In female-to-male/gender identity disorder (FTM/GID) patients, no voice therapy (VT) is required, as the administration of male hormones will naturally cause the voice to become low-pitched. However, in male-to-female (MTF)/GID patients, the administration of female hormones does not cause the voice to become high-pitched. Since 2014, we have performed type 4 thyroplasty (TP4) and preoperative and postoperative VT for MTF/GID patients. In this study, we examined the outcomes of VT. The speaking fundamental frequency increased, while the functional and physical points on the Voice Handicap Index (VHI) decreased slightly, and the emotional points on the VHI significantly decreased. Postoperative complaints included difficulty speaking, difficulty passing as female, and a different subjective image of their eventual female voice. The importance of preoperative and postoperative VT was reconfirmed. However, it is also important for these patients to learn how to speak, how to dress, and how to wear make-up.
