This case series presents three transgender women who underwent gender-affirming treatment with concurrent feminizing glottoplasty and penile inversion vaginoplasty. In our series, combining these into one procedure minimized anesthesia exposure and did not increase operative time, hospitalization, or complications, suggesting that they can safely combined. Gender dysphoria and vocal dysphonia are common among transgender women (TGW). 1 Gender-affirming surgical procedures can improve quality of life of transgender persons. 2 Specifically, voice training and therapy may be effective methods for improving voice perception in transgender women. 3 However, some may require pitch elevation surgeries to achieve desired pitch. Transgender women also frequently seek genital surgery to construct a neovagina. Despite their benefits, each surgical procedure portends the risks of anesthesia, hospitalization, and complications. As an academic hospital center specializing in comprehensive surgical and therapeutic management of transgender patients, we are often able to combine surgical procedures to minimize these risks. Most recently, we have combined feminizing glottoplasty (FG) and penile inversion vaginoplasty (PIV). This has served to prevent two anesthetics, minimize travel, improve patient care, and decrease cost. We are unaware of previous reports combining these two important gender-affirming feminizing procedures. 2 | CASE SERIES Three patients, age range 45-51 years old, underwent combined FG and PIV at our center between 2017 and 2018. Each