The voice is an integral part of the identity. For many transgender women, aligning their voice with their gender is a crucial and deeply personal step in their transition journey. At WIH Hospital, we specialize in Male to Female Voice Feminization Surgery (VFS), a sophisticated procedure designed to raise the pitch of the voice for a more feminine quality. WIH Hospital has over 20 years of expertise in this specialized field.
Human voice is golden because we use it every single day to communicate with others, create beautiful music and a way to understand one’s emotions or feelings. We laugh, scream, shout or cry using our voice. The voice does not only serve as a channel to connect with people, it is also a unique way of determining a person’s age or gender. This makes the human voice so complex, but how does it works?
Your voice is a product of these three main sources: A power source (your lungs) where the air coming in and out of the lungs gives energy to the vocal cords in the voice box to create a sound.
A sound generator (our vocal cords) consisting of two vocal folds that vibrates (moving back and forth) with the passing airstream creating a sound.
A resonator (throat, nose, mouth, nasal passages) amplifies the voice and make it distinct and recognizable from one person to another.
By merely hearing someone speak, you can immediately distinguish if that person is a man or a woman thus making the voice a significant gender marker and equally important to gender reassignment surgery and facial feminization for a male to female Transgender.
Voice Feminization Surgery (Feminization Laryngoplasty) is a surgical procedure that involves modifying the vocal folds—shortening, thinning, or tightening them to raise pitch and achieve a more feminine voice that aligns with a female vocal profile.
A month-long stay in Thailand is recommended by Dr. Premsuda to complete the entire voice feminization process. This includes
If you’re planning multiple procedures, Dr. Premsuda prefers to schedule feminizing voice surgery separately from any procedures performed by Dr. Chettasak. This is due to differences in intubation techniques required for general anesthesia. The medical team will determine suitable surgery dates based on your total duration of stay in Thailand.
Larynx
Pitch
Vocal Folds Length
Vocal Tracts
Large
Low
17-25 mm
Large
Small
High
13-17 mm
Small
In general, men have larger larynx and vocal tract result in lower pitch while women have smaller larynx result in higher pitch. Since female hormone replacement and voice therapies can only do little in feminizing the voice, most male to female transgenders seek surgical remedy to complete their transition.
There are many surgeons all over the world who operate feminizing voice surgery but finding for a specialist and deciding on what technique to choose can be very crucial. This is why Chettawut Plastic Surgery Center developed a partnership with Dr. Premsuda Sombuntham MD, a board-certified ENT laryngologist who specialized in feminizing voice surgery (Feminization laryngoplasty).
Dr. Premsuda utilizes anterior web formation technique which involves the dissection of the anterior portion of vocal fold membrane and suturing out vocal fold muscles to shorten vocal fold’s size.
According to recent studies, this procedure provides the most reliable result to change a low pitch (masculine voice) into a higher pitch pattern (feminine voice) with natural quality.
The anterior web formation technique does not affect the integrity of voice box framework so singing with stable and natural pitch is possible after surgery.
During general anesthesia with special technique of intubation, the anterior web formation is done precisely under ENT microscope for permanent thinning of the vocal folds.
Since the vocal folds are approached intra-orally with special instruments, there will be no scar or incision on the neck skin.
Larynx
Pitch
Vocal Folds Length
Vocal Tracts
Large
Low
17-25 m
Large
Small
High
13-17 mm
Small
Dr. Premsuda recommends 1 full month stay in Thailand in order to complete the whole process which includes:
– Pre-operative assessment by strobolaryngoscopy
– Feminizing voice surgery done under GA (general anesthesia) as inpatient basis with one night admission at the hospital
– Recovery in one of our three affiliated hotels where the nurse team will come to visit and provide necessary care/advise daily (except Sundays)
– Post-operative evaluation by strobolaryngoscopy
For patients who plan to have multiple procedures in addition to feminizing voice surgery in one trip, Dr. Premsuda prefers to perform the feminizing voice surgery separately from the other procedure/s done by Dr. Chettawut due to the difference in intubation technique during general anesthesia. The suitable surgery dates will be decided by the medical team based on the patient’s total stay in Thailand.
Before leaving Thailand, you will undergo a thorough post-operative evaluation by strobolaryngoscopy.
Further instructions will be given during this time, including the plan to attend a voice training with a speech therapist in your area. Voice therapy is a significant step to practice and enhance the results of voice feminization surgery.
We recommend a stay of 1 full month in Thailand. This allows for the pre-operative assessment, the surgery, a one-night hospital stay, a supervised recovery period, and a final post-operative evaluation before you travel home.
You will be under general anesthesia during the procedure. Post-operatively, patients typically experience a sore throat, which is well-managed with medication. The discomfort is generally mild.
Yes, voice therapy is a highly significant step. We strongly recommend it. Surgery raises the pitch, but a speech therapist will teach you how to control intonation, resonance, and articulation to achieve a comprehensively feminine voice.
As with any surgery, there are risks, though they are minimal in the hands of a specialist. Potential risks include infection, breathiness, or dissatisfaction with the pitch. Your surgeon will discuss these with you in detail during your consultation.
