Voice Therapy and Surgery

People who are transitioning may want to modify the way they speak to better align with their gender. The Center for Gender Surgery at Boston Children’s Hospital offers patients access to voice services as part of their gender journey. We work with clinicians from the hospital’s Voice and Velopharyngeal Dysfunction Program to fully evaluate and address vocal concerns that can occur as part of the gender transition process.

What to expect

A typical appointment takes up to two hours, including meeting with an otolaryngologist and a speech language pathologist. The evaluation includes both a general medical and an otolaryngologic-specific history as well as an examination performed by one of our physicians. The examination will likely include a scope evaluation to look at your vocal cords or voice box. We will obtain an acoustic measurement, or digital recording, of your voice, which allows for interpretation of fundamental frequency, range, loudness and other characteristics. Our speech language pathologist will assess the tone, resonance and pitch of your voice, as well as your language and interpersonal communication (pragmatics) through word choice, phrase structure and intonation.

Based on our findings and your goals, we will then help you alter these aspects of voice in a way that allows you to safely achieve a voice that better aligns with your gender identity. Many patients can learn to safely alter their voice without the need for surgery. However, some patients may benefit from surgical modifications, which may include surgery to help raise the pitch of your voice (Wendler glottoplasty). These surgeries can be combined with surgery to alter the appearance of the Adam’s apple (tracheal shave). Our clinicians will discuss the most appropriate options with you.