What is spasmodic dysphonia, RFK Jr.’s voice condition?

Ani Freedman
·3-min read
Donald Trump’s cabinet pick has a rare neurological disorder that causes the muscles in his voice box to spasm.

Robert F. Kennedy Jr., who is being considered to lead the Department of Health and Human Services, has a very distinct voice. When he talks, you’ll notice a shaky raspiness that comes with his words. Former NPR host Diane Rehm faced the same issue—but chose to continue her radio show, On My Mind, despite her diagnosis in 1998.

Both have a rare speech disorder called spasmodic dysphonia. The treatable, but not curable, condition affects the vocal cords, according to the Cleveland Clinic. It can cause your voice to break, sound tight, strained, strangled, or very breathy.

“It’s a neurological injury,” Kennedy said in an interview in November 2023.

What causes spasmodic dysphonia?

The disorder is a neurological problem, the Cleveland Clinic says, that is believed to start in the basal ganglia—a part of the brain that coordinates muscle movement. It causes involuntary movement in the muscles of the voice box or larynx.

The exact cause is unknown, according to Johns Hopkins Medicine, but it could potentially be triggered by another illness, like a cold or the flu, an injury to the voice box, a long period of voice use, or stress.

Symptoms of spasmodic dysphonia

Symptoms usually develop gradually, between ages 30 and 60. Kennedy says he was diagnosed at age 42 with the disorder.

People with spasmodic dysphonia will often have the following symptoms, according to the Cleveland Clinic:

  • Breathy, soft voice or feeling like you’re whispering.

  • Strained and tight voice.

  • Hoarseness.

  • Certain sounds cutting off while speaking, making the voice sound broken.

  • Shaky or trembling voice.

How common is it?

The Cleveland Clinic says around 500,000 people are diagnosed every year with spasmodic dysphonia, with women being more likely to have the condition than men.

What are the types of spasmodic dysphonia?

There are three different types of spasmodic dysphonia:

  • Adductor spasmodic dysphonia: The most common type, making your voice suddenly sound strained, tight and hoarse.

  • Abductor spasmodic dysphonia: The second most common type, where your voice sounds very breathy, or you can even lose your voice and produce no sound when you talk.

  • Mixed spasmodic dysphonia: Rarely, some people can have issues where their voices turn strained, tight and breathy.

Can you treat spasmodic dysphonia?

“I never knew when I went to speak what was going to happen,” Kennedy said in an interview. That led him to pursue a surgery in Japan, in which a titanium bridge was implanted between his vocal cords to keep them separate.

There are other, more common forms of treatment for the disorder, however. These include:

  • Botox injections

  • Voice therapy

  • Selective laryngeal adductor denervation-reinnervation, a surgery to improve muscle control by disconnecting and reconnecting nerves between your vocal cords and brain.

Thyroplasty, which places an implant into a paralyzed or weak vocal cord to move a nonfunctioning vocal cord toward the functioning one to allow for better voicing.

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This story was originally featured on Fortune.com

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