Scientific American published an interview from sister publication Cerveau & Psycho with Jean Abitbol, a Paris-based ear, nose and throat physician, phoniatrician, and craniofacial surgeon. The central theme was that when something changes your voice, it changes the way you think about yourself:
We see this very clearly when we operate on patients to change their voice; their self-identity is strongly disrupted. For example, I met a lawyer who had a very deep, masculine voice because of an edema on her vocal cords caused by her smoking. (She smoked two packs of cigarettes a day.) She had a great charm and authority in her profession, where she interacted with criminals on a daily basis. (“My world is the prisons; I defend all the thugs,” she told me.) But she wanted to change her voice, which her fiancé didn’t like, and asked me to operate on her. I advised her to change her fiancé instead! She burst out laughing and had the operation done by a colleague.
When I saw her again, she had a very high-pitched voice and told me something terrible: “I am schizophrenic about my voice.” She no longer recognized herself when she spoke, and was seized by the impression that “it wasn’t her,” that it was someone else speaking. The consequences were terrible: her fiancé had left her, she could no longer work, she lost all her court cases, she had no authority, she no longer dared to open her mouth in prison…. Not because her voice had become higher pitched, but because there was a sort of rupture of harmony with who she was, a conflict with herself, a feeling of loss of identity that destabilized her. She started smoking again, recovered her voice in two or three years and gradually regained influence in her professional life.