CAROLINE YANG, MD; JAMES I. COHEN, MD; TOBY MELTZER, MD; DONNA GRAVILLE, PHD

PORTLAND, OREGON

Management of male-to-female transsexual patients is complex and requires a multidisciplinary approach. Vocal differences between men and women, such as pitch, are easily discernible; therefore, acquiring a feminine voice is helpful for these patients in being perceived as female. The purpose of this study was to quantify the pitch change in male-to-female transsexuals who underwent cricothyroid approximation and to measure patient satisfaction. Retrospective chart review of 52 transsexuals who had a cricothyroid approximation yielded 23 patients who had undergone sufficient preoperative and postoperative vocal testing. A self-evaluation questionnaire was used to evaluate satisfaction with vocal change. The mean postoperative elevation in fundamental frequency was +61.7 Hz after an average of 6.4 months of follow-up. Questionnaires were returned by 22 of the 23 patients and showed 68% of patients to be neutral to extremely satisfied with the operative results. These data show cricothyroid approximation to be effective in elevating pitch in the short term and patient satisfaction with the results to be favorable.