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Researchers measure physical changes to trans women's vocal cords as a result of voice training

Just a moment...

https://www.science.org/content/article/vocal-therapy-changes-voices-transgender-patients-without-need-surgery

Original article is here (paywalled 😑). Not sure how far to take these results with such a tiny N but interesting if it can be replicated with a larger sample size. It looks like they initially hypothesized that HRT had caused the changes but ended up rejecting that idea in favor of it being the voice training.

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Axolotling

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This study seems to me to be a retreading of old ground by cis people. Like I can appreciate getting more data that yes, trans people aren't freaks, but the study just seems like a massive "duh".

Why did they think hrt changed vocal chords in trans women in the first place? It's pretty well known that hrt cannot take away the things that first puberty already changed. I also don't like how the article presents voice feminization surgery as if it's a common and normal choice for most trans women. Even beyond the implication that trans people need surgery to be successful in their transition, voice feminization surgery is extremely risky and is only ever recommended in extreme cases. If they couldn't even do that amount of research, it doesn't make me feel confident that the study is all that worthwhile to think about.

Secondly, why only focus on trans women? It'd be more interesting if they included trans men in the picture since on their side of the fence, hrt actually does affect their voice. It would be interesting if the study compared their trans participants with cis benchmarks at all, actually. Maybe the study itself does that where the article does not, but for reason #1 I don't feel like it's worth my time to check.

Lastly, the actual results of the study are pretty "duh". Just by the physics of how the human voice works, it's pretty easy to see that yes, having a breathier and higher pitched voice will lead to having thinner vocal folds. Because having thinner vocal folds is what causes those effects on the voice in the first place. The study mixes up the cause and effect here, so it isn't exactly groundbreaking research. What would've been more appropriate to examine is the vocal chords at rest compared to either cis benchmarks or the speaking voice average. Since the conventional wisdom is that voice training can't really change your voice at rest, that would be more interesting to look at.

Overally I appreciate having more data about trans people, but didn't find the study or article to be particularly knowledgeable about trans people in the first place.

ada

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voice feminization surgery is extremely risky and is only ever recommended in extreme cases

It's no more risky than any other transition surgery. I don't know why we demonise vocal surgery in trans fem circles instead of treating it like any other transition surgery, when ultimately, that's what it is.

Axolotling

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Maybe it's because I'm risk averse or maybe I'm just not as well read on it, but I do personally think it's generally riskier than other transition surgeries.

For vaginoplasty, even if the job is botched, you'll still be able to walk normally. FFS, you'll still be able to talk and eat and smell normally. Breast augmentation, you can still lift your arms normally. Plus since these three are the "main" options available, there's more people doing it and more people experienced in handling the complications.

For vocal surgery, if the job is botched, you can permanently damage your voice and not be able to shout. And even then it still takes a degree of voice training to get a good result (althought it does lower the bar). The relative rarity of the procedure also does not inspire me to take that kind of risk.

I'm open to being convinced that it's not as risky as I think it is, but I do think that it's a pretty risky option. Especially when you compare it to voice training on its own, which is way harder to fuck up. And voice training will get most people across the line.

ada

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It's easy to not get the results you want from VFS, that's true. Many people don't. But no one loses their voice from it. Most of the horror stories are from a form of VFS (cricothyroid approximation) that surgeons haven't performed for years, and even then it wasn't the lose of voice, it was unwanted changes in voice, and failure of the surgery over time.

Put it this way. I know more people that are disappointed with their VFS than their GRS, but I know far more people that have had complications (sometimes serious) from their GRS than from their VFS.

I'm absolutely behind not getting any surgery you don't want, particularly VFS, because it's so often not going to give the results people want. I just take issue with the idea that it's dangerous, because it gets in the way of people making informed choices about their own transition options. In reality it's no more risky than any other surgery.

LadyAutumn

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There's a wealth of misinformation out there about vocal feminization surgery. I am currently in the planning stages of getting mine. The general view that it is somehow more risky than other surgeries does real harm to people like me trying to access them.

I honestly would've pursued it years ago if people hadn't had me convinced it's 50/50 you never speak again or something like that. Vocal chord surgery is common, it's a very routine form of plastic surgery that is practices on cisgender and transgender people all around the world. Vocal feminization is a very precise safe procedure when done in the hands of a competent glottoplasty surgeon. It has complications as any surgery does. It's certainly not anymore risky than breast augmentation or reassignment surgery is.

The majority of transgender women report dissatisfaction with their voice. Training is not something that is easily readily doable for everyone. I've been at it for 8 years with professional help and my voice passes about as often as it did 5 months in. It's really only other queer people who gender my voice correctly. Vocal feminization surgery should be much more widely discussed in our community. Vocal masculinization is often a hugely celebrated / anticipated effect of T in trans masc communities. Like we know that how your voice is gendered has a massive effect on your quality of life. We do not have that our voices are literally unaffected by estrogen, and under most insurance plans Vocal feminization is considered an optional surgery. Misinformation is part of the reason why it's viewed as optional, and part of the reason that so many who have voice dissatisfaction even after training are never even told that it's an option.