A male voice in trans women may seem like a minor detail, but, in reality, it can also be perceived as a lack of alignment with that gender identity. It is a challenge for these people to achieve this very important dimension, which they can access through various treatments ranging from voice therapies to more invasive procedures, such as phonosurgery. And Barranquilla, in the Colombian Caribbean, has been emerging as a global reference for this type of method.
Trans women from different parts of the planet arrive in the capital of Atlantico to achieve that much-desired tone of voice. Their goal is to overcome the barrier of the 180 Hz frequency, that limit between the highness and lowness of the human voice, from which it is perceived as feminine. Many strain their voices to achieve the feminine vocal tone they seek, but in the long term, that effort produces fatigue and can lead to a hoarse voice.
In that city, the otolaryngologist Antonio Ballestas has his practice and his prestige, who, since 2014 opened the path in Colombia and Latin America for voice feminization. The method he uses is the Wendler glottoplasty, a surgical technique that consists of shortening and thinning the vocal cords so that they are capable of emitting high-pitched sounds. The advantage it has is that it is done through the mouth and does not leave external scars, and it lasts around 1.5 hours.
With the operation, for many of these patients, it is as if the specialist performed magic, because they arrive with a deep voice and leave the operating room with a softer, higher tone, reports Semana magazine. The surgery is complex, and must be millimetric and precise, since what they do is transform the anatomy of the vocal cords.
A procedure that is not reversible
“Anatomically, the vocal cords of men are longer and thicker, while those of women are shorter and thinner,” Ballestas explained to that outlet. “What we do is transform those male vocal cords into female ones, reducing their size and thickness so that they can emit higher sounds. It is similar to a guitar string: If you tighten it, the sound is higher. That is what we achieve with the surgery.”
In his office in the north of Barranquilla, where he also treats patients with his son, up to 16 surgeries are performed monthly on people who arrive from any latitude, who are warned that this procedure is not reversible.
“To achieve the anatomical changes that allow a feminine voice, it is necessary to remove structures that make the voice vibrate. Those parts are sutured and no longer vibrate the same way. If one tries to reverse it, the vibratory capacity is not recovered. It is a definitive surgery, for life,” he warned in the magazine.
After Antonio Ballestas had operated on around 600 patients in more than a decade of service to this population, his son, Samir Ballestas, returned from the United States (he studied at Emory University), and they began to work together.
“Everything started when I attended a voice surgery conference in Bogota, between 2012 and 2013, where a European doctor presented cases of voice feminization in transgender women,” Antonio Ballestas told Semana. “It caught my attention a lot because it was something I did not know.” He trained with a specialist in Spain, and that same doctor accompanied him in three surgeries he performed in Colombia, the first of which was in 2014 in Barranquilla. From then on, the specialist and the city have been sought out for vocal feminization.