Several surgical procedures are available to alter a person's voice, the most common being Crico-thyroid Approximation (CTA) [source: Lawrence.] This outpatient surgery is aimed at stretching the vocal cords by pulling and suturing two pieces of cartilage together. Other procedures involve cutting the vocal cords to make them shorter or using a laser to scar a section of the vocal cords, resulting in increased tightness and a higher pitch. A more invasive surgical procedure, which has been shown to create a more feminine sound, not only calls for cutting the vocal cords but also removing a section of thyroid cartilage so the vocal cords are both shorter and tighter [source: Lawrence].
Now, let's discuss recovery and risks. Transgender voice surgery will leave a small scar on the neck where the incision was made; it's barely noticeable. Soreness and hoarseness, however, are quite common and the patient will probably have a lower sounding voice in the short term during the healing process. This is because of the swelling and temporary scarring, which is similar to what a person experiences when battling laryngitis or a bad cold. For this reason, patients are encouraged to rest their voices for approximately two weeks [source: Thomas].
The decision to undergo transgender voice surgery can be life-changing. Post-recovery, many patients express shock at how much their identity was tied to their previous voice. Transgender voice surgery can do more than change your current voice from masculine to feminine -- it can lead to an entirely different voice that has few, if any, of the characteristics that you previously associated with yourself. This is particularly problematic for someone like a singer or speaker who depends on his voice for professional or recreational reasons. A formerly strong and resonant voice can become hoarse, weak and lacking in pitch variation. Speech therapy can be of help in this area but cannot "cure" the issue [source: Constansis].
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