, vocal fold characteristics, mental state, and their ability to follow all post-op care instructions and voice exercises to retrain the patient’s phonatory and resonance patterns.
After the initial recovery period, the surgeon may recommend speech therapy to help the patient adjust to their new voice and develop healthy vocal habits. Speech therapy can also help the patient improve their vocal range and quality over time. The length and frequency of speech therapy sessions will depend on the patient’s individual needs and goals.

Accessibility
At LACENTA, we believe that all individuals experiencing gender dysphoria should have access to gender-affirming care, regardless of their insurance status or income. We understand that the cost of gender-affirming care can be a barrier for some patients, and we are committed to providing compassionate and affordable care to all who seek it. We work with over 100 different insurance carriers and offer flexible payment plans for those who are uninsured or who’s carrier will not cover the procedure to help make gender-affirming care more accessible to our patients.

At LACENTA, we prioritize patient safety, comfort, and satisfaction. Our team of healthcare professionals is dedicated to providing personalized care and support for every patient we treat. We also understand the unique challenges that transgender individuals may face in accessing healthcare, which is why we are committed to providing a safe and welcoming environment for all patients, regardless of their gender identity or expression.

If you are ready to take the next step towards gender-affirming care, please contact our practice to schedule a consultation. We look forward to helping you achieve the voice that best aligns with your true self.