Voice change surgery in the transsexual.

Sexual reassignment surgery for individuals with gender identity confusion has been highly successful, especially in the male-to-female transformation. A troublesome problem for some of these individuals is the retention of their male voice. Although castration and estrogen therapy may produce minor elevations of pitch and the assumption of a falsetto voice produces a more typical but contrived female tone, the basic male anatomic structure of the larynx must be altered to effect a physiological transformation. In three transsexuals, an attempt was made to effect a more female tonal quality by shortening the vibrating length of the vocal folds. Through a laryngofissure, the anterior one third of each cord was denuded and the raw edges approximated. This produced an anterior web that successfully resulted in pitch elevation in all three cases.