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Physical Conditions

Sometimes the voice is simply not available.

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Various physical conditions prevent or severely limit voice use: chronic laryngitis, vocal cord nodules or paralysis, conditions involving severe fatigue (ME/CFS, fibromyalgia), post-surgical recovery (including laryngectomy), respiratory conditions, and medication side effects. Critically, the NHS advises that even whispering should be avoided with conditions like laryngitis — it strains the larynx just as much as loud speaking and is not a valid workaround. Attempting to use the voice against medical advice risks worsening the condition. Being online and being unable to speak are not mutually exclusive.

What they cannot do

• Use their voice without risk of pain, injury, or worsening their condition
• Predict when their voice will or won't be available
• Push through with voice — even briefly — without causing real physical harm
• Whisper as a compromise: whispering strains the larynx equally (NHS)

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Common misconceptions

• They'll recover soon — it must be temporary
• It can't be that serious if they're still online and active
• They could try just a little — even whispering would be fine
• If they were really that unwell, they wouldn't be here

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How to actually help

• Accept their stated limitations without requiring justification or proof
• Never suggest voice or whispering "just this once"
• Understand that online activity and inability to speak coexist routinely
• Make all key information available in text without being asked

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