VOICE IN TRANSITION

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The voice is an important part of one's identity. When the voice does not fit the perceived gender we speak of gender dysphonia. Changing the voice and communication is often a part of transition. 

Men on average have a lower pitch than women (on average 120Hz). This is because men have a larger voice box (larynx), so their vocal cords are longer and thicker. The vocal cords vibrate more slowly leading to a lower voice. Women have shorter and thinner vocal cords, leading to a higher average vocal pitch (220Hz on average). In between is a zone where it is difficult for others to distinguish whether the voice is female or male (150-185Hz). We call this the gender ambiguous zone. 

Besides pitch, there are many other aspects that make your voice sound more masculine or feminine (e.g., resonance, loudness, intonation, etc.).

If you are not satisfied with how your voice sounds, you can visit us for examination and treatment.

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HOW ABOUT THE EXAMINATION?

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The voice organ and its function are examined by a ENT-specialist and a voice therapist (speech therapist). The vocal apparatus has 3 functions: breathing, protecting the airway during swallowing, and voicing. Every human being depends on these 3 functions every moment of the day.

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In addition to a thorough questioning and clinical examination of the neck, a visual examination of the vocal cords (laryngoscopy) is done at rest and during voicing. This is supplemented by a stroboscopy, an examination in which the vibration pattern of the vocal cords is slowed down by means of short flashes of light and thus displayed in greater detail.

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Then we listen to the vocal tract and vocal capacity and an objective vocal examination is done. Among other things, we let you tone glide, vocalize softer or louder, sing softly in the head voice, etc. to find out what is possible with your voice. We also examine aerodynamic parameters (maximum phonation time), acoustic perceptual parameters (e.g., habitual speaking pitch, voice quality as a function of change intensity and pitch) and vocal range (intensity and frequency dynamics).

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In addition, we examine your expectations and wishes with regard to your voice using a number of questionnaires and an interview.

SPEECH THERAPY

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Therapy for trans women usually starts with the inclusion of the female gender role, because then there are plenty of opportunities to practice in everyday life. However, trans men can also benefit from speech therapy, especially if they often sing.

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In speech therapy, very step-by-step learning is done to speak at a pitch appropriate for you. After learning to hear differences in pitch, it builds up systematically, going from sounds to words, automatic sequences (counting, listing days of the week, etc.) reading, and conversation to finally spontaneous speech in real communication situations.

 

Attention is also paid to other aspects such as pitch variation, articulation and, recently, resonance. In addition to the verbal aspects of communication, non-verbal communication is an essential part of our communication. During the training, extensive attention is paid to this as well.
 

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HORMONES 

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In female-to-male transition, the vocal cords become thicker and longer under the influence of male hormone treatment, a process that also occurs during natural male puberty. As a result, the voice becomes deeper.

 

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VOICE SURGERY

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These surgeries are mainly performed on transgender patients when there is insufficient vocal increase after intensive speech therapy. There are several techniques for this, of which we prefer the Wendlerglottoplasty as it is the least invasive. The vibrating part of the vocal cords is shortened by inserting a web at the front of the vocal fold which raises the pitch of speech. This procedure is performed under general anesthesia via day hospitalization.

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Read more here: Pitch Elevation in Trangendered Patients: Anterior Glottic Web Formation Assisted by Temporary Injection Augmentation

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