Shortly after the top surgery it was clear that there were people still misgendering me. While I’d most often been addressed as “sir” before surgery, I was finding that “ma’am” was creeping into the picture a little more than I liked. Frankly, I didn’t like it one bit. I’d always had the issue over the phone but in person it hadn’t been so common in the past. I thought that if my voice pitch was lower – more masculine – this problem would go away.
My therapist gave me the name of a group of voice specialists to contact to see what kind of vocal therapy they could offer that would help with my problem. I contacted them immediately and got on the schedule to see a vocal therapist/doctor. The nurse said that I’d also need a physician’s referral for therapy so during the same visit I met with the surgeon who heads the department – he would be my referral.
The initial consult with the vocal therapist was filled with discussion about specific therapies for female to male transition. We also discussed that any work we did would need to ensure that I would still be able to sing when all was said and done. We were all on the same page and agreed that the initial focus would be on vocal exercises to drop my pitch, then we would work to adjust speech patterns to integrate more “male” attributes. They sent a scope into my nose to record the inside of my throat and capture the movement of my vocal cords as I recited specific words, phrases, and sounds. They measured my hertz level to determine where my current pitch fell within the female and male level indicators. As it turned out, I was not far out of the male range at all. We immediately began the vocal exercises. I was given printed sheets to take home and practice and instructed to return in two weeks to monitor and record progress.
After I’d finished with the vocal therapist, the surgeon examined me and discussed options for dropping my voice pitch. He watched and listened to the video that had just been recorded of my voice. He explained that I had three options available to me: vocal therapy exercises, hormone replacement therapy – testosterone, or a surgical procedure. I’d discussed the first two options just minutes before with the vocal therapist and since I’d already decided that testosterone wasn’t the way I wanted to go; we began the therapy. I asked the surgeon to explain the surgery he’d proffered. He explained it was called thyroplasty and was a relatively simple procedure where they make an incision on your neck, cut the cartilage near the Adam’s Apple and enter the voice box. Then with a couple of snips and stitches adjust the vocal cords to drop the pitch. It seemed simple, but kind of extreme; and since this was the first I’d heard of a surgical option, I thanked him and I told him I would first like to try the vocal exercises to see if they worked.
I was all set to spend the next two weeks working on the vocal exercises. It was repetitive work and a couple of days into the process I could hear a slight change in my voice. My pitch seemed to be dropping and I was motivated. On the third day my voice started getting hoarse and sore. I was doing exactly what the doctor had instructed, but I could tell that the only reason my pitch was dropping was because I was tiring my vocal cords. Regardless, I kept going. I wasn’t sure if this was normal at the beginning. We hadn’t discussed this, but I knew it wasn’t going to be an easy process. I returned to the doctor’s office after two weeks as planned. The doctor could easily hear that my voice was compromised and when looking at my throat, saw the irritation and knew I was in pain. He said to stop the exercises to let my voice rest and return in two weeks. He would have a new plan for me.
Three days later my voice was returning to normal. I’d kind of liked the drop in pitch that the hoarseness had given me, but that was now gone. I didn’t like the idea of starting over, but that was what was happening.
After two weeks of vocal rest I was feeling a bit frustrated for having to start over; but I was hopeful that the doctor would have a good plan in place to move forward and maybe get back on track. That didn’t seem to be the case at all. His solution was a new series of repetitive exercises. The only difference was to slow down the process and hope to see improvement without aggravating my vocal cords this time. He then explained that I would likely have to consciously practice these audible adjustments ongoing – anytime I spoke. He explained it was unlikely – although not entirely out of the question – that muscle memory would take over and give me the deep voice I wanted. He also thought it best to focus on speech pattern and articulation than pitch. Essentially, I would be pretending to have a masculine voice instead of actually having one. This was not what I was looking for at all.
I considered the fact that I’d only been at the vocal therapy for a short while and while I was sitting there with the scope recording my voice again, I weighed my options. It was time to look seriously at surgery. I told him that was the direction I thought would be best for me. He brought up testosterone again as an option, but agreed that I was a good candidate for the thyroplasty. He said he would have the nurse contact the insurance company and call me to get on the surgeon’s calendar. More surgery was not in my original plan, but I’d waited so long to transition and I was on board for anything that might speed the process and give the best results. This looked to be the best next, and hopefully, final step.