Vocal surgery

Vocal surgery is a surgical process intended to change the pitch and/or tone of one’s voice. There are several different kinds of surgery, which depend on the surgeon in question and your needs and wishes. Vocal surgery is typically sought by trans people who were presumed male at birth (PMAB), including women and non-binary people, as estrogen-based hormonal affirmation cannot change the tone or pitch of the voice. 

Vocal therapy and/or vocal coaching is always recommended alongside vocal surgery. This is because many vocal surgeries only change the pitch and not the tone or inflection of the voice. 

Not all trans people want, seek or can have surgery, and being trans doesn’t necessitate surgery either. Find out more about that here.  

There are several vocal surgical options:

Anterior glottal web formation shortens the vocal cords to help raise the pitch of the voice by reducing the ability to produce lower pitches. It also narrows the airway.

Cricothyroid approximation elongates the vocal cords by fixing the cricoid cartilage to the thyroid cartilage. Studies have found that this technique doesn’t last as long as other surgical options.

Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) is a newer surgical technique which  involves simultaneously shortening the vocal fold length, and also increasing vocal fold tension through the partial removal of superficial vocal cord tissue and the bringing together of the vocal folds using sutures, whilst trying to maintain the natural funnel shaped configuration of the under-surface of the front of the vocal cords (folds).

Recovery will depend on the procedure undertaken. You can expect to need to rest entirely from speaking for a short-to-medium length of time after any of these surgical options. This could be from weeks to months.

After vocal surgery, strict voice rest is usually required. Your voice will continue to heal and evolve for a period of time, depending on the surgical technique. Some vocal surgery also requires ongoing voice therapy and rehabilitation. Talk with your surgeon about what recovery and aftercare looks like for you. 

The cost of vocal surgery will depend on the surgeon and the location the surgery is being done. 

It may be possible to get a Medicare benefit for your anaesthetist, surgeon, surgical assistant, and pathology. In addition, some private health insurers cover your hospital stay, and a portion of surgeon, assistant, and anaesthetist fees. Ask your surgeon for the MBS Item Number they use (often 41879 and 41864) and check in with Medicare or your insurer, if you have one. For more information about accessing compassionate release of superannuation, go to our Superannuation page. 

Vocal surgery options are limited in Australia. The Australian Professional Association for Trans Health (AUSPATH) hosts a provider list of their members. It includes surgeons in Australia and is available here.

Surgery using the ‘Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure’ technique is available in some specialist voice centers in Australia and overseas. 

All surgeries carry some risk, including complications, infection, blood clots, and rarely death. It’s important to ask your surgeon about possible risks and how to avoid them.