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 The voice of transition

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Professor Andrea Luigi Cavalot, otolaryntologist, Director of the Complex of Otolaryngology and Director of TO5 Asl Surgical Area dell’Asl TO5, the only complex in Italy which operates transgender patients who want to change their voice, tells us about how people in surgery don’t feel like they are fit in the wrong body. They are just wearing the wrong clothes.

Dealing with the change of the voice is for Cavalot a challenge. The doctor tells us that his former director at the Molinette Hospital had once asked him to take care of the patients that preserved their male voice even after having changed their sex. The professor accurately studied a japanese surgery technique and made the necessary arrangements in order to slim any complications at best. This specific surgery used to be a high risk of bleeding and air leakages that caused swelling.

Thanks to this modification, the surgery can be reversible: precisely because it is reversible, this surgery can be done at the beginning of the transition process, unlike the change of the sex. Reverse techniques can be used to return to the initial situation, even if nobody has ever asked his doctor to do it.

Everyone think that this surgery involves the vocal cords, but it concerns their housing. The surgery actually consists in folding like an accordion the membrane between the thyroid cartilage and the cricoid, avoiding dissecting it.

The surgery can be done after beginning the hormone therapy. The results are more evident in the transitions from male to female. Hormone therapies are produces a better result in the transition process from female to male. Testosterone increases the vocal cord’s mass lowering the voice tone.

This surgery is covered by the National Health Service SSN is part of the LEA, the Essential Assistance Levels. The only surgery that isn’t covered by the National Sanitary Service is the Adam’s apple exclusive surgery, which is considered merely esthetic. 

The Otolaryngology Structure of the TO 5 Asl, of which Cavalot is director, has remained the only public structure in Italy for this type of surgery. Professor Cavalot has operated on over 500 patients in the city’s sanitary company and now the waiting lists are extended also due to the Covid. Cavalot and his medical team project opened up new horizons and is constantly evolving, contributing to improve the quality of the life of the transgender patients. 

Some people, especially outside this environment, don’t understand why this surgery is made. They think that public resources shouldn’t cover these operations. But they don’t consider the fact that, most of the time, changing voice isn’t a whim, but a requirement.

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