In this clip, Christella Antoni argues that people with croakiness, dysphonia, a constricted voice, or significant laryngeal muscle tension should ideally avoid progressing directly to vocal cord surgery, because surgery temporarily compromises the vocal cords through inflammation and restriction and may leave some lingering effects. If these tension patterns aren’t resolved beforehand, surgery can exacerbate them, making it much harder to improve the voice afterward. Christella emphasises that surgery to raise pitch won’t miraculously fix other voice issues or necessarily make a voice fully feminine, and they want this message communicated more clearly.