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Surgical Interventions for Voice Masculinization: A Scoping Review.

Arjan Kalra1, Paul C Bryson2, Laurence Gascon3

  • 1Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.

Journal of Voice : Official Journal of the Voice Foundation
|January 15, 2026
PubMed
Summary
This summary is machine-generated.

Voice masculinization surgery can help transgender men achieve a deeper voice when hormonal therapy is insufficient. Type III laryngoplasty offers the best voice deepening results, while less invasive injections also show promise.

Keywords:
Gender affirmation surgeryPhonosurgeryPuberphoniaTransgender maleVoice masculinization

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Area of Science:

  • Otolaryngology
  • Gender-affirming care
  • Voice surgery

Background:

  • Hormonal therapy is standard for transgender men's transition, but voice pitch dissatisfaction affects up to 20%.
  • Voice therapy is a common next step, but surgical options are a last resort for persistent high vocal pitch.
  • The effectiveness of surgical interventions for voice masculinization is not well-documented.

Purpose of the Study:

  • To conduct a literature review of surgical and procedural options for voice masculinization in transmasculine individuals.
  • To analyze outcomes of interventions for puberphonia due to limited data on voice masculinization procedures.

Main Methods:

  • A scoping review was performed by two independent reviewers on surgical and procedural interventions for voice masculinization.
  • Literature on surgical and procedural outcomes for puberphonia was also searched due to limited studies.
  • Data collected included fundamental frequency, non-procedural treatments, symptoms, interventions, outcomes, and complications.

Main Results:

  • The review included 4 articles on voice masculinization and 8 on puberphonia.
  • Surgical treatments for voice masculinization included type III laryngoplasty and direct vocal fold injection with testosterone.
  • Voice deepening in transmasculine patients averaged -43.75 Hz; in puberphonia patients, it averaged -68.61 Hz.

Conclusions:

  • Conservative voice therapies are often successful for voice masculinization.
  • Type III laryngoplasty demonstrated the most significant voice deepening.
  • Less invasive procedures like injection laryngoplasty with testosterone or hyaluronic acid show potential for voice deepening.