Robert F. Kennedy Jr.’s halting, gruff speaking voice, which at times can make him hard to understand, has been front and center during his confirmation hearing Wednesday as President Donald Trump’s nominee to lead the US Department of Health and Human Services.
Kennedy’s vocal rasp is not caused by an infection or respiratory condition. Instead, he has spasmodic dysphonia, a rare neurological condition in which the muscles that open and close his vocal cords spasm involuntarily, creating a strained or strangled quality to his speech.
Kennedy, 71, has publicly discussed how the condition robbed him of his typically strong speaking voice in his early 40s.
“At that time, I was making a lot of my income doing public speaking, and I could speak to large halls without any amplification,” Kennedy said in a February 2024 interview while running for president.
“When I was 42 years old, I got struck with a disease, a neurological disease, an injury called spasmodic dysphonia, and it makes my voice tremble,” he said, adding that “I think it makes it problematical for people to listen to me. I cannot listen to myself on TV.”
Muscle contraction disorder begins in the brain
Spasmodic dysphonia affects up to 50,000 people in North America, and is a subset of dystonia, a muscle contraction disorder that can affect many parts of the body. In one type of vocal dystonia called lingual protrusion dystonia, a person’s tongue can protrude when they try to speak, strangling their words.
The most common form, cervical dystonia, affects the neck, causing wobbling or worse, the inability to hold the head upright. Blepharospasm, another kind of dystonia, is a forced squeezing shut of the eyelids that reduces or blocks vision. Still other types of dystonia can focus on the legs, hands and feet, even the entire body.