Your voice is one of the most fundamental features by which the world recognizes and identifies you. It also plays a key role in how gender is perceived.
What determines whether a voice is perceived as male or female?
Just like a fingerprint, each voice is unique, and several characteristics together influence how it conveys gender. One of the most important factors is pitch—whether the voice is high or low. Pitch is primarily determined by the size of the larynx, the length, thickness, and tension of the vocal folds. However, pitch alone does not define whether a voice sounds male or female. Other anatomical and functional aspects, such as the size and shape of the chest, pharynx, oral cavity, and resonance spaces, also play an important role. In addition, speech rate and patterns of intonation contribute to the perception of gender. Altogether, pitch, pitch range, resonance, and intonation interact to form the “gendered quality” of a voice.
This becomes a challenge for transgender individuals, especially for transgender women, when their voice does not align with their gender identity. Beyond personal discomfort, a deep or masculine-sounding voice may lead to misgendering, unwanted attention, or even harassment.
Voice in transgender men (transmen)
For trans men, voice changes are often less problematic. During the physical transition process, testosterone therapy (hormone treatment) alters muscle structure throughout the body. Its effects on the larynx and vocal fold muscles typically lower the pitch, enabling the voice to be perceived within a male range.
In cases where the voice does not deepen sufficiently despite testosterone therapy and continues to be perceived as feminine, voice deepening surgery (relaxation laryngoplasty) under local anesthesia can be performed (see Voice Deepening). Additionally, voice therapy focusing on resonance and intonation training can help the voice be perceived as more masculine.
Voice in transgender women (transwomen)
For trans women, hormonal treatment and voice therapy are usually not enough to raise the pitch into a female-sounding range. In such cases, surgery becomes necessary. With growing awareness and availability of surgical options, more transgender women are seeking procedures to modify their voices.
The male larynx differs structurally from the female larynx: male vocal folds are typically longer, thicker, and less tense. As with guitar strings, thicker and looser strings produce lower tones, while thinner and tighter strings produce higher ones. Similarly, altering the length, thickness, and tension of the vocal folds makes it possible to raise vocal pitch.