Why does RFK Jr. sound like that? What to know about spasmodic dysphonia, Robert F. Kennedy Jr.'s rare neurological condition
The 71-year-old has been living with a rare neurological disorder that impacts his voice since 1996.
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Robert F. Kennedy Jr.'s first confirmation hearing with the U.S Senate prompted a surge in web searches for queries like "why does RFK Jr.'s voice sound like that?" and "what's wrong with RFK Jr.'s voice?" from both Canadian and American search users.
On Wednesday, President Donald Trump's nominee for Secretary of Health and Human Services answered questions about his stance on vaccines, Medicaid and abortion rights for more than three hours. The lengthy sparked public interest in the cause of the 71-year-old's quivering voice: spasmodic dysphonia, a neurological disorder.
“I feel sorry for the people who have to listen to me," Kennedy said in a 2024 interview with the Los Angeles Times. "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."
What's wrong with RFK Jr.'s voice?
Kennedy was diagnosed with spasmodic dysphonia in 1996 when he was 42. He has since undergone treatments to try and restore his speaking voice. The former U.S. presidential hopeful said that he "can't stand" his voice and that the condition was a "very, very slow progression." Kennedy said at times, mornings were particularly difficult for him.
"When I opened my mouth, I would have no idea what would come out, if anything,” Kennedy recalled.
What is spasmodic dysphonia, what causes it and how is it treated? Keep reading to learn more.
What is spasmodic dysphonia?
Spasmodic dysphonia (SD), sometimes referred to as laryngeal dystonia, is a rare neurological condition impacting the voice and speech that impacts approximately 50,000 people in North America. For people with SD, muscles spasms in the larynx (also known as the voice box) cause the voice to sound tight, strangled or strained.
SD is a chronic condition that typically begins between the ages of 30 and 50 and impacts women more frequently than man. While there are various types, Kennedy was diagnosed with most common form of the condition, Adductor spasmodic dysphonia, which means the vocal folds stiffen and "slam" together causing the voice to sound broken.
The less common from of SD, abductor spasmodic dysphonia, causes the vocal folds to remain open. This makes the voice sound weak and breathy.
What causes spasmodic dysphonia?
It's still unclear what causes spasmodic dysphonia to occur. According to Penn Medicine, psychological stress can sometimes cause SD and although there is evidence to suggest it begins in the part of the brain that controls motor function, the basal ganglia, and may also run in some families.
What are the symptoms of spasmodic dysphonia?
Symptoms of spasmodic dysphonia can include:
Hoarse, gravelly voice
Choppy or halted speech
Sudden or gradual difficulty speaking
Breathy or weak speaking voice
People with SD may notice that their symptoms go away when laughing, crying, singing, shouting or whispering. Stress can also intensify symptoms.
How is spasmodic dysphonia diagnosed?
Spasmodic dysphonia can be difficult to diagnose since there's no definitive test for the condition. According to Mount Sinai, SD is usually diagnosed by ruling out other illnesses or disorders that could cause the same symptoms. Speech-language pathologists or an otolaryngologist (ear nose and throat specialist) can help diagnose SD.
How is spasmodic dysphonia treated?
SD is a lifelong condition with no cure. Depending on the severity of the disorder, healthcare providers may recommend psychological counselling, voice therapy or oral medications.
Many people with SD receive strategically placed Botox injections into the larynx muscles to help relieve spasms for a period of time (approximately 2-4 months).
In some cases people with SD may require surgery to remove a portion of the nerve that controls laryngeal muscle spasms to weaken the spasm and improve symptoms.
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