Just as each voice is unique like a fingerprint, so too are the larynx and vocal folds. The size and shape of the larynx, as well as the length and thickness of the vocal folds, vary significantly from person to person. Therefore, the surgical intervention(s) required for pitch elevation in transgender women must be individualized.
For some patients, a single surgical technique may be sufficient to achieve a feminine-sounding voice. In others, two or more procedures may need to be performed together in the same session. In certain cases, surgeries are staged and carried out at intervals of 9–12 months. Close communication with the surgeon, sharing concerns and expectations openly, is essential for navigating this long and challenging process successfully.