Why professional singers and actors often do not seek treatment for vocal disease

The vocal training demonstrations were part of the public information events at McGill School of Communication and Disorders for World Voice Day on April 16. Photo fund provided by the author

Professional singers and actors are at higher risk of voice injury. Performers must master their voices in a refined way to meet the aesthetic requirements of their work. Most people may not pay much attention to their own voices, but for performers, any minor changes in their voice can prevent them from working and can seriously disrupt their lives and careers.

A common form of voice disorders are benign lesions of the vocal folds, such as nodules and polyps. Affected people may experience voice interruptions and difficulty singing high notes, for example.

Among professional singers, about 46 percent say they have a history of voice disorders, compared to 18 percent of the general population. For those in their early stages, nearly 60 percent of acting students showed clinical signs of vocal dysfunction.

In the Voice and Upper Airway Laboratory at McGill University, we study a wide range of upper airway and laryngeal health conditions using computational models and cell cultures, as well as human studies. In the Canadian health care system, health professionals who manage patients with voice disorders include ear, nose and throat doctors (ENTs, also known as otolaryngologists) and speech therapists.

Stigma and voice health

Stigma is a social phenomenon in which individuals are marked as different, which allows for discrimination and inequality. The stigma surrounding medical condition often worsens the condition due to the stress it causes. In addition, people who experience health-related stigma are often reluctant to seek professional medical help. For example, people with mental illnesses such as depression and addiction are less likely to seek counseling because of the stigma surrounding these conditions.

Similarly, voice violations also stigmatize performers. This made the performers hesitant to seek appropriate and timely medical care. Broadway singers reportedly chose not to reveal that they had a voice disorder because it could hurt their career prospects.

Top view of healthy vocal folds and benign lesions of the vocal folds (nodules and polyps). Credit: Shutterstock

In addition to this external pressure, performers blame themselves for their vocal health problems, believing they are a sign of an unqualified performer. In fact, even highly skilled and successful artists can have voice disorders. However, the scientific evidence for vocal stigma is mostly anecdotal.

For a master’s thesis project conducted in our laboratory, we wanted to find out how voice stigma can affect Canadian performers. in particular,

1. Do professional Canadian singers and actors feel stigmatized about voice disorders?
2. If so, are performers less likely to seek medical help when they experience voice stigma?
3. Who is likely to experience vocal stigma the most?

An online study of voice stigma was created to answer these questions. With the help of the National Association of Singing Teachers (NATS) and the Alliance of Canadian Film, Television and Radio Artists (ACTRA), 200 Canadian singers and actors between the ages of 21 and 65 were hired to complete the 64-item survey. An additional 200 Canadians who had no experience in the presentation industry were also hired to complete the same online survey as the control surveys.

Vocal stigma affects Canadian performers

Overall, Canadian performers had about 15 percent more voice stigma than control groups. The performers also showed less motivation and intention to seek help from health professionals if they have a vocal disease.

The study also found that younger performers and those with previous voice impairments tended to experience more voice stigma. Artists’ reputations are probably more vulnerable in their early careers, and people who have not had a voice disorder are less aware of voice stigma.

Multidisciplinary seminar on vocal health for singers, actors and other professional voice users, presented jointly by McGill and the University of Bergen (Norway) on World Voice Day. Credit: School of Communication Sciences and Disorders, McGill University; Photo fund provided by the author

Our study also found that voice stigma is characterized more by external pressure than by internal beliefs such as self-blame in Canadian performers. Contractors feared losing both their current and future jobs if employers found out they had a voice violation.

Subsequent economic pressures may be complicated by the challenges of accessing specialized vocal health services, including long waiting times for public ENT clinics and the high cost of private alternatives.

Possible solutions to remove voice stigma

Like other stigmas, voice stigma is a complex problem without a universal solution. Education and contacts from voice health experts can be part of the solution, with the potential both to reduce voice stigma and to help performers protect their voice.

For example, the McGill School of Communication and Disorders conducts annual public seminars, panel discussions and free voice screenings for World Voice Day. We hope to expand this program to reach more artists across the country.

Improving contractors’ access to services could also play a role. For example, by improving employment coverage and medical insurance for performers in need of vocal health care. Maintaining medical confidentiality is also important to ensure that performers’ careers are not unfairly damaged by past health problems.

However, the first step is to raise awareness of the vocal stigma in the performance industry.

New study of vocal injuries presents profiles of hundreds of injured singers, provided by The Conversation

This article was republished by The Conversation under a Creative Commons license. Read the original article.

Citation: Keeping injured voices in silence: Why professional singers and actors often do not seek treatment for a vocal disease (2022, June 14) extracted on June 14, 2022 from

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