Voice Information 

   Date:    Sun, 20 Feb 1994 
   From:    Ed Sovik 
   Subject: voice

Some questions concerning voice surgery recently were posted
here on TRANSGEN  and I just wanted to throw in my two cents worth.
Someone mentioned a  voice surgeon in Philadelphia, PA who had
"accidently" discovered a new  procedure to help the T* community
with their problems in obtaining a  more feminine, and thus passable
voice. By the description presented, I  believe the person being
referred to is Robert T. Sataloff. He and his  team of speech pathology
professionals can be contacted by writing to  this address:  

Robert Thayer Sataloff, MD, DMA  1721 Pine Street  Philadelphia,
PA 19103  

In January 1992 he published an article in which he described
a patient  who previously had a thyroidectomy, and due to complications
while  healing developed a soprano voice even though the patient
was male and ad  a barr. Two years following the development of
a soprano voice, the patient  consultanted Dr. Sataloff to try
and retify the situation. To Sataloff's  suprise (and the T* community's
great fortune), apparently this person  experienced an overlapping
of the cricoid and thyroid cartilages after  his thyroidectomy
and these two tissues fused together during healing. The  consequent
effect was that his vocal pitch increased substantially (from 
112 Hz to 214 Hz). More complete details can be found in  

Sataloff, R. T.; J. R. Spiegel; L. M. Carrol; and R. J. Heuer.
"Male soprano voice: A rare complication of thyroidectomy."  _Laryngoscope_
1992 Jan, 102(1), pp90-93.  

Sataloff has subsequently termed this new procedure a "cricothyroid 
fusion." This should not be confused with with another similar 
procedure introduced by a Japanese surgeon in the early 1970s
(1973?)  known as a "cricothyroid approximation" which has also
be used to help  T* folk, albeit with limited and disappointing
results. Also, it is  apparently different from the procedure developed
by Toby Mayer in Beverly  Hills, CA of which I have scant information.
Anybody know of an article  on Mayer's technique?  

The problem for me herein is twofold: 1) money, and 2) reliability
of  results. To address the issue of money, we have all heard and
experienced  this one. Pertaining to this procedure, however, it
seems exorbitantly  expensive. When I contact dr. Sataloff in the
Summer 1993 about  doing the cricoid fusion procedure, he responded
by telling me  about the cricoid approximation procedure he was
willing to do.  In addition the cost was huge (I mean HUGE!). Depending
on the procedures  used for the diagnostic evaluation and whether
you spend a night in the  hospital, it could run as much as $12000-
15000 (this info is from when I  contacted him in Summer 1993 and
may be out-of-date). Hefty price tag to  sound like a girl! (Please
contact Dr. Sataloff directly for complete  details on procedures,
pricing, and the like.) For me this is way out reach  at present.

The problem of reliability of results is more significant, for
if it does  not work, then it does not matter how much money you
have. According to  one of the postings on TRANSGEN a few days
ago someone said that Sataloff  had performed 25 such operations,
and that only one was unsuccessful,  being completely reversible
in that event (which is what his article  states as well). The
same claim has been made for Toby Mayer's procedure  (nothing about
reversible from Mayer) in that he claims to experience a 95%  success
rate. Also, an article in _Chrysalis Quarterly_ speaks very  highly
of Dr. Mayer's procedure. However, I know of two (not knowing
them  personally, but only knowing of them, I realize this is heresay)
people here  in Seattle who went to Mayer who had highly undesirable
complications  (i.e., not being able to swallow). This seems like
a high rate of failure  for Seattle considering that this procedure
has only been performed a few  humdred times by Mayer and has a
95% success rate (as stated by  the literature provided by Mayer)
. This information about Mayer leads  me to question the data of
experimental procedures provided by service  providers as possibly
corrupted. I wonder what complications Mayer or Sataloff  have
experienced with their procedures that they may not want us to
know  about? Granted this line of questioning may seem a bit paranoid,
but  considering the possible consequences (i.e., permanent loss
of voice,  inability to swallow and thus eat, etc.), it is not

Is there anyone on TRANSGEN who has had M2F voice surgery? If
so could  you please relate your experience. Or if you have friend,
could you please  have her post a note about the experience so
that we may all gain from  it. Also, what other surgeons are doing
work in this area? I know of two  others, but do not have the info
available at this moment.  

For individuals unfamiliar with the literature on voice modification
for  the T* communtity, here are some references that I have found

   Oates, Jennifer; and Georgia Dacakis. "Voice, speech and language:
   Considerations in the management of male-to-female transsexualism,"
   in _Transsexualism and Sex Reassignment_ edited by A. W. Walters and
   Michael W. Ross. New York: Oxford University Press, (1986), pp82-91
   and pp171-174.

   An excellent place to start. A good overview with an very handy
   reference section. If the above Oates and Dacakis article is
   unavailable, try  obtaining its predecessor 

   Oates, Jennifer M.; and Georgia Dacakis. "Speech pathology
   considerations in the management of transsexualism: A review."
  _British Journal of Disorders in Communication_ 1983 Dec, 18(3),

   Other articles which are of interest include 

   Mount, Kay H.; and Shirley J. Salmon. "Changing the vocal
   characteristics of a postoperative transsexual patient: A
   longitudinal study." _Journal of Communication Disorders_ 1988,
            21, pp229-238.
   Mahieu, H. F.; and H. K. Schutte. "New surgical techniques for
   voice improvement." _Archives of Otorhinolaryngology_ 1989,
            246(5), pp397-402.
   Gunzburger, Deborah. "An acustic analysis and perceptual data
   concerning voice change in male-female trans-sexuals." _European
   Journal of Disorders of Communication_ 1993, 28(1), pp13-21.
   Wolfe, V. I.; D. L. Rutusnik; F. H. Smith; and G. Northrop.
   "Intonation and fundamental frequency in male-to-female transsexuals."
   _Journal of Speech and Hearing Disorders_ 1990 Feb, 55(1), pp43-50.

   The article by Mount and Salmon (1988) was very interesting to
   me because  it was the first time (and only) I had seen in the
   professional literature  of a formal method being presented to
   assist T* client through  non-surgical means. I also have another
   article that happens to be in  ** Italian **, and thus I am looking
   for a translator. Anybody out there?  

   Any questions or comments concering this posting, feel free to
   e-mail me  directly or post stright to TRANSGEN.  

   Kathryn Forester  University of Washington (Seattle)  dullard@u.


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