Voice Transition Options: A Comprehensive Comparison of Voice Training, Vocal Fold Surgery, and Hormone Therapy as Voice Transition Methods

Explore voice transition methods—training, surgery, hormones—and learn how they impact voice control. Discover the best approach for your unique needs.

May 22, 2024
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Written by Undead Voice Founder, Speech-Language Pathologist and Voice Transition Expert, Nicole Gress (she/they)

Comparing Voice Transition Methods: Vocal Training vs. Surgery vs. Hormones

If you don’t quite love your voice, and you’re thinking of exploring different voice transition methods, understanding the range of options available can empower you to make informed decisions that best align with your goals and needs. At Undead Voice, we believe that mastering your voice involves a comprehensive approach that goes beyond the outdated focus of just altering pitch. Our curriculum focuses on five key pillars, each essential for developing full control over your voice and creating an effortless, natural-sounding, and sustainable voice you love. This article will explore how voice training, vocal fold surgery, and hormone therapy interact with these pillars.

The Five Pillars of Voice Mastery

At Undead Voice Lab, we emphasize the following five proprietary pillars as crucial for voice mastery:

  1. Vocal Weight: Controlling the bass in your tone, similar to adjusting the thickness of strings on a guitar, to remove or add weight to your voice.
  2. Vocal Tilt: Engaging muscles to vary your voice from sweet and empathetic to direct and assertive, useful in expressing the full range of emotions.
  3. Resonance: The most crucial focus of voice transition, affecting perceived gender by altering the brightness or darkness of your voice.
  4. Pitch: Adjusting your voice pitch higher or lower without causing tension, with the main focus on balancing pitch with resonance for a natural sound.
  5. Dynamics: The movement of your vocal range, incorporating your unique personality and cultural identity into your vocal expression.

Voice Training

Voice training is the most comprehensive and effective way to transition your voice. Working with a specialized voice transition training program or specialist, you can develop a voice that affirms your gender identity while maintaining your unique personality. This method is non-invasive, highly effective, and can be achieved in just six months at Undead Voice Lab.

Voice training is the only method that allows you to explore and master all five pillars of your voice. This approach provides the most control and flexibility, allowing you to create a voice that feels authentic and sustainable. Whether your goal is a brighter, higher, thinner, lighter voice, or a darker, deeper, thicker, and lower voice, or anywhere in between, voice training is accessible and effective for all gender identities and voice goals.

For those who want to achieve a darker, deeper voice without the permanent changes to the body and voice that come from testosterone, voice training alone can be a highly effective option. Additionally, for those taking estrogen, voice training is the only way to alter the voice, making it an essential part of the transition process.

Vocal Fold Surgery

Vocal fold surgery primarily affects the pitch of your voice and is typically pursued by those who want to increase or raise the pitch of their voice.

  • Benefits: Surgery can provide a more permanent alteration of voice pitch, reducing the need for continuous pitch-related voice training.
  • Challenges: Surgery does not address the other four pillars—vocal weight, vocal tilt, resonance, and dynamics. Even those who undergo surgery often still need to pursue voice training to achieve a natural-sounding, sustainable voice. At Undead Voice Lab, we always advise individuals to attempt voice training before considering voice surgery.

Hormone Therapy

Hormone therapy involves administering gender-affirming hormones, which can lead to changes in the voice, particularly for those taking testosterone. However, its effects vary based on the individual's stage of puberty and gender.

  • Benefits: Testosterone therapy can significantly deepen the voice for people taking testosterone, affecting the pitch. These changes are permanent, providing long-term benefits.
  • Challenges: For those who have completed adolescent puberty, estrogen taken in adulthood has zero effect on the voice. Testosterone impacts only the pitch of the voice, not the other four pillars. The changes from testosterone can take up to five years to settle, during which time there can be breaks and inconsistencies in the voice. Voice training can help smooth out these breaks and let you overcome most of the inconsistencies. Although the vocal folds get bigger and the pitch range expands to lower ranges, it doesn't mean your pitch habits change. Those on testosterone hoping for a deeper voice can fully take advantage of the growing range through simultaneous voice training.

Comparison of Methods

Each voice transition method interacts differently with the five pillars:

  • Voice Training: Comprehensive and non-invasive, addressing all five pillars most effectively through a structured program with coaching and feedback.
  • Vocal Fold Surgery: Primarily changes pitch, but supplementary voice training is often needed to address the remaining four pillars of voice.
  • Hormone Therapy: Can change pitch for those taking testosterone, but does not affect other vocal characteristics, making additional voice training beneficial. Estrogen has no effect on the voice.


Choosing the right voice transition method is a deeply personal decision and should be made based on thorough research and consultation with medical professionals and voice specialists. Remember, each person's journey is unique, and what works for one individual may not work for another. It's important to weigh the benefits and drawbacks of each option and consider how they interact with the five pillars of voice mastery to find the best path for your voice transition journey.