Why RFK Jr.'s Voice Sounds the Way It Does

If you've watched RFK Jr. testify in Senate hearings recently and wondered what's going on with his voice — you're not alone. The shaky, strained quality to his speech has been a topic of conversation since he stepped into public life more prominently, and he's been open about the reason for years.

He has spasmodic dysphonia — a neurological disorder that causes involuntary spasms of the vocal cords. And he's had it for decades.

"I had a very, very strong voice until I was 46 years old," Kennedy said in a 2023 interview. "In 1996, when I was 42 years old, I got struck with a neurological disease called spasmodic dysphonia that makes my voice tremble. At the time I didn't know what was wrong with it."

He added that the condition makes it hard for people to listen to him — and that he cannot listen to himself on television. Ever.

Early in 2023 he traveled to Japan for what he described as a "novel" surgery that he said made his voice "much better." Whether you've noticed an improvement depends on when you started listening.

What Spasmodic Dysphonia Actually Is

The disorder affects an estimated 500,000 people in the United States alone, making it relatively rare but far from unheard of. It typically shows up between ages 30 and 60 and is caused by faulty signals from the basal ganglia — the part of the brain that controls involuntary muscle movement. Those misfiring signals cause uncontrollable spasms in the vocal cords.

Normally, when you speak, air pushes up from the lungs through the vocal cords, which vibrate in a controlled rhythm to produce sound. With spasmodic dysphonia that rhythm gets disrupted. The cords can come together too tightly producing a strained, hoarse, or strangled sound — or too loosely, producing something weak and breathy. Some people experience both.

There are three types. Adductor spasmodic dysphonia is the most common and involves the cords pressing together too hard. Abductor is the opposite — cords coming together too loosely. Mixed spasmodic dysphonia combines elements of both and is the rarest form.

The condition is chronic. There is no cure. Symptoms tend to get worse under stress, exhaustion, or vocal strain — like speaking over a crowd or on the phone. Interestingly the disorder typically only affects the speaking voice. Singing, laughing, and whispering are usually unaffected, which is one of the more puzzling quirks of how it works neurologically.

Treatment options include Botox injections to block the nerve signals causing the spasms, voice therapy, surgical options, and in some cases communication devices. Women are up to three times more likely to be diagnosed than men. Up to one in four cases have a family history of the disorder.

Other People You Know Who Have It

Kennedy isn't the only public figure navigating this condition.

Selma Blair disclosed in 2019 that her multiple sclerosis had led to spasmodic dysphonia, noting on Good Morning America that her voice had become shakier than usual.

Diane Rehm — the beloved NPR host who drew three million weekly listeners — was diagnosed in 1998 and continued hosting her program until she retired in 2016. She became one of the most visible public advocates for awareness around the condition simply by continuing to do her job.

Darryl McDaniels of Run-DMC was diagnosed in 1997 and kept his music career going. Country singer Johnny Bush, British singer-songwriter Linda Thompson, and singer Jimmie Rodgers have all dealt with it too. Scott Adams, the late creator of Dilbert, discussed his own diagnosis and recovery publicly in 2006.

The condition shows up across professions and backgrounds. What these people share is having built public careers that depend on their voice — and having to navigate that with a disorder that makes the voice unpredictable.

For Kennedy specifically, someone who built much of his early income on public speaking, the diagnosis in his early 40s represented a significant personal challenge. Whatever anyone thinks of his politics or his current role leading Health and Human Services, the voice is simply a medical reality he's been managing for 30 years.

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