Robert F. Kennedy Jr.'s Voice Is Easily Explained By Science

Being in the public eye inevitably puts everything about you under scrutiny, including your actions, appearance, and speech. It's this latter point that has garnered Robert F. Kennedy Jr. more attention in recent years. Kennedy's increased public appearances as a 2024 presidential candidate as well as his most recent role as U.S. Secretary of Health and Human Services have required more speaking events. As a result, many are hearing his raspy voice for the first time. The Secretary hasn't shied away from his vocal issues, which he has experienced for about three decades now, per the Los Angeles Times. The culprit for Kennedy's voice difficulties is rooted in a rare condition called spasmodic dysphonia.

Spasmodic dysphonia (laryngeal dystonia) is a type of neurological voice disorder that causes sudden, involuntary spasms within the key muscles controlling vocal folds (cords). Instead of vibrating to help produce the sound of your voice, spasmodic dysphonia causes your vocal cords to spasm. Depending on the type of spasmodic dysphonia you have (adductor, abductor, or mixed), your voice can sound raspy, strained, or even breathy. Adductor spasmodic dysphonia is the most common form of this condition, and it causes speech that sounds hoarse and strained from muscle spasms that bring your two vocal cords too close to each other. This is also the type of spasmodic dysphonia Kennedy has, according to Time. The rate of spasms can also vary, with some causing breaks in speech every few words to every few sentences.

Overall, spasmodic dysphonia is considered rare, with the Cleveland Clinic noting an estimated 500,000 U.S. cases. There's also currently no cure. Yet there are treatments available that may help improve symptoms as researchers work to understand more about the possible underlying causes of this voice disorder.

While scientists know the effects of spasmodic dysphonia and have classified it as a neurological disorder, researchers still have not pinpointed the exact underlying cause. As a neurological condition, it's thought that certain parts of the brain are involved in spasmodic dysphonia development. Possibilities include the cerebral cortex and basal ganglia, which both play roles in body movement. In particular, the basal ganglia controls involuntary muscle movements that might explain the muscle spasms associated with spasmodic dysphonia.

While its links to the brain might surprise you, spasmodic dysphonia may also be attributed to genetic and environmental components. According to the World Journal of Otorhinolaryngology-Head and Neck Surgery, researchers have previously investigated whether significant trauma can play a role in its development, although the results were inconclusive. What's more, the condition is up to three times more prevalent in females, says the Cleveland Clinic. It can also have either a gradual or sudden onset of symptoms. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), spasmodic dysphonia typically develops in adults 30 to 50 years of age.

There isn't one single test available to diagnose spasmodic dysphonia. Typically, a doctor or neurologist will refer people with suspected cases of the voice disorder to an otolaryngologist for further evaluation. This specialist can help identify spasmodic dysphonia with a combination of voice measurements as well as a stroboscopy exam to see the vocal folds. People who experience possible symptoms and signs of voice disorders may also see a speech-language pathologist (SLP) to gain a better picture of vocal struggles.

Aside from helping to diagnose spasmodic dysphonia, an SLP can also teach people to help manage their symptoms with the help of voice therapy. In theory, voice therapy can be tailored to meet an individual's everyday needs to improve quality of life. For example, an SLP may help provide strategies for speaking with others as well as giving speeches.

Voice therapy is usually not a standalone treatment for spasmodic dysphonia, though. One of the more common medications used for this condition is botulinum toxin (Botox) injections. These are injected around the laryngeal muscles to help prevent vocal fold muscle contractions. While not curative, the injections can help reduce symptoms for a smoother speaking experience. The downside is that Botox can cause side effects that might temporarily worsen symptoms, such as a breathy or hoarse voice. It's thought that Botox and voice therapy work hand-in-hand for the best outcome. Surgical intervention is another possible treatment option for spasmodic dysphonia. Although surgery can reduce spasms, it can also make your voice breathy and weak-sounding.

It's worth noting the role of stress in spasmodic dysphonia. While there isn't an established cause and effect between the two, the NIDCD says that stress can sometimes make symptoms of adductor subtypes worse. Stress management may help with some of the symptoms of this disorder, which is why Dysphonia International recommends regular exercise and relaxation, as well as a healthy diet and consistent sleep patterns.