He is a voice feminization surgeon who helps trans folks achieve voices that reflect who they are

Many of us may be familiar with gender-affirming surgery. However, only a few of us may be aware of voice feminization surgery. This is a process by which transgender women can achieve a voice that more accurately reflects who they are. To raise awareness about the procedure and answer any questions people may have, a voice feminization surgeon took to Reddit's "I Am A" forum, where experts hold question and answer sessions. Chadwan Al Yaghchi, who was trained as an ear, nose and throat (ENT) surgeon, developed a special interest in trans healthcare over the years and has since introduced a number of voice feminization procedures in the United Kingdom.

Some of the surgical procedures Al Yaghchi has introduced include his own modification to the Wendler Glottoplasty technique. He described this as "a minimally invasive procedure [that] has since become the preferred method for voice feminization." He wrote, "Working closely with my colleagues in the field of gender-affirming speech and language therapy, I have been able to help a significant number of trans women to achieve a voice which more accurately reflects their gender identity." He went on to encourage fellow Reddit users to ask questions about voice feminization, including but not limited to the role of surgery in "lightening" the voice, why surgery is the best route for some and how surgery, speech and language therapy work together.

One Reddit user asked, "Does a surgery like this move someone's whole vocal range up? Is it limiting somehow? (In the sense that they'll gain less pitch than they lose, if that makes sense.)" To this, Al Yaghchi clarified that there are two different procedures: glottoplasty and cricothyroid approximation. With the former, the whole range goes up although there are variations as some will have a wider or narrower range. With the latter, the vocal range gets significantly narrower. The surgeon warned, "Neither operation is recommended for professional singers as the impact could be considerable and possibly career-ending."

Another individual asked if trans men could deepen their voice. "Yes, there are options to make the voice deeper, mainly relaxation laryngoplasty (more commonly known as type 3 thyroplasty)," he responded. "However, this is hardly required in trans men as the voice drops naturally once they have started on testosterone replacement." The surgeon also contrasted surgery with traditional voice training methods. Ultimately, the results depend on who the patient is, Al Yaghchi clarified. He stated, "It varies from person to person. Some can achieve pitch elevation with therapy alone while others struggle or find the voice forced and the pitch difficult to maintain. Regardless therapy is always required for a good outcome of surgery." 

For those curious about the logistics of the surgery, Al Yaghchi shared details about how long it takes and what the recovery period is like. "The surgery including anesthetic time and waking up is around 60 minutes," he explained. "It is done as a day case where you go home after [a] few hours." And, he was careful to make sure everyone understood the risks of the surgery. He stated, "You will not end up mute, [but] there are general surgical risks such as bleeding pain and infection, there is a small risk of teeth damage, extremely small risk of laser injury. All these are small risks. Some people will have an excess inflammation of the cords that will require treatment and might lead to prolonged hoarseness. Finally, there are possible voice long term risks including, possible reduction of vocal volume which might impact the ability to shout and project the voice and long term hoarseness and strain which can be managed by speech therapy." If you are interested in learning more about the procedure, you can click this link to check out a resource from Mayo Clinic.