High is not automatically falsetto

Adult male voices vary. A voice can be higher than average, disliked by its owner and still sound recognisably adult. Puberphonia generally refers to a distinctly falsetto or prepubertal-type speaking pattern, not a failure to meet an imagined masculinity target.

QuestionPersistent falsetto patternHigher adult male voice
Overall qualityOften distinctly falsetto or prepubertalRecognisably adult, simply higher
Main concernVoice did not settle after pubertyPitch, depth or masculinity dissatisfaction
Lower registerMay appear in cough, laugh or guided tasksAlready speaking in an adult register
What helpsSpecialist voice assessment and targeted therapyAssessment if concerned; sometimes coaching or support for distress