In mid 1998 I had hopes that I would be able to transition to full time by the at the beginning of 1999 but due to financial constraints I didn't actually make it until May of 1999. I did however have my CTA surgery in preparation for a January 1999 transition to full time.

My voice while not exceedingly low at 130 Hz. wasn't all that feminine sounding in my own mind although as long as I didn't need to raise my voice it was passable. However when I had need to raise my voice to be heard there was no doubt that it was a male voice. So I made arrangements with Dr. Toby Meltzer and Dr. James Cohen of Portland OR to perform the procedure on me in mid November of 1998. My spouse was kind enough to go with me for hand holding and moral support and on the trip back again was very helpful as I was unable to speak at all for 10 days. This is the normal period of complete voice rest which the doctor's require after surgery. I now have a MUCH better understanding of what people who have lost the ability to speak for whatever reason have to go through. It was a very unnerving and unpleasant experience! Most thought that since I was unable to speak that I was also deaf and exaggerated their mouth movements or would start writing on a pad for me, which would have been comical except that got me to thinking of the difficulties that the deaf really do experience.

As for the surgery itself, the procedure was fairly simple to accomplish. At around 2pm on November 17 at Eastmoreland Hospital in downtown Portland OR, I registered and was taken to a room. I then changed into a hospital gown and answered questions on my family's medical history, had an I.V. started, was given 2 valium tablets and told to relax until they came for me at around 4pm.

This is my commentary on my voice surgery that I've had prior to having my Gender Reassignment Surgery. This surgery involved two different procedures. The first of which is my CTA or CricoThyroid Approximation voice surgery and an accompanying trachea shave at the same time.

A little after 4pm I was taken into the operating room. The procedure was to be done under local anesthetic and I was to be awake throughout. Dr. Meltzer proceeded to make several injections in my neck around the tracheal area to numb it. After approximately 15 minutes or so Dr. Cohen made the primary incision just above my adam's apple. Then pulling the skin outwards he used a surgical laser to detach the skin from the trachea and somewhat below it. After getting sufficient room in which to work he proceeded to put in several suture from the front of the trachea to an area below it. At this time he asked me to do a count from 1 to 10, which I did with no problem. He then proceeded to tighten the suture's. After he had tightened the suture's which had the effect of rotating my trachea forward and down thus putting my vocal cords into considerable tension, he once again asked me to do a 10 count. I was unable to do more than whisper my count! He said that was fine and they proceeded to start the trachea shave at that point.

I think that it was Dr. Meltzer who did the actual trachea shave. Using a tool I can only associate with a dremel cutting tool. As much of the protruding cartilage from my adam's apple as was feasible without disconnecting my vocal cords was removed. Unfortunately I had a rather large adam's apple to begin with so afterwards I still have a small lump on my throat. Still it's nothing like what I began with. After finishing with the trachea shave Dr. Meltzer began to close the incision. About half way through the closure I got feeling back in my throat area! Well I can safely tell you that I don't care at all to be sewn up with feeling in my skin!!! Being unable to speak, it took me a bit to get across that the local had worn off and that I needed more. To his credit, once Dr. Meltzer realized what I was trying to tell him, he immediately shot quite a bit of numbing medication back into my throat. Finally after the procedure was over I was taken back to my room to wait about an hour to make sure their was no immediate complications.

After about an hour I was released and told to return to Dr. Meltzer's office the following afternoon for a follow up. We stayed in Portland for almost a week after the surgery to make sure that if I had any complications we would be close to my doctor.

However I came through the surgical part with flying colors and it was back home for rest and recuperation. I was very meticulous about my post-op instructions and went the full 10 days voice rest period with only a few minor slip-ups! Afterwards I went through the period of "Mini Mouse" voice in which my voice was soooooo high that I felt I could etch crystal with it! The normal female voice range runs from 180 Hz. to around 250 Hz. After I first began speaking again I don't know just how high my voice was but it was really comical to hear. It was extremely high pitched.

Unfortunately my voice didn't come down nearly as much or as fast as I had been told that it would. At the present time, now some 10 months after surgery my voice is still tipping the scales at 285 Hz. which is still 35 Hz. ABOVE the UPPER female range. It has a very monotone quality also. I went to see a voice therapist in Kentucky to see if she could help me get my voice back into the female range an also help me deal with it's monotone sound. She hadn't had dealings with this type of procedure and the exercises she had me do were not helping. I was naturally very disappointed with the results of my surgery so in July I contacted Dr. Cohen and asked him what I could do about my voice. His suggestion was for me to fly back to Portland and take therapy with his own staff therapist since they were trained to deal with these sort of problems. I agreed and flew back to Portland for a week to take therapy in July of 1999.

It is in my opinion that unless one has the very deepest of voices you should try to raise the pitch of your voice with therapy alone. It was my goal to try to have the pitch of a genetic female without having to constantly think of keeping my voice in that pitch range. In actuality I've only traded being out of range on the low side to being out of range on the high side. If I can get my voice back down to the correct pitch and learn to modulate it, it will still involve voice therapy technique's and the almost constantly reminding myself to try to use them to stay at the lower pitch. This then makes any advances due to the surgery a moot point since any gain is still offset by the need for constant voice technique.