I have a stammer

Tasneem Khan is a GP in Bradford, and a primary care researcher at the University of Leeds. Her Instagram handle is @dr.tasneem.khan

I have a stammer.

I am one of 80 million people worldwide.

I block, I pause, I repeat, I stumble, and very often I give up what I want to say. But after decades of hiding, compensating, and apologising, I can finally say, I have a stammer.

Up to 8% of children will stammer at some point, usually between the ages of 2 and 6.^{1, 2} This is usually temporary, and most children will grow out of it. Speech dysfluency can also be a result of neurological insult, such as stroke, trauma and degenerative disease.³

And then there’s the rest of us, 1% of the population, where the stammer has continued into adulthood.
My stammer is a noun, not a verb. I don’t choose to stammer. It’s an entity in its own right, an unwelcome companion whom I have never managed to get rid of.

I spent most of my life as an undercover stammerer. I recognised early on that I was getting stuck on words, so I started a word-finding covert operation. Every sentence was scanned before I spoke, and any potential enemy words were substituted with precision. This became habitual, a reflex. And it worked really well, until someone asked me my name. When ordering a drink at Starbucks I would always give someone else’s name (It is harder to say the T in Tasneem). I felt like a fraud, but it got the job done. Drinks orders were always ‘orange juice’ – my palate adjusted to like the foods I could pronounce. Never did like pppppepperoni pppppizza anyway.

I was congratulated on my fluency. This reinforced the notion that my stammer was a dirty little secret and it must stay hidden at all costs. When I stammered I was told to relax, to slow down. Being told to relax is a sure way to get the autonomic nervous system firing. Slowing down didn’t help. It just took me longer to get stuck.

For those of you who remember Pop idol you will recall Gareth Gates. Thanks to him, stammering suddenly became known for more than its comedic value. But there was controversy about the fluctuations in his dysfluency – he didn’t always stammer on the same words, sometimes he didn’t stammer at all, so was it all fake? Of course not, the stammer is a sneaky little menace, it pops up when it feels like it, there is very little predictability, another reason to make you feel like a fraud.

I had speech therapy in my teens. I remember being told ‘maybe being a doctor isn’t the right job for you because you will have to use the phone a lot’. I chose to ignore that advice.

I had more speech therapy at university. I was always fluent in my group speech therapy sessions, much to my dismay. This was the stammer once again plotting to make me seem like an imposter.

I attended courses where we learnt breath control to ease the sounds out through the larynx. I wore specialised belts around my waist to assist diaphragmatic breathing. And all of this worked temporarily. But it was hard work. It was exhausting. And it all fed into the notion that stammering is bad, it needs to be hidden, it needs to be fixed.

I finally discovered the stammer-affirming model of speech therapy.⁴ It’s pretty simple – stop hiding it. Let yourself stammer. No more word-finding, no more situational avoidance, no fancy breathing techniques. Just, talk.

Now this was not easy. I started informing people that I stammer and apologising for the extra few minutes that they would require to listen to what I would have to say. In medical school OSCE’s I was asked how much extra time I needed – well I didn’t know. Would the extra time actually help me get my words out? Or would I end up being extremely fluent and appear to be a fraud (again). I never felt I could tick the ‘I have a disability’ box. The stammer had prevented me from doing a lot of things and had a profound impact on my life, but I wasn’t looking for a blue badge to compensate. Turns out that stammering can be considered as a disability under the UK’s equality act 2010. But even in the Royal College membership examinations there was confusion about what reasonable adjustments I would require. In the end I had none.

Stammering can mould a person’s life. And there is a constant battle in trying to reclaim ownership of your voice. Speech dysfluency has a strong link to anxiety and depression,⁵ and actual ‘treatments’ for stammering are themselves associated with increased levels of anxiety and treatment failure.^{6, 7}

6 years at medical school, 12 years as a junior doctor, and 3 years as GP. The medical school curriculum, postgraduate training, the Royal College examinations, the continuous professional development – none of this has EVER mentioned stammering. Surely a condition this prevalent, with such a huge impact on quality of life, deserves a footnote at least.

As a doctor when you are faced with someone who stammers, what do you do? Give them time, eye contact and space. But what about the well-meaning parent who asks for a speech therapy referral for her child, who tells you ‘I keep telling him to slow down and not be nervous’. You do the referral, but what do you say to her?

You tell her that speech therapy is not designed to ‘fix’ the stammer. It is designed to educate and empower. You tell her to please not instruct the child on how to speak – asking them to slow down, sliding on certain words, substituting words – this will only feed into the anxiety surrounding dysfluency. You say please don’t ask your child to relax, that never helps. And you look at the child and tell them – you are not alone.

I’ve stopped apologising.

I am now a mother of a child who stammers (yes, it can be inherited in some non-Mendelian fashion¹– as if there wasn’t enough guilt to deal with). I want to empower my son to stammer openly. I am honest about the frustrations, the unpredictability, that feeling when your own voice betrays you. I still have days where I come out of my clinic into the waiting and turn back around because the patient’s name is stuck in my throat and I need a minute to compose myself. But that’s my journey. I don’t choose to stammer. I have a stammer. It’s stuck with me. And I will speak.

Deputy Editor’s note: see also – https://bjgplife.com/supporting-patients-and-colleagues-who-stammer/

References

1. Yairi E, Ambrose N. Epidemiology of stuttering: 21st century advances. J Fluency Disord. 2013;38(2):66-87.
2. Gattie M, Lieven E, Kluk K. Adult stuttering prevalence II: Recalculation, subgrouping and estimate of stuttering community engagement. J Fluency Disord. 2025;83:106086.
3. Junuzovic-Zunic L, Sinanovic O, Majic B. Neurogenic Stuttering: Etiology, Symptomatology, and Treatment. Med Arch. 2021;75(6):456-61.
4. Irani F, Azios M, Boyle M, Coalson GA, Palasik S, Rodriguez J, et al. Reimagining stuttering therapy and outcomes through an acceptance and collaborative lens. J Fluency Disord. 2025;83:106105.
5. Briley PM, Gerlach H, Jacobs MM. Relationships between stuttering, depression, and suicidal ideation in young adults: Accounting for gender differences. J Fluency Disord. 2021;67:105820.
6. Dayalu VN, Kalinowski J. Pseudofluency in adults who stutter: the illusory outcome of therapy. Percept Mot Skills. 2002;94(1):87-96.
7. Byrd CT, Coalson GA, Conture EG. CARE Model of Treatment for stuttering: Theory, assumptions, and preliminary findings. Front Psychol. 2024;15:1488328.

Featured photo by Michael Dziedzic on Unsplash.