Diagnosis and Management of Vocal Complications after Transgender Surgical Chondrolaryngoplasty
Diagnosis and Management of Vocal Complications after Transgender Surgical Chondrolaryngoplasty
Surgery Fails to Feminize Voice and has High Complication Rates
By Peter A. McCullough, MD, MPH
Someone asked me about the Adam’s apple and elective voicebox surgery performed on men who are seeking transgender change to appear more like women. I know this is a delicate structure and susceptible to physical injury of the vocal cords and the nerves after medically necessary surgery is done for polyps and laryngeal cancer. It was not a surprise to learn about unacceptable rates of damage to the voicebox when unnecessary surgery is done on a man who desires to fool others using surgery to look and sound like a woman.
Nuyen et al, performed a consecutive chart review, of the 94 men with prior outside history of chondrolaryngoplasty, 27 (29%) reported chronic postoperative hoarseness, deepened pitch, or loss of upper register. On endoscopy, short, lax vocal folds with persistent anterior glottic gap and phase asymmetry were commonly noted; anterior commissure dislocation was confirmed in-office by using needle localization through absent thyroid cartilage. After open resuspension of the anterior commissure with feminization laryngoplasty, post-repair modal-speaking, minimum, and maximum fundamental frequencies (F0) increased on average by 7, 8, and 5 semitones, respectively (p < 0.01), when compared to pre-repair values. On average, perioperative maximum phonation time did not change significantly (p = 0.15). Average self-assessment of vocal femininity increased modestly by 48% (p < 0.01).
These data suggest laryngeal surgery on normal men fails to produce vocal femininity to a large extent despite changing external appearance of the neck. Chondrolaryngoplasty on the normal larynx and third party payment for such procedures should be dropped.
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Interesting topic for certain. How often do you even hear the words Adams Apple? A gender clue?
Rebellion has it's costs, sin is its own reward. I am perplexed at how the thought/speech/behavior of us all has been crafted to produce such dysphoria among men, mainly, over their own existence. And am thankful that I and mine were spared such hell.
I pray/think/speak to God, hoping that the delusion will be lifted from these poor lost souls, that we may light a path of peace and joy, even mirth and celebration, at being allowed to repent and share His purpose to our lives with everyone we see and interact with.