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Lecture given in Bologna, Italy 8 April 2005 for the 19th Biennial Symposium for the former HBIGDA - Harry Benjamin Gender Dysphoria Association and now WPATH, the World Professional Association for Transgender Health. This covers my experience performing cricothyroid approximation surgery (CTA) as well as a newer procedure, the Feminization Laryngoplasty surgery (FemLar).