This study investigates the short- and longer-term effects of glottoplasty up to six months after surgery on acoustic voice parameters, listener perceptions, and client's satisfaction in trans women. Secondly, the impact of chondrolaryngoplasty and voice therapy on the glottopasty outcomes was investigated.
A prospective longitudinal non-controlled trial was used. Thirty-five trans women undergoing glottoplasty or a combination of glottopasty and chondrolaryngoplasty were included in this study. A voice assessment was conducted before surgery and 1 week, 1 month and 6 months after surgery. The following outcome parameters were measured: fundamental frequency (fo), intensity, frequency and intensity range, Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Voice Handicap Index (VHI), Trans Woman Voice Questionnaire (TWVQ), and visual analogue scales (VAS) measuring client's satisfaction. Listener perceptions of masculinity-femininity were collected using a listening experiment.
Significant differences over time were found for all fo and intensity parameters, DSI, AVQI, VHI and TWVQ scores. Listener perception and self-perception of femininity was higher after surgery. Significant differences in evolution of listener perceptions were found between the groups with and without voice therapy.
Glottoplasty improves voice related quality of life and is an effective method to increase the fo and associated perceptual femininity. After glottoplasty an immediate and short-term decrease in voice quality, vocal capacity and frequency range was measured with a progressive recovery on the longer term. Long term side effects of glottoplasty are a reduction in speaking intensity and intensity range. Voice therapy seems to improve the outcomes of glottoplasty, but should be further investigated in future studies.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Voice
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Voice perceptions and quality of life of transgender people.J Voice. 2011; 25: 553-558
- Voice in female-to-male transsexual persons after long-term androgen therapy.Laryngoscope. 2014; 124: 1409-1414
- Hormone treatment of the adult transsexual patient.Horm Res. 2005; 64: 31-36
- Voice, articulation, and prosody contribute to listener perceptions of speaker gender: a systematic review and meta-analysis.J Speech, Lang Hear Res. 2018; 61: 266-297
- Effects of speech therapy for transgender women: A systematic review.Int J Transgender Health. 2021; 22: 360-380
- The role of voice therapy and phonosurgery in transgender vocal feminization.J Craniofac Surg. 2019; 30: 1368-1375
- Effect of Endoscopic Glottoplasty on Acoustic Measures and Quality of Voice: A Systematic Review and Meta-Analysis.J Voice. 2023; 37: 117-127
- A new conceptual approach for voice feminization: 12 years of experience.Laryngoscope. 2017; 127: 1102-1108
- Transgender phonosurgery: a systematic review and meta-analysis.Otolaryngology–Head Neck Surg. 2017; 156: 803-808
- Effect of Wendler Glottoplasty on Acoustic Measures of Voice.Laryngoscope. 2021; 131: 583-586
- Pitch elevation in trangendered patients: anterior glottic web formation assisted by temporary injection augmentation.J Voice. 2014; 28: 816-821
- Vocal tradeoffs in anterior glottoplasty for voice feminization.Laryngoscope. 2021; 131: 1081-1087
- Botzer M,et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7.Int J Transgender. 2012; 13: 165-232
- Calibration of clinical audio recording and analysis systems for sound intensity measurement.Am J Speech Lang Pathol. 2015; 24: 608-618
- Nasaliteitsmeting met de nasometer.Logop Foniatr. 1991; 63: 97-101
Boersma PPG Praat, a system for doing phonetics by computer. Glot Int. 2002;5. 341-345.
- Mertens F, et al. Evaluation of the vocal performance of children using a voice range profile index.J Speech, Lang Hear Res. 1998; 41: 232-238
- Molenberghs G, et al. The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach.J Speech, Lang Hear Res. 2000; 43: 796-809
- De Bodt MS, et al. The dysphonia severity index used with a percentage scale.Stem, SpraakTaalpathol. 2002; 11: 30-37
- Van Cauwenberge P,et al. Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels.J Voice. 2010; 24: 540-555
- Minor BL, et al. The REDCap consortium: Building an international community of software platform partners.J Biomed Inform. 2019; 95: 103208
- Dutch (Flemish) version of the trans woman voice questionnaire.Vakgroep Spraak-, Taal- en Gehoorwetenschappen. Ghent University, Belgium2016
- Oates JM, et al. Development and preliminary evaluation of the transsexual voice questionnaire for male-to-female transsexuals.J Voice. 2013; 27: 312-320
- Musschoot S, et al. The voice handicap index: an instrument for the quantification of psychosocial consequences of voice disorders.Logopedie. 2000; 13: 29-33
- The Voice Handicap Index (VHI) development and validation.Am J Speech Lang Pathol. 1997; 6: 66-70
- Practical Statistics For Medical Research.New York, USA; CRC press, 1990
- Pitch elevation in male-to-female transgender persons-the würzburg approach.J Voice. 2017; 31: 244.e7-244.e15
- Who or what has the capacity to influence voice production? Development of a transdisciplinary theoretical approach to clinical practice addressing voice and the communication of speaker socio-cultural positioning.Int J Speech Lang Pathol. 2020; 22: 559-570
- Effect of Wendler glottoplasty on voice and quality of life of transgender women.Braz J Otorhinolaryngol. 2023; 89: 22-29
- Addition of Wendler glottoplasty to voice therapy improves trans female voice outcomes.Laryngoscope. 2021; 131: 1588-1593
Casado JC, O'Connor C, Angulo MS, et al. Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment. Acta Otorrinolaringol Esp. 2016;67:83–92.
- Glottoplasty for male-to-female transsexualism: voice results.J Voice. 2011; 25: 120-123
- Effects of Gender-confirming Pitch-raising Surgery in Transgender Women a Long-term Follow-up Study of Acoustic and Patient-reported Data.J Voice. 2019; 33: 781-791
- Anterior glottic web formation for voice feminization: experience of 27 patients.J Voice. 2017; 31: 757-762
- An examination of vocal tract acoustics following wendler's glottoplasty.Folia Phoniatr Logopa. 2019; 71: 24-28
- Chondrolaryngoplasty in transgender women: Prospective analysis of voice and aesthetic satisfaction.Int J Transgender Health. 2021; 22: 394-402
- Cohen WA, et al. Esthetic reduction of the thyroid cartilage: a systematic review of chondrolaryngoplasty.JPRAS Open. 2019; 22: 27-32
Published online: February 10, 2023
Accepted: January 12, 2023
Publication stageIn Press Corrected Proof
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.