Trans and gender-diverse (TGD) individuals often seek gender-affirming voice care to support the development of a voice that aligns with their gender identity. For trans women, this often includes laryngeal surgery, particularly Wendler’s endoscopic glottoplasty, with adjunctive voice therapy to try and achieve a higher pitch and more feminine voice. This case series presents data from 58 adult trans women who underwent transoral microlaryngoscopys and glottoplasty followed by 10–14 days of strict voice rest, postsurgical stroboscopy and postoperative voice therapy. Acoustic measures outcomes, including fundamental frequency (sf0), range and spectral measures, and patient-reported outcome measures, were taken pre-surgery and between 3 and 6 months post surgery. Associations between acoustic and patient-reported measures were analysed but indicated heterogeneity within the sample. Analysis using a linear mixed-effects model demonstrated group-level improvement in fundamental frequency to a higher pitch. Spoken sf0, minimum and maximum sf0 and Trans Women Voice Questionnaire (TWVQ) showed improvement but spectral measures and phonation range deteriorated and there was marked individual variability of outcomes. The authors conclude that gender-affirming glottoplasty with postoperative voice therapy demonstrates individual variation in outcomes, but a group trend towards improved acoustic (sf0) and patient-reported outcomes. They stress the importance of multidimensional voice assessment for TGD patients to reflect more domains than sf0 alone.
What are the outcomes for people who undergo gender-affirming glottoplasty with postoperative voice therapy?
Reviewed by Gemma Clunie
Beyond Group Outcomes: Gender-Affirming Glottoplasty and Postoperative Voice Therapy.
CONTRIBUTOR
Gemma Clunie
BA (Hon), MSc, PhD, MRCSLT, Imperial College Healthcare NHS Trust; Honorary Research Fellow, Imperial College London, UK.
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