woman with megaphone

I have given a number of medical talks over the years—reports on my research, reviews of surgical topics, mentoring speeches, and grand rounds, among others. I prepare for these talks extensively but tend to speak extemporaneously to engage better with my audience. I’m pleased to say that, in general, I have received good feedback. Several times, however, I have been given the “constructive criticism” that my voice is “girly” or “immature.”

I will be the first to admit that I am not an expert on oration or public speaking. I have no background in stage acting or performance. And despite the speech accolades of my youth (as a high schooler, I was the Lincoln-Douglas Debate state champion in California, and while in college, a friend and I won the Adams Cup for Parliamentary Debate at Yale), I know very little about what the ideal speaking voice is supposed to sound like.

My focus for my medical talks is simple and content-based: speak clearly, convey my message, and use a voice that my audience will understand. To be sure, I am a woman of petite stature and my speaking pitch is soprano to mezzo-soprano. I am also a fully grown adult with gray hair and a busy plastic surgery practice who has published and spoken extensively in my field.

Yet with recent media attention to the many perceived flaws with female voices, I cannot help but wonder about the extent to which this phenomenon applies to the world of science and medicine.


Upspeak, vocal fry and other complaints about the way women speak

Women have been criticized for “upspeak”—using a voice that trails upward in pitch at the end of a sentence. This is a version of a “Valley Girl” lilt, and it has been described by linguist Mark Liberman as a speech pattern that makes it sound like we are asking for permission or posing a question. It sounds weak and lacks authority, we are told. Kelly Ripa is an example of a woman who frequently employs upspeak.

Hillary Clinton
Photo credit: Cliff Owen/AP | via Common Dreams | CC-NY-SA 3.0

Conversely, women are also criticized for “vocal fry”—using a hoarse, low-pitched rumble that is commonly employed to add emphasis, depth, or satire to speech. According to NPR On the Media host Bob Garfield, this sounds unrefined and lacks gravitas; he says it is “annoying,” “repulsive,” and “mindless.” Examples of vocal fry users include Tina Fey and Lindsay Lohan.

Interestingly, vocal fry has been described as “the opposite of upspeak” by The Daily Dot’s Amanda Marcotte. She argues that it conveys more authority than monotone speech because the voice takes on a lower pitch at the end of a sentence. Yet it is still derided as an irritating female speech affectation.

There is also a more general series of complaints about women’s voices that reverberates in the media. Hillary Clinton’s voice is too “nagging” according to Fox News journalist Mark Rudov, Sarah Palin’s voice “causes ears to bleed” according to the Free Wood Post, and Ann Coulter’s “whiny voice is so distracting” according to AOL TV reporter Jane Boursaw. Politics aside, these complaints cross the aisle to suggest that there are very few pleasing and acceptable ways women can speak.


How are women supposed to speak?

Taken as a whole, criticisms of female voices of authority are difficult to make sense of. If women’s voices are derided for being high-pitched, low-pitched, varied, and, well, feminine, how exactly are women in professional roles supposed to speak?

vocal cord anatomy
Vocal cord anatomy
Photo credit: Wikipedia

In medicine, public remarks are intended to educate and elucidate content-heavy material. Perhaps even more so than in other realms, the topics we discuss publicly are technical and complex: molecular biology, anatomy, pharmacology, physiology, pathology, and more. While speaking voices should certainly be clear, the societal trend of policing women’s voices distracts and detracts from this important subject matter.

There is no way to take the woman out of her own voice, nor should there be. Women have smaller vocal folds and laryngeal cavities than do men, generally speaking, and it is unsurprising that the higher pitch and lower volume of female speech patterns reflect this. Also unsurprising is the female tendency to use forms of vocal inflection to vary oratory sounds, given that there is less possible volume variation.

This variance in women’s speech does not make it girly, immature, whiny, cloying, annoying, or otherwise objectionable. It simply makes it the way half of the population tends to vocally project. And in medicine, as in all fields, it makes it worth listening to. It simply makes it the way half of the population tends to vocally project. And in medicine, as in all fields, it makes it worth listening to.

Originally published on TDWI 8/5/2015, it is being republished here as a timely reminder of yet one more challenge women face in getting heard. [A version of this post first appeared on The Doctor Blog on 07/31/15.] You can learn more about the author here: LaraDevganMD.com.


  1. Seems like too broad a brush is being used here. Most women in the US do not speak in a tone or manner that I find grating or off-putting, but there are certainly some voice types, male and female, that I find either distracting or even annoying.

    Multiple factors determine how we speak as adults, including where we grew up, what type of speaking was common or acceptable in our home, and of course genetics. Often, we are not really aware of how our speech is perceived unless someone comments on it or we listen to a recording of ourselves.

    Should we attempt to change our voices in order to appease others? No. Should we consider if we are speaking professionally and if we can improve how we speak in order to better command attention and convey our ideas? Definitely.

    Ultimately, it is entirely a personal decision.

  2. Vocal fry and upspeak are not just issues with women voices, but they tend to be more common. This is a pretty recent issue (last few decades), and it’s not related to the biology of women. It’s a bad habit pretty specific to American culture that distracts from the message and perception of credibility. It can be easily broken if you stop reading articles like these that say it’s okay and instead just put a bit more energy into speaking and say things like you mean it and not that you’re asking a question asking for validation. It’s like speaking with a lot of “um”s… a little practice will solve the problem.

  3. If somebody has a problem with your voice sound quality then it is THEIR PROBLEM not yours. You prepare like I do….you over prepare in order to have a completely satisfied audience. As a male with a less than deep masculine voice I have had experiences such as yours. Those who complain are just jealous of your intellect, composure, and ability to convey information in a presentation that is interesting and attention getting. Simply put, it ain’t your problem. Besides if they comment about it you know that they were listening to at least part of what you presented.

  4. Heck with the voice, it’s that female terminology, which may sound fine coming from Aunt Sarah but is ridiculous in a STEM professional. “What’s that thingy down there?” needs to be replaced by “Is that a nodule in the right lower lobe?”, and some sports terminology helps a lot too. And nobody is going to write a referral letter for somebody who tries to stay low-key: if you nailed something, say so instead of acting surprised.

  5. I am a woman physician. Years ago, before I gave grand rounds for the first time, I practiced my talk and recorded it. I was surprised at how whiney and unconvincing I sounded. I began to practice modulating my voice, realizing that presentation is as important as content. Vocal skills can be learned. I don’t have statistics but it seems to me that male colleagues pay more attention to how they sound.

  6. You’ve got to be kidding. You’re going to judge my performance, a woman with definitive girly voice because I am very short despite the fact I have a degree in medicine along with a specialty in family medicine with emphasis in rural and wilderness medicine, because I sound like a female in a Japanese anime movie? Do these guys have better things to do with their time?

    Yes, I have been accused of being a Doogie Houser when I was in medical school, and I still had surgical attendings thinking I was a medicine student when I was a Fam Med attending, but I just laugh it off. More times, they were amazed and would say: “But you look so young!” Tell me that when I’m seventy please. But in the long run, it’s what my patients think, and my veteran and schizophrenic patients tell me I am so easy to talk to.

    So when I get crap from these judgmental specialists I need to talk to, I remind them that I AM A REFERRING PHYSICIAN! If they don’t want my business because I talk chipmunk, I can certainly go elsewhere.

    And I have.

  7. […] girly, whiny, or worse, but here’s why women’s voices are just fine the way they are.The Problem with the Way Women Speak published first on […]

  8. One more thing: These seem to be distinctly North American phenomena, and white North American phenomena at that. I watch a lot of British media, much of it pretty recent, and I have never heard Englishwomen speak like this. Nor can I recall meeting any black or Hispanic women who talk this way.

  9. I agree with bliz and Buddy. Vocal fry sounds like nails on a chalkboard, and also sounds a bit robotic. And squeaky voices are just as irritating as any other high-pitched sound. Both are eerily devoid of genuine emotional expression and seem to fit with phony plastic personae. These are not the only options available for female speech, and it’s insulting to imply that they are. Greta Garbo, Lauren Bacall, Marlene Dietrich, Kathleen Turner, Julie Christie, Bette Midler, Ellen Degeneres–all of these women have been able to open their mouths without sounding ridiculous, and they all have different personalities, too.

    By the way, I have yet to meet a lesbian who uses a lot of uptalk or vocal fry.

  10. No. It is avoidable. You dont have to speak like immature valley girls or use vocal fry monotone sarcasm. This is a cultural thing and choice that can be and should be managed better by women. Just like women and men can judge men for bro voice or mansplaining voices, women, too, should be called out for their annoying voices as well. I know plenty of intelligent and unintelligent women that just use their normal voice and personality rather than a generic valley girl or vocal fry problem. Doing it performatively as an entertainer, or between other women doing it too is different than women that talk like this all the time in life due their inability to control their voice and be mature and adaptable. IT’S POSSIBLE. IT EXISTS. TO JUST SAY “OH WELL, THIS ISN’T OUR PROBLEM. THIS IS NATURAL AND ANYONE CRITICIZING THESE VOICES ARE THE ONES WITH PROBLEM FOR BEING JUDGEMENTAL.” THAT SEEMS JUST FINE TO VALIDATE YOUR OWN LAZINESS IN SPEAKING NORMALLY AND DEFENSE MECHANISM TO JUSTIFY CONTINUUING TO SPEAK LIKE AN IDIOT, BUT IT’S YOUR PROBLEM AND EASILY CAN BE MANAGED JUST AS BROS THAT GROW UP WORKING IN BUSINESS OR WHATEVER HAVE TO DROP THEIR VOICE, OR STONERS, OR JOCKY MAINSPLAINERS BECOMING A NURSE OR HUSBAND TO A STRONG WOMEN THAT NEEDS TO EXPLAINING LOL. There’s all kinds of annoying voices out there that are entirely sociological and cultural, not natural. You have zero excuse. M’kay.

  11. I feel strongly that women in the past did not speak with that girly chipmunk voice. People can learn to speak properly. Listen to how women sounded in film for decades. Audrey Hepburn, Grace Kelly’s voices are just two examples of beautiful voices. People sounded normal. There was no forced creaking. Young women today sound so terrible. It is terribly annoying and sounds so fake.

    • exactly…it is cultural….this writer is just devising excuses and defense for her own laziness and idiocy….everyone as they grow up lose their other voices–stoners, jocks, bros, a bostonite or southerner that’s moved and lived elsewhere into adulthood, tough guys, ghetto voice, slangs of all types, and even mel freaking gibson lol….on and on and on and on and on it goes for all adult working human beings to speak properly and change from their youth—except women apparently, …for them their voices no matter how annoying and improper is just simply nature, as everyone knows women have spoken this way since the beginning of times, and that the real problem is all these mean shallow ppl judging their annoying immature voices…ahhh, poor first world women problems…worlds smallest violin….


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