| From: | Oga Kingsley |             
|---|

Will you give it a try even if            you got the money? It's not hat bad, however you run the risk            of loosing your voice totally if anything goes wrong. Wait            lemme give you details...
            
          People in China are              undergoing risky surgery in order to make their voices more              masculine or feminine. Several clinics now offer people the              surgery - which was traditionally carried out on patients              undergoing a sex change.
            Voice operations are the              latest in a booming cosmetic surgery market, with doctors              offering the procedures reporting that demand for the              surgery has risen steadily in recent years. This is despite              the known risk that surgery can cause loss of voice              altogether, as well as pneumonia.
            Academics say the rising              popularity of these procedures shows the pressure Chinese              people are under to conform to gender stereotypes. 
            One person who has had the              surgery is Lu Xiang, 23, who endured years of being mocked              for his 'girly' high pitched voice.
            'For many years, my              classmates and colleagues made fun of me because of my              voice, calling me a sissy,' Lu told Global Times journalists.
            'I couldn't get a girlfriend              either. 
            'Women didn't see me as a              real man, and instead treated me like one of their female              friends because of my girly voice.'
            Lu's voice did not drop              during puberty and in his job as a call centre operator, he              was frequently mistaken for a woman.
            People also assumed he was              gay because of the way he spoke.
            So despite the potential              risks of the surgery, he decided to go ahead and have an              operation which would make his voice lower.
            It involved cutting a              segment of cartilage from his larynx and injecting Botox              into his vocal cords.
            Mr Alasdair Mace, an ENT              surgeon at Charing Cross hospital in London, told MailOnline that Botox              causes the vocal chords to become shorter and more loose,              deepening the voice. Mr Mace carries out around two 'voice              surgeries' a month, usually on patients undergoing a sex              change, or patients with a defect in their voice through              birth or injury.
            He said Lu's case is unusual              because normally females transitioning to becoming male who              are hoping for a deeper voice would be given testosterone              therapy which works well to deepen their voice's pitch.
            HOW 'VOICE SURGERY' TO                  DEEPEN THE PITCH WORKS
                 Mr Alasdair Mace, an              ENT surgeon at Charing Cross Hospital in London, carries out              two 'voice surgeries' a month, usually on patients              undergoing a sex change, or patients with a defect in their              voice through birth or injury.
            Here, he explains to              MailOnline how a procedure to lower the pitch of the voice              would work... 
            Mr Mace said: 'The pitch of              the voice is determined by length, the thickness, and the              tension of the vocal chords.
            'You can stretch the vocal              chords - the thinner they become, the higher the voice will              go.
            'The thicker and the more              lax the vocal chords, the deeper you'll go.
            'Botox makes the chords              shorter, flatter and more floppy, deepening the voice.
            'The chords are also              attached to a bit of horse-shoe shaped cartilage called              thyroid cartilage.
            'If you cut a little bit of              cartilage out and drop it back, this shortens, stiffens the              chords and the voice will become deeper.'
            He added that the Botox              injection is usually temporary.
            'It's a vacuous aim if you              inject it into the vocal chords because it'll wear off. So              they keep having to come back.'
            He added that the procedure              carries well-known risks. 
            He said: 'If you have too              much you weaken the chords so they can no longer come              together and you'll lose your voice.
            'The reason we have vocal              cords is originally to protect the lungs from things going              down the wrong way.
            'There's a risk of causing              pneumonia by paralysing them. 
            'People having the procedure              would have to know about the risks: losing the voice, the              chest infections.' 
            Lu underwent a surgical              procedure presumably because he was already male and so              testosterone therapy would not be appropriate.. 
            He explained how the              procedure works: 'The vocal chords are attached to a bit of              horse-shoe shaped cartilage called thyroid cartilage.
            'If you cut a little bit of              cartilage out and drop it back, this shortens, stiffens the              chords and the voice will become deeper.'
            'Injecting Botox makes the              chords shorter, flatter and more floppy, deepening the              voice. 
            However, he added that the              Botox injection is usually temporary.
            'Botox paralyses muscles.              You use it for wrinkles; It only works for three to six              months. Which is why people have to keep going back for              more.
            'It's a vacuous aim if you              inject it into the vocal cords because it'll wear off. So              they keep having to come back for more injections.'
            Patients risk losing their              voice temporarily, and catching chest infections, he added.
            He said: 'If you have too              much you weaken the chords so they can no longer come              together and you'll lose your voice.
            'The reason we have vocal              cords originally is to protect the lungs from things going              down the wrong way. Even animals who don't speak have vocal              chords for this purpose.
            'There's a risk of causing              pneumonia by paralysing them. People having the procedure              would have to know about the risks: losing the voice, the              chest infections.'
            One Chinese doctor says he              has performed more than 200 vocal surgeries over the last              four years.
            Huang Yideng, a doctor from              The Chinese People's Liberation Army 118 Hospital, said most              people who came to him for surgery were men like Lu with a              high-pitched voice but wanted to sound more 'manly'.
            Women with low-pitched              voices who wanted to sound more 'girly' also opted for the              procedure.
            One manager at a centre that              carries out the operations said demand for the surgery from              China has risen in recent years.
            Zhou Meiling, a manager of              the Yeson Voice Center in South Korea, said four years ago              about 20 Chinese clients came to the clinic each year.
            Last year, around 100              Chinese patients visited, she said.
            One 23-year-old man had a              procedure which involved cutting a segment of cartilage from              his larynx and injecting Botox into his vocal cords. He              wanted to sound deeper after years of his 'girly' voice              being mocked
            Many were seeking to improve              their competitiveness in the job market. 
              
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Different procedures exist,              but one option is to place titanium plates between the              throat muscles, causing the vocal chord to stretch, raising              the pitch, the Telegraph reports.
            An incision can be made in              the vocal chord, or part of it can be burnt away with a              laser.
            This causes scarring which              stiffens the chord, making the pitch higher. 
            Many might dismiss such              cosmetic surgery as a symptom of vanity, but some academics              blame rigid Chinese gender roles.
            'Gender is performed, in the              sense that men are expected to behave in ways that conform              to preconceived ideas of masculinity, and women are expected              to behave in ways that conform to preconceived ideas of              femininity,' Chen Yaya, of Shanghai Academy of Social              Sciences, told the Global Times.
            People who already have              normal voices, but still seek vocal surgery are doing so out              of pressure to conform more fully to gender stereotypes, she              said.
            She added: 'Our society              needs to be more inclusive of differences within genders, so              that people with unconventional voices or other              characteristics that don't conform to their gender              stereotype won't be pressured into the pain of surgery.'
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