Undergoing HRT causes various desired outcomes, and one of the possible impacts is the changing of your vocal chords, and thus, your voice.

Hormone replacement therapy (HRT) is a vital part of the gender transition process for many transgender people. While HRT can bring about significant physical and emotional changes, one aspect that often concerns singers or aspiring musicians is its potential effect on the singing voice.

When transmasculine individuals undergo HRT with testosterone, they often experience a significant change in their voice. The hormone leads to vocal masculinisation, which involves the thickening and lengthening of the vocal cords. This results in a deeper, more traditionally masculine voice. The degree of vocal change varies from person to person.

Singers who transition through testosterone may experience challenges in adapting to their new vocal range. It may take time and effort to retrain their voice and develop new vocal techniques to accommodate the lower pitch. Some singers may lose some of their higher vocal range, but with practice and vocal training, they can still sing and perform effectively. It's important to work with a vocal coach or speech therapist who can help navigate these changes.

For people who are transfeminine and take oestrogen, this hormone primarily affects secondary sexual characteristics, such as breast development and fat distribution. Unlike testosterone, oestrogen does not have a significant effect on the voice, meaning that there are generally no significant changes to the vocal range.

How can you preserve your singing voice while being on HRT, especially if you take testosterone?

To preserve your singing voice while on HRT, especially if you're taking testosterone, you can consider the following strategies:

  • Vocal training- Working with a vocal coach or speech therapist who specialises in voice therapy is important. They can help you adjust to your new vocal range, develop new singing techniques, and maintain your vocal health.
  • Vocal exercises- Regular vocal exercises help maintain and strengthen your voice. These exercises can improve vocal range, flexibility, and control.
  • Stay hydrated- Proper hydration is essential for vocal health, so drink plenty of water to keep your vocal cords lubricated.
  • Rest- Give your voice adequate rest to prevent strain or injury.
  • Avoid smoking and excessive alcohol- Smoking and excessive alcohol consumption can be harmful to your vocal cords. Avoid these habits to maintain vocal health.

Does taking a low dose of testosterone help preserve your singing voice?

Taking a low dose of testosterone can help preserve your singing voice compared to a full dose. A lower dose of testosterone results in less dramatic changes in vocal pitch and quality. However, it's important to note that individual factors such as genetics and the duration of hormone replacement therapy (HRT) still influence the effect of testosterone on the voice. While a lower dose might be less impactful, more is needed to guarantee a complete preservation of the original voice. Vocal training and therapy can still be valuable in adapting to any changes.

How does low-dose testosterone affect your voice differently compared to taking the full dose of testosterone?

The amount of testosterone taken can impact the rate and extent of voice changes. If a lower dose is taken, the changes will be more gradual and subtle, allowing some people to maintain a voice closer to their pre-HRT voice. A full dose, on the other hand, can result in more pronounced changes, leading to a deeper, more traditionally masculine voice. However, the extent of the change can vary significantly from person to person, and even with a lower dose, some may still experience noticeable differences in their voice, though to a lesser degree.

It takes time and practice to adapt to a new vocal range. Transgender people undergoing hormone replacement therapy (HRT) should be patient with themselves and practice regularly to strengthen their voices and become more comfortable with their new range.

Regular vocal exercises and warm-ups are essential in maintaining vocal health and flexibility. These exercises can help individuals extend their vocal range and improve their vocal control.

What voice surgeries are available?

Some people may consider voice surgery. These surgical procedures can achieve a more desired vocal pitch and quality. However, surgery is an irreversible step and should be carefully considered.

Here are some common voice surgeries:

  1. Voice feminisation surgery (VFS) is a procedure that aims to raise the pitch of the voice. The surgeon shortens the vocal cords during the procedure, which increases the vocal pitch and typically results in a more traditionally feminine voice. This surgery is usually minimally invasive and performed using endoscopic techniques. The recovery time is relatively short, and individuals undergoing VFS typically receive voice therapy afterwards to fine-tune their vocal skills.
  2. Voice masculinisation surgery (VMS) is a procedure that aims to lower the pitch of the voice. During this surgery, the vocal cords may be lengthened, or the cartilages in the larynx may be altered to achieve a deeper, more traditionally masculine voice. This procedure is generally more complicated than vocal feminisation surgery and may require a longer recovery period. It is recommended that individuals undergo voice therapy after the surgery to help them adapt to their new voice.
  3. Cricothyroid approximation (CTA) surgery is a technique used to alter the pitch of the voice. During the procedure, the surgeon adjusts the cricothyroid joint to change the length and tension of the vocal cords, which can result in a higher or lower pitch. The cricothyroid joint connects the cricoid (laryngeal cartilage) and thyroid cartilage. Its function is to adjust the pitch of the voice by regulating the tension of the vocal cords. This surgery is less common than VFS or VMS and is performed in specific cases.
  4. Femlar (feminising laryngoplasty) is a technique developed explicitly for voice feminisation. It involves modifying the laryngeal cartilages and tissues to achieve a higher pitch and more feminine vocal quality.
  5. Glottoplasty raises the pitch of the voice by modifying the shape and size of the vocal folds, sometimes with implants.

Undergoing HRT can have an impact on a person's singing voice. However, transgender people can maintain their singing abilities and continue their passion for music with determination, vocal training, and support. It's important to understand that the effects of HRT on the voice can vary from person to person. Thus, finding what works best for you is a unique and personal journey that may require patience and perseverance. With the right guidance and effort, it is possible to harmonise your voice with your authentic self.