Feminization laryngoplasty: assessment of surgical pitch elevation

The aim of this study is to analyze change in pitch following feminization laryngoplasty, a technique to alter the vocal tract of male to female transgender patients. This is a retrospective review of 94 patients undergoing feminization laryngoplasty between June 2002 and April 2012 of which 76 individuals completed follow-up audio recordings. Feminization laryngoplasty is a procedure removing the anterior thyroid cartilage, collapsing the diameter of the larynx as well as shortening and tensioning the vocal folds to raise the pitch. Changes in comfortable speaking pitch, lowest vocal pitch and highest vocal pitch are assessed before and after surgery. Acoustic parameters of speaking pitch and vocal range were compared between pre- and postoperative results. The average comfortable speaking pitch preoperatively, C3# (139 Hz), was raised an average of six semitones to G3 (196 Hz), after surgical intervention. The lowest attainable pitch was raised an average of seven semitones and the highest attainable pitch decreased by an average of two semitones. One aspect of the procedure, thyrohyoid approximation (introduced in 2006 to alter resonance), did not affect pitch. Feminization laryngoplasty successfully increased the comfortable fundamental frequency of speech and removed the lowest notes from the patient's vocal range. It does not typically raise the upper limits of the vocal range.