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Feminine after cricothyroid approximation?

John Van Borsel¹, Elke Van Eynde, Griet De Cuypere

¹Ghent University Hospital, Faculty of Medicine and Health Sciences, Ghent, Belgium. john.vanborsel@ugent.be

Journal of Voice : Official Journal of the Voice Foundation

|February 7, 2007

Summary

Cricothyroid approximation (CA) surgery can raise voice pitch in male-to-female transsexuals (MFTs). However, this surgery alone may not be enough to achieve a voice perceived as fully female by listeners.

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Area of Science:

Otolaryngology
Speech and Voice Science
Gender Affirming Care

Background:

Previous studies focused on acoustic changes after cricothyroid approximation (CA) surgery for male-to-female transsexuals (MFTs).
Perceptual evaluation of gender perception is crucial, as acoustic pitch changes alone may not suffice for feminization.

Purpose of the Study:

To investigate the perceptual effectiveness of cricothyroid approximation (CA) in feminizing the voice of male-to-female transsexuals (MFTs).
To assess listener perception of gender based on auditory and audiovisual speech samples.

Main Methods:

Video recordings of nine MFTs, nine nontranssexual males (NTMs), and nine nontranssexual females (NTFs) were presented to 42 student judges.
Judges rated voices on a visual analog scale for perceived femaleness in both auditory-only and audiovisual conditions.
Perception scores were analyzed in relation to average fundamental frequency.

Main Results:

MFTs' voices were perceived as intermediate between NTMs and NTFs in both auditory and audiovisual presentations.
Perception of femaleness showed a significant correlation with average fundamental frequency.
CA surgery effectively raised voice pitch but did not fully feminize vocal perception.

Conclusions:

Cricothyroid approximation (CA) is a viable surgical option for increasing voice pitch in MFTs.
Voice feminization requires more than just pitch elevation; CA surgery alone may be insufficient for achieving a perceived female voice.
Further interventions may be necessary to align vocal acoustics and perception with desired gender identity.