Laser Reduction Glottoplasty for Voice Feminization: Experience on 28 Patients

Area of Science:

• Otolaryngology
• Gender-affirming care
• Surgical innovation

Background:

• Voice feminization is a crucial aspect of gender affirmation for transgender women.
• Laser reduction glottoplasty is an emerging surgical technique to achieve a more feminine voice pitch.

Purpose of the Study:

• To evaluate the long-term voice outcomes of laser reduction glottoplasty in transgender women.
• To assess patient satisfaction and objective voice parameters post-surgery.

Main Methods:

• A retrospective cohort study of 28 transgender women undergoing endoscopic laser reduction glottoplasty.
• Pre- and postoperative voice assessments included Voice Handicap Index (VHI-30), Transsexual Voice Questionnaire (TVQ), and acoustic analysis (F0, jitter, shimmer, NHR).
• Patient self-ratings, and evaluations by medical students and voice experts were also conducted.

Main Results:

• Significant improvements in VHI-30 and TVQ scores were observed post-surgery (P < .001).
• Mean fundamental frequency (F0) increased significantly from 132 Hz to 198 Hz (P < .001).
• While 75-79% of voices were perceived as feminine by evaluators, 32% of patients desired further voice modification, with 68% overall patient gratification.

Conclusions:

• Laser reduction glottoplasty is an effective and satisfying procedure for voice feminization in transgender women.
• The positive voice outcomes appear durable for at least 5 years.
• A secondary surgical procedure may be necessary for some patients to achieve optimal voice feminization and satisfaction.