Nora played ice hockey in the selection of male changed his sex and became women’s team

His voice did not fit with her, but a surgeon of Malaga feminizó your ringer

The leaf of health of the patients ‘trans’

How to help a teen transsexual

When his wife found the clothes and the accessories of a woman that Nora was hiding in a box, your best kept secret has ceased. Although 60 years ago was born with physiognomy of male, she always felt it, but locked within itself. It was in that moment when his true identity began to cut a path in the face of others. He stripped himself of the ties and all that, until then, we were bound and he was defined as a man, by obligation and undertook a long-desired process of change, including the physical, that allowed him to be viewed as the woman you feel. The last step: transformation of your voice.

As a player of ice hockey since he was a teenager, first in a team of men that arrived to the Spanish team and after in women, his tone of voice was not a handicap. However, in his work as a commercial, when talking on the phone, the sound of his words, yes he was in degree of vulnerability and insecurity. “I felt a little self-conscious, thinking that others would believe that they were talking with a man. I weakened,” he says.

That was the main reason why, as eight years ago decided to go through surgery to reconstruct his genitals, the past month of march she put in the hands of a surgeon to touch up their vocal cords. “The first treatment that a woman passes a transsexual is hormonal -estrogen and anti-androgens – and this does not change the timbre of the voice, which generated enough frustration,” explains Ignacio Cobeta, chief of Otolaryngology, part of the Unit of Gender Identity that offers multidisciplinary care at the University Hospital Ramón and Cajal of Madrid.

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According to an article published by the ent doctor Elena Mora next to Cobeta in the scientific Journal Journal of Voice in 2017, this discrepancy between being a woman and listen to men generates uncomfortable situations, frustration, anxiety, anguish, they try to avoid the telephone, speak in public… In short, it restricts your social life.

For that reason, Nora decided to bet strongly and was subjected to the glotoplastia of Wendler, a type of surgery that involves shortening the length of the vocal cords, increase your voltage and reduce the mass to the timbre of the voice sounds more feminine. “It is a growing trend that does not require incision in the neck,” says the ent specialist Juan Carlos Casado, Hospital Quirón Health-Marbella (Málaga), maybe the greatest world expert in this technique and the surgeon who operated on Nora. “Few groups working on this. I have received people from Holland, Finland, Usa and South america.”

Also note that has been operated by many people from arab countries, where the stigma of transsexuality is still higher than in Europe. In Spain, there is no reference unit state, so that a lot of people have to undergo this surgery by private road, the price of which, including the speech therapy sessions, is around 5,000 euros. The goal of this technique is to modify the anatomy of the larynx. How? With previous general anesthesia via direct laryngoscopy suspended.

As stated Married, “is accessed through the mouth and make two stitches in the commissure and the anterior third of the vocal cords to reduce the length and increase the tension of the same. Then, by vaporization with a laser diode of the anterior surface of the vocal cords, it manages to reduce its mass.”

The intervention can last between 45 and 90 minutes. “Given the small space of the larynx, technically the work is very thorough,” explains Cobeta. Requires entry of a night and should maintain absolute rest during the first five days. “It is advisable to control the efforts vowels”, pointing Married.

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sometimes, the patients also want to remove the nut -or Adam’s apple – in the neck (through a small incision), associated precisely with the increased length of the larynx and the vocal cords male. “Those with a very deep voice usually have the well-known Adam’s apple,” says the surgeon.

it has already Been several months after the intervention, and Nora satisfied with the results: “it gives Me an aspect of voice more feminine, I feel more comfortable talking to people on the phone and in public, because I notice that people believe that they are talking to a woman, that is who you really are doing it”.

however, the first thing that experts recommend are a few speech therapy sessions. “We work to create a harmony between how you feel and your voice,” says Vanessa Sanchez, speech therapist, specialist in feminization of the voice in the Rehabilitation Clinic C. R. L., which collaborates with the Unit of Gender Identity, of the Hospital Ramón y Cajal. “We help them to improve their prosody and intonation, breathing exercises, relaxation and simulation of the daily activities, where, above all, they work on two aspects: the muscle, which has to do with the anatomy of the production of the voice, and the prosodic, that is related to the way you talk and deals with aspects such as the non-verbal language, intonation, expressions, or syntax”.

The changes start to be felt from the eighth class (two per week of 45 minutes each). “Around 20% or 30% you decide that with this approach have already been feminized enough to his voice,” says Cobeta. The other bet to go a step further and undergo an operation like that of Nora.

In the words of Cobeta, “with this surgery are shortened between two and four millimeters the vocal cords and can earn a 40 hertz of average fundamental frequency”, resulting in a voice with a higher tone, more sharp and more stereotypically feminine. The surgery linked to the speech of rehabilitation later, adds the specialist, “can you get the 75% of the women managed to improve after all the process multi-disciplinary”. The remaining 25% stated that they did not improve or be unsatisfied with the results. “It is a question of expectations and, in my experience, there is a certain random factor that we cannot control at 100%, as a abnormal scarring,” says the expert. “There are women with low tones of whose voice is very attractive in the means of communicationón”.

Before returning to the speech therapy sessions, must take at least 15 days. During this new approach, pointing to Vanessa Sanchez, “the procedure of work is the same. Clarify doubts after the operation and we refresh what they learned previously”.

To Nora, the feminization of the voice has been the last key to “being a woman in full”. Had many years of thinking in upload this final rung. Now that he has, he can’t be more satisfied. “It helps Me feel more secure. Since I don’t have to fake a voice more feminine throughout the day. It is very tired”, illustrated by Nora.

THE KEY DIFFERENCE IN THE tone OF VOICE

The key of the timbre of the voice is located in the approximately five millimeters of more that measure the vocal cords of men. To have greater length and more volume, they produce a sound more serious when they vibrate. “As a guitar, the notes are more acute when the portion vibrating is less”, compare Cobeta. The less the portion vibrating of the string, the greater number of undulations per second, which results in a fundamental frequency more high, own of the female voice. In trans men androgens yes get masculinize your vocal pitch, but in women, estrogen does not cause variation.

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