Surgery or training? Start with how a voice actually works →

About Trans Voice Guide

Nick Peplow

hi, I’m Nick — Welcome!

Nick Peplow

I’m Nick Peplow, the person behind every guide on this site

My day job is running Thailand Care, an independent service that helps international patients arrange treatment at accredited hospitals in Bangkok.

A lot of the people who come to us are trans women and non-binary people planning facial or genital surgery, and voice comes up in almost every one of those conversations, usually late and usually as a question nobody has answered straight. Is surgery worth it? Will it make me sound like a woman? Why does one surgeon want a year of therapy first and another will book me next month? The information out there is mostly surgeon marketing and forum threads, and the part that matters most, that pitch is only one of the things a listener hears, tends to get left out.

I write about what training and each operation actually change, who they suit, what recovery demands and what they cost. The site is new, and the guides are being added one at a time.

The result will be a guide to changing your voice in either direction, from training on your own and with a therapist through testosterone, glottoplasty and the larger laryngeal operations, each with a plain read of what it can and cannot do, a cost breakdown by country and the questions I'd want you to ask at your consultation.

Where the guides come from

I've sat in on enough consultations to know how they tend to go. You arrive with a list of questions and forget half of them. You get told a number of semitones without being told what it will sound like. You get quotes that don't line up, because one includes the therapy afterwards and one doesn't.

The guides draw on that experience and on published research and professional guidance, including:

  • WPATH Standards of Care, version 8
  • Journal of Voice
  • The Laryngoscope
  • American Speech-Language-Hearing Association practice guidance on gender-affirming voice

Clear answers, no agenda

This is an independent website that I own, pay for and run myself. It is not affiliated with any surgeon, clinic, hospital or voice coaching business.

  • I review every guide against current clinical guidance and published results
  • Outcomes are given as ranges, and where the long-term evidence is thin, which for voice surgery is often, I say so
  • Surgeon and therapist listings, when the directory opens, will be free and cannot be bought
  • Your questions shape what I write next

How I research and check each guide is set out in the editorial policy.

The bit I do for a living. I also run Thailand Care, which arranges treatment for international patients at Bangkok hospitals. It's where the experience behind these guides comes from, and it's a commercial interest, so I'll be plain about how I handle it. Voice surgery is a small specialty everywhere, the surgeons with the most experience are spread across several countries, and the recovery needs a therapist you can keep seeing, which often argues for having it done closer to home. Nothing here steers you to book through me. If you do want help planning surgery, wherever you have it, you pay the hospital's own price with nothing added for my involvement. If a page ever reads like a pitch, tell me.

Are you new here?

I’d start with the [Start Here guide](/start-here), which explains what training and surgery each change and the order people usually do them in.

Two good places to start

Start Here: Your Guide to Changing Your Voice

Wendler Glottoplasty

Frequently asked questions

Have you had voice surgery yourself?

No, and I say that up front because people reasonably want to know where a site like this is coming from. I'm writing from years of sitting beside patients through consultations, quotes and recoveries as the person coordinating their care, and from the clinical literature. Where lived experience matters more than that, I say so rather than pretend.

Are you a doctor or a voice therapist?

No. I'm not a surgeon, a speech-language pathologist or a voice coach, and nothing on this site is medical advice or a training programme. Decisions about your own voice belong with you and the people who can actually listen to it.

Who pays for this site?

I do. There are no sponsors, no paid listings and no ad networks. If that ever changes, the editorial policy and privacy policy will say so before anything goes live.

Can I get my practice listed?

Not yet. A directory of surgeons and voice therapists is planned, and when it opens, listings will be free and cannot be bought. Get in touch with your qualifications, what you offer and where you practise, and I'll add you when it goes live.

I found a mistake. What do I do?

Tell me. I check every correction, fix the page if you're right, and note the change at the bottom with the date.

Contact

Got a question, a correction or a surgeon or therapist to suggest? [Get in touch](/contact), I read everything.