Indian treatment for puberphonia focuses primarily on voice therapy with techniques like direct laryngeal manipulation and uvula manipulation and resonance (UMAR), as well as phonosurgery for resistant cases. Voice therapy involves structured vocal exercises and speech techniques to naturally lower voice pitch, while direct pharyngeal/ uvula manipulation involves internal pressure on the air flow to achieve a male voice. Phonosurgery, such as relaxation thyroplasty, is a surgical option to shorten the vocal folds if voice therapy is ineffective or delayed which indirectly result in pharyngeal phonation..