Robert F. Kennedy Jr.’s voice sounds quivering and gravelly due to a neurological condition called spasmodic dysphonia. The condition affects the muscles in the voice box or larynx, explains the National Institute on Deafness and Other Communication Disorders.
Spasmodic dysphonia (SD) is a chronic voice disorder that results from involuntary spasms of the muscles inside the larynx, leading to interrupted speech and poor voice quality. These spasms may cause the voice to break, sound strained, or breathy. The exact cause of SD is unknown, but it is believed to be linked to abnormalities in the basal ganglia, a part of the brain that helps control movement.
According to TODAY, this is a relatively rare condition that Kennedy discovered he suffered from back in the 1990s. “I can’t stand my voice,” he told NBC News in 2023, adding that he had surgery in Japan to implant a titanium bridge between his vocal folds.
Researchers suggest spasmodic dysphonia can be genetic or a leftover disability from a respiratory infection. Kennedy has said that he suspects that the flu vaccine triggered his condition.
According to Mount Sinai, only 50,000 people in North America suffer from SD, which often appears in middle age. It affects more women than men and people who do a lot of public speaking are at greater risk. Stress can exacerbate the condition.
According to Johns Hopkins Medicine, there are three types of SD:
• Adductor spasmodic dysphonia, where the vocal cords come together too tightly during speech, causing the voice to sound strained or strangled.
• Abductor spasmodic dysphonia, where the vocal cords open too widely, leading to a breathy or whispering voice
• Mixed spasmodic dysphonia, which is a combination of both adductor and abductor symptoms and very rare.
The experts at Dysphonia International say that it’s important to learn about all the treatments available for SD to help evaluate and manage symptoms. Botulinum toxin injections (Botox) help eliminate muscle spasms in the vocal folds by blocking nerve impulses that normally signal the muscle to contract. The benefits vary from person to person, but generally last three to four months.
Voice therapy can help people learn new breathing techniques and speech patterns to better manage the condition. The techniques can be geared to specific circumstances, such as speaking in public, on the phone, and speaking with less effort.
There are also surgical options. It is important to consult with an experienced otolaryngologist to determine the most appropriate approach. Psychologically, the condition can take its toll. People with SD often feel that their voice doesn’t accurately portray their emotions, personality or competence. This can cause emotional stress, loss of jobs, income, and personal relationships.
“I feel sorry for people who have to listen to me,” Kennedy said. “My voice doesn’t really get tired. It just sounds terrible. But the injury is neurological, so actually the more I use the voice the stronger it tends to get. If I could sound better, I would.”