Voice feminisation surgery (Wendler’s glottoplasty)

Voice feminisation surgery is designed to raise the pitch of your voice by changing how your vocal folds (vocal cords) vibrate. At The London Clinic, the main technique used is Wendler’s glottoplasty, which is usually combined with laser reduction surgery, to create a shorter vibrating length of the vocal folds so that the voice sounds higher.

During Wendler’s glottoplasty, a small section at the front of the vocal folds is carefully joined together to form a “web”, which reduces the part of the folds that vibrates when you speak and raises the pitch of the voice. The surgery is performed under general anaesthetic using delicate instruments through the mouth, so there are no external cuts on the neck.

For many people, voice is a key part of gender expression, and a voice that feels “out of sync” with gender identity can cause distress, dysphoria or loss of confidence. Voice therapy can make a major difference, but some patients still feel their voice is regularly misgendered or hard to maintain in everyday life and look for a more permanent change.

Voice feminisation surgery may be considered if:

✔ You are a transgender woman, non‑binary person or someone whose gender identity is not aligned with your current voice and you wish to achieve a higher, more typically feminine pitch

✔ You have completed, or are undertaking, structured voice therapy and remain dissatisfied with the pitch or stability of your voice

✔ Your voice contributes to gender dysphoria, anxiety or reduced confidence in social or professional settings

✔ You have healthy vocal folds and realistic expectations of what surgery can and cannot change (pitch vs resonance, loudness, expression)

Glottoplasty may not be suitable if you have ongoing vocal fold disease (such as nodules, scarring or inflammation), rely on a very wide vocal range for work (for example, professional singers or some teachers), are unable to commit to strict voice rest and post‑operative therapy, or have not yet tried voice therapy.

Vocal feminisation surgery can raise the average speaking pitch and support a voice that is more closely aligned with your gender identity, which may improve comfort, confidence and reduce gender dysphoria.

Potential benefits for suitable patients include:

✔ A higher, more typically feminine speaking pitch

✔ Results that are generally long‑lasting once healing is complete and therapy is finished

✔ Support in feeling more congruent between your voice, gender identity and social presentation

✔ A tailored surgical and therapy plan, with options to combine Wendler’s glottoplasty and laser reduction surgery where appropriate

✔ Care from ENT and laryngology specialists experienced in gender‑affirming voice work, supported by speech and language therapists and a wider multidisciplinary team

All surgery on the voice carries risks, and it is important to balance the potential benefits with a clear understanding of what surgery can and cannot do. Your surgeon and speech therapist will discuss these in detail and check that expectations are realistic before you decide to go ahead.

General risks of any operation and anaesthetic can include:

• Bleeding, infection and pain or discomfort after surgery
• Reactions to anaesthetic medications or other complications related to your general health

Risks more specific to voice feminisation surgery can include:

• Hoarseness, roughness or breathiness of the voice, that can persist after surgery
• A voice that is higher in pitch but still not as feminine as you had hoped, or that sounds less natural than expected
• Loss of some lower pitch range, making it harder to produce a deep voice when desired
• Vocal fatigue or reduced loudness, especially if the voice is overused during recovery
• Scar formation or other changes to the vocal folds that may require further treatment
• Need for ongoing speech therapy after surgery to stabilise and safely use the new voice

At The London Clinic, Wendler’s glottoplasty is performed using fine endoscopic instruments and surgical laser technology introduced through the mouth, avoiding external scars on the neck. Where appropriate, laser reduction surgery can be combined with glottoplasty to adjust the size and tension of the vocal folds and further refine pitch.

Every treatment plan is tailored to your individual voice, goals and medical history, and is closely integrated with pre‑ and post‑operative voice therapy. This joined‑up approach aims to achieve a stable, sustainable voice that you can use confidently in day‑to‑day life.