Many turn to voice surgery to make their voices sound more masculine or feminine. Photo: Li Hao/GT

After years of being mocked for his unusually high-pitched voice, 23-year-old Lu Xiang underwent surgery on his vocal cords in order to make it lower.

"For many years, my classmates and colleagues made fun of me because of my voice, calling me a sissy," said Lu. "I couldn't get a girlfriend either. They didn't see me as a real man, and instead treated me like one of their female friends because of my girly voice."

Unlike most boys, Lu's voice did not drop during puberty. In his job as a call center operator, he was frequently mistaken as a woman by customers on the other end of the line.

"Other people simply assumed that I was gay because of the sound of my voice," Lu said.

So when Lu heard that it was possible to lower the pitch of his voice, he didn't hesitate, despite the potential risks of the surgery which could have resulted in him losing his voice completely. The procedure to lower the pitch of Lu's voice involved cutting a segment of cartilage from his larynx and injecting Botox into his vocal cords.

Huang Yideng, a doctor from The Chinese People's Liberation Army 118 Hospital, said most people who sought out such surgeries were men like Lu, who had high-pitched voices but wanted to sound more "manly," or women with low-pitched voices but wanted their voices to sound more "girly."

Huang said he had performed more than 200 vocal surgeries over the last four years.

"Voices act as gender cues, so people who have voices that don't conform to the gender stereotype often suffer enormous mental anguish [over the sound of their voices]," Huang said. "As people become more and more concerned with their external comportment, vocal surgeries are becoming more and more commonplace."

Zhou Meiling, a manager of the Yeson Voice Center in South Korea, said that demand for the surgery from China had risen steadily in recent years.

"Four years ago, about 20 Chinese clients came to the clinic each year. Last year, we received around 100 Chinese patients," she said.

Zhou added that in addition to those who had unusually high or low voices, there were those sought to have surgery in order to improve their competitiveness in the job market. 

"Some girls who already have relatively normal voices ask the doctors to make their voices more dainty, like [Taiwanese actress] Lin Chi-ling, who has been accused of faking her voice to make it sound more sweet," said Zhou.

While some might consider such requests as arising from little more than vanity, Chen Yaya, the vice secretary at the Gender and Development Center from the Shanghai Academy of Social Sciences, said that the popularity of such surgeries betrayed the prevalence of gender stereotyping in Chinese society. 

"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," she said.

"People who already have normal voices, but still seek vocal surgery are doing so out of pressure to conform more fully to gender stereotypes."

"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," Chen said.

Having already undergone the surgery however, such matters are beyond the concerns of Lu.

"I have a normal man's voice now, and nobody makes fun of me because of my voice anymore," he said.

"I have a better relationship with everyone around me."