Discrimination on the basis of voice

We live in a culture that constantly judges someone because of how they sound. 

In the upcoming finale of Season 17 of “The Voice,” judges and the audience will choose a winner, while similar popular shows such as “America’s Got Talent,” “American Idol,” and “The Masked Singer,” earn huge audiences for voice competitions. 

The upcoming Grammy Awards feature nominations for artists such as Lizzo leading the pack with eight nods followed by newcomers Billie Eilish and Lil Nas X with six nominations each. 

As a voice surgeon, I take particular interest in the celebration of the human voice. Yet, discrimination on the basis of voice is rampant and commonplace. 

For instance, in announcing the Grammy nomination, Gayle King’s voice was hoarse. Fans flooded Twitter expressing concern, a sentiment that quickly turned into attacks on King for being a “distraction” for “getting others sick 

Yet such hoarseness, or dysphonia, is not uncommon as 18 million adults report a voice disorder. That is equal to about 1 in 13 adults annually. Hoarseness also affects quality-of-life. Our voice is how we communicate with our family, friends, and the world around us. Emerging technology is also rapidly becoming voice-based. 

Voice assistants, such as Alexa or Google Home, have seen a sharp rise in the last year. These smart speaker sales will likely rise 35 percent this year which represents almost 92 million units. This technology is now being incorporated into our interactions with the outside world. You can now order a 7-Eleven treat through a voice assistant or book a trip to Bali. 

For those with voice disorders, this convenience is not accessible. 

A recent study from Harvard University found that severe dysphonia actually had a worse effect on quality of life than losing sight in one eye. Part of this is due to the perceived negatively that surrounds a dysphonic voice. Listeners have negative attitudes towards voices that are dysphonic. 

A research article from the Journal of Voice found that this negatively transverses 12 different descriptive domains, all in a negative fashion.  Recently, Miss Manners answered a question relating to the bothersome effect of a  friend’s “annoying” voice.  

Voice is a part of one’s identity. Discrimination based on voice is bias.   

As a voice specialist, I see patients with all types of conditions that can affect the voice. Some cases resolve on their own, others leave patients with permanent disability. I have firsthand seen the look of uncertainty on the face of a rising singer diagnosed with vocal cord nodules or the face of a university professor diagnosed with vocal tremor. 

It’s the look of “Can I continue doing what I love?” 

Earlier this year, this discrimination was brought into the spotlight when actress Lupita Nyong’o reported that she used spasmodic dysphonia, a permanent neurological voice disorder, as her inspiration for the voice of her horror character in the movie ‘Us.” As a result, the National Spasmodic Dysphonia Association denounced demonizing persons with SD and the president of RespectAbility, Jennifer Laszlo Mizrahi, was quoted as saying, “connecting disabilities to characters that are evil marginalizes people with disabilities.” Ms. Nyong’o later apologized.

Certainly, there are professions where a strong, clear voice are necessary for public safety. Patrol officers, firemen and trauma surgeons all need the ability to project and communicate efficiently. 

While across many disciplines this is an era of working towards more inclusivity, discrimination based on voice remains. It is not acceptable to demonize what doesn’t sound ideal. 

If it is the goal to practice looking at the beauty within a person eliminating bias, then the same mantra applies to acceptance and nonjudgment of dysphonic individuals. It is time to listen to the voice within. 

Inna A. Husain, M.D., is an assistant professor and director of the Voice, Airway, Swallowing Disorders Program at Rush University Medical Center and a Public Voices Fellow through The OpEd Project.