No one would know I paid a scientist to slit my throat like a cartoon pirate. You all know money isn’t my favorite subject about these things, because it is awkward. There are the haves and the have nots, and I don’t want to seem boastful. You would never know it by the US president, but in the US there is a taboo against discussing how much something cost you, how much you spent, or how much you have. Even to your own children or parents, these things are considered the most private thing.
However, taboos have never stopped me from showing my genitals to 161k people I haven’t met. Why should money be more sensitive? There’s a postop sensitivity joke in there somewhere.
I have to say, by the time I got this voice surgery, I was no longer on my amazing insurance. It would have been free, covered under my Out or Pocket Máximum for the year. If you’re not from the USA: our insurance system is the most twisted capitalist scam. But I digress.
Instead of paid, it cost me about $3,200 to the hospital and $700 separate surgeon fees. The total bill if I had paid cash would have been $25k— or maybe they would have negotiated with me if I had brought cash. Sometimes if you’re paying cash, the trans ally surgeon will take you to a less expensive outpatient center to save costs over Johns Hopkins Hospital’s grand operating theaters. There must be twenty professionals in the room at any time.
Well, here’s the throat all healed up. I don’t think my voice will settle any more from this point. What I have now is what I’ll get. My total drop since pre-Testosterone is three to four octaves. Testosterone gave me one octave drop, maybe 1.5; surgery gave me another 2.5 octaves.
I get asked often if I tried voice therapy. I did. It helped a little, maybe 5-10% if I focused on it hard. Surgery helps 100% of the time and I never have to think about it. I can’t sing anymore, and my voice can’t get loud anymore— but high price was worth it for me.
I dread the spade of trans people in the future who might say flippantly, “I want a passing voice, but I don’t know if I want to lose my singing voice.” Ok. Don’t have this surgery unless you NEED it. If you aren’t certain you’d sacrifice nearly anything, don’t do it. Every sound out of me that outed me, that made people distrust me for the mismatch, that made them subconsciously uncomfortable—
I would rather have lost the ability to speak entirely than gone on like that. It didn’t matter to me that I didn’t know what it would sound like. As long as the new voice didn’t come out of me like a female stranger? I could take the plunge into the unknown. YES, I miss singing… in a way that puts fractures in my heart— but in a way, I never could sing with a voice that didn’t hurt me to hear. So, as much as I had sung, I never really had my own singing voice to lose. The strength of my speech will have to repair those fractures. I chose this. I wanted it. I accept. I do not regret it, despite the costs.
The physical scars, only I know where they are— and now you:
nestled into the lowest wrinkle above my collarbone.
I have nothing like lingering pain or sensitive places. The risk of surgical complications is low, but the risk of postoperative drawbacks was certain. We expected those and accepted them ahead of time.
The recovery was emotionally trying, in full silence a week, trying not to speak the second week, speaking as little as possible the next month. I sounded hoarse for three months at least— people kept asking me irritatingly if I had a cold. Maybe up until six months. By that point I had 80-90% of my final speaking range. I expected my singing range to keep growing, and I went to voice therapy to explore ways to grow. Ultimately, what I have is what I have: around 8 pitches, singing and speaking.
I played an old recording of my voice pre-operatively then spoke in the present. These are the graphs a free app made for me, Voice Pitch Analyzer. Take what you will from it.
I asked my spouse what it is like that my voice is different. Passing the keyboard so you can hear from them directly:
“ At first, their voice was quiet and strained. But that is because I was their partner through the recovery, I heard every stage. Gradually, their voice got stronger and clearer until it settled into the voice I hear daily.
“As someone who has struggled with vocal dysphoria being a trans woman, I’m thrilled when @Enbytex gets a correct gender on the phone, at a drive through, etc. The biggest change is not the pitch— though the pitch has been changed significantly— but the strength. Their voice is quieter now? Maybe? Or maybe it just resonates at a frequency that the google-home assistant curiously can’t seem to detect (first world problems).
“I try to help as much as I can, elevating the volume of my voice for theirs. But that new voice is rich and resonant. Even so, it’s still the voice of the person I love. Richer tones now and that with a history too. I like the deeper tones and even the smaller sounds that come out in these new pitches.”
Voice surgeon, Dr. Simon Best, otolaryngologist at the Johns Hopkins Hospital in Baltimore, Maryland, USA; member of the Johns Hopkins Center for Transgender Health.
Johns Hopkins Center for Transgender Health, Chief medical director, Dr. Devin O’Brien Coon, plastics, facial reconstruction, and microsurgery.
Voice therapist, Ashley Davis, Speech Language Pathologist and Voice Therapist, Johns Hopkins and JHCTH.
Do I recommend? Absolutely. Among the most skilled in the world. Drawbacks, the waiting lists, they’re slow to call back and you have to reach out again, and sometimes they have to reschedule dates. If you go in knowing that, it’s easier. Jhcth@jhmi.edu is the way to get in touch.