Voice Care

Michigan Medicine is proud to provide comprehensive voice care services to the transgender community. We offer specialized therapy and vocal cord surgery to help patients communicate in a way that is more aligned with their gender identities.

To initiate care, please ask your doctor for referrals to Speech Pathology and Otolaryngology (Ear, Nose, and Throat). Ask your provider to indicate that you are seeking transgender voice and communication treatment in the referral notes.

During your evaluation, you will have visits with both a speech pathologist and a laryngologist (a specialized ear, nose, and throat doctor). During these visits, we will assess your voice with tests such as videostroboscopy (allowing us to see how your vocal cords work) and perceptual/acoustic voice analysis (allowing us to assess the functional capabilities of your voice). This will allow us to determine the optimal treatment plan for achieving your voice goals.

It is best to reach out to your insurance company and verify whether they cover voice/speech therapy for gender affirmation. We do offer some self-pay options for individuals without coverage.

Many patients find voice therapy is highly successful in helping them achieve a voice that reflects their identity. For others, vocal surgery can be added to further modify the voice’s pitch. Examples of gender-affirming voice surgeries performed at Michigan Medicine:

Voice-Feminizing Surgery:

  • Wendler Glottoplasty/Feminization Glottoplasty: This is an incisionless surgery performed through the mouth under anesthesia where a small controlled scar is created between the vocal cords, which shortens them and raises the pitch of the voice.
  • Laser-Assisted Voice Adjustment (LAVA): This is an incisionless surgery performed through the mouth under anesthesia where a laser beam is applied to the vocal cords to make them thinner, raising the pitch of the voice.

Voice-Masculinizing Surgery:

  • Type III Thyroplasty: This is a surgery performed with a small incision in the neck where the tension is reduced on the vocal cords, lowering the pitch of the voice.
  • Vocal Cord Augmentation: This is an incisionless surgery performed through the mouth under anesthesia a filler (typically, your own fat) is injected into the vocal cords to make them thicker, lowering the pitch of the voice.

If you are potentially interested in gender-affirming vocal cord surgery, we recommend submitting a formal service inquiry through the CGSP by calling 734-998-2150 to help you determine if voice surgery is a covered benefit and any insurance requirements for coverage. Similar to other gender-affirming surgeries, most insurance companies require you to have one of two letters of support from mental health providers.