Cricothyroid Approximation

Please reconsider cricothyroid approximation (CTA) as a means of feminizing a male voice. The procedure approximates the thyroid and cricoid cartilages, which disables one of the two muscles responsible for raising pitch (TA & CT). Comfortable speaking pitch often initially rises as intended, but the usable vocal range is typically cut by more than half. When the surgery succeeds, the result tends to sound like a man speaking in falsetto rather than a feminine voice. When it fails, the vocal cords stretch, drop pitch , yet the cricothyroid joints ankylose and no longer function—so the muscle is no longer available to fall back on, and future revision surgery is compromised.