Editorial Policy: How We Research and Review

Most of what is written about voice surgery comes from the people selling it and doesn't say where its numbers came from. This page sets out where mine come from, how they're checked and what happens when one is wrong.

Where the information comes from

Every guide on this site starts from three kinds of source.

Clinical guidance. The WPATH Standards of Care, version 8, and professional guidance for speech-language pathologists working with transgender voice are the baseline for who is offered what, the role of therapy before surgery, and what a responsible assessment looks like.

Peer-reviewed literature. For technique descriptions, pitch outcomes, complication rates and revision rates, I rely on published studies, systematic reviews and meta-analyses, mainly from journals such as the Journal of Voice and The Laryngoscope. Most voice surgery studies are small, follow people for a year or two at most, and are written by the surgeons who performed the operations. Where that is the state of the evidence, the page says so rather than presenting one number as settled.

Surgeon and therapist materials. Pre-operative packs, consent forms, voice-rest instructions, therapy programme outlines and published price lists. These are the most useful source for what recovery involves day to day, and for realistic cost ranges.

Forum posts and social media tell me what questions people have; they aren't used as a source for medical claims.

How outcomes are reported here

• Where a page gives a pitch change, it is a range, and it says what was measured where that is known: average speaking pitch, the lowest comfortable note, or the top of the range. A held vowel and a stretch of conversation give different numbers for the same voice.
• Pitch is never presented as the whole result. Where a study also measured how listeners perceived the voice, or how satisfied patients were, that is reported alongside it.
• Where the long-term evidence is thin, which it is for most of the newer and larger operations, the page says that plainly.

How pages are written and checked

I write everything on this site myself. Before a page goes live, I check every factual claim against at least one of the sources above and check cost information against current published price lists in the countries named.

Review and updates

Each guide carries a last-reviewed date, and I aim to re-check the following on a fixed schedule:

• Cost pages: every six months
• Procedure and training pages: once a year, or sooner if significant new research is published
• Directory entries, once the directory opens: once a year, and immediately if a surgeon or therapist stops practising or moves

Independence

Nobody but me funds this site, and no surgeon, clinic, hospital, voice coaching business, app or device maker has any tie to it.

• No surgeon, clinic or therapist pays to be listed, and no one can pay to be ranked higher, featured or described more favourably.
• No content on this site is sponsored.
• I don't accept free or discounted surgery, training, travel or accommodation in exchange for coverage.

Corrections

If you find something wrong, whether it's a factual error, an outdated price, a surgeon who has retired, or a description that doesn't match your experience, please tell me. If the correction stands up, the page is fixed and a dated note at the bottom says what changed.

What this site is and isn't

This site provides general information about voice training and voice surgery. It is not medical advice, it is not a training programme, and it does not establish any kind of clinical relationship. Whether surgery suits your voice can only be judged by a laryngologist who has examined your larynx and a therapist who has heard you speak.