title: The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review.
abstract: OBJECTIVE
  This study aimed to review the evidence of the effectiveness of pitch-raising surgery performed in male-to-female transsexuals.
  
  
  METHODS
  A search for studies was performed in PubMed, Web of Science, Science Direct, EBSCOhost, Google Scholar, and the references in retrieved manuscripts, using as keywords "transsexual" or "transgender" combined with terms related to voice surgery. We included eight studies using cricothyroid approximation, six studies using anterior glottal web formation, and six studies using other surgery types or a combination of surgical techniques, leading to 20 studies in total.
  
  
  RESULTS
  Objectively, a substantial rise in postoperative fundamental frequency was identified. Perceptually, mainly laryngeal web formation seems risky for decreasing voice quality. The majority of patients seemed satisfied with the outcome. However, none of the studies used a control group and randomization process. Further investigation regarding long-term results is necessary.
  
  
  CONCLUSIONS
  Future research needs to investigate long-term effects of pitch-raising surgery using a stronger study design.
authors.affiliation: Wasstraat 96, B-9000 Ghent, Belgium. Electronic address: silkevandamme@live.com.
authors.forename: Silke
authors.initials: S
authors.lastname: Van Damme
authors.affiliation: Wasstraat 96, B-9000 Ghent, Belgium.
authors.forename: Marjan
authors.initials: M
authors.lastname: Cosyns
authors.affiliation: Wasstraat 96, B-9000 Ghent, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Deman
authors.affiliation: Wasstraat 96, B-9000 Ghent, Belgium.
authors.forename: Zoë
authors.initials: Z
authors.lastname: Van den Eede
authors.affiliation: Wasstraat 96, B-9000 Ghent, Belgium.
authors.forename: John
authors.initials: J
authors.lastname: Van Borsel
mesh_terms: D005260:Female; D005783:Gender Identity; D006801:Humans; D007830:Larynx / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D010898:Pitch Perception; D012649:Self Concept; D012737:Sex Factors; D057830:Gender-Affirming Surgery; D013061:Speech Acoustics; D013067:Speech Perception; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome; D014833:Voice Quality
keywords: male-to-female; surgery; transsexualism; voice