Author(s)
Fariha Rahman, BSC
Lindsay Booth, MD Gabrielle French, MD FRCSC
Affiliation(s)
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Section of Otolaryngology - Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada
Abstract:
Introduction:
Animated characters with visible differences are frequently villainized, marginalized, or linked to poor outcomes. The depiction of otolaryngologic specific conditions remains under investigated. This study analyzed the frequency and portrayals of facial deformities, dysphonia, and hearing loss in animated films.
Methods:
All full-length animated films released between 1937 and 2024 were retrieved from Disney Plus Canada. Characters with facial deformities, dysphonia, or hearing loss were identified and confirmed by a fellowship-trained pediatric otolaryngologist. Dysphonia was defined using GRBAS-based qualities, while hearing loss included explicit impairment or device use. A structured character trait survey assessed identity, role, relationships, and narrative outcomes. Each character was independently reviewed by three raters, with inter-rater reliability evaluated using Fleiss’ and Cohen’s ?.
Results:
From 196 films, 198 characters with 260 otolaryngologic findings were identified: 190 had facial deformities (73%), 68 dysphonia (26%), and 2 hearing loss (0.8%). Large noses (32%), facial scars (10%) and hoarseness (13%) were the most common. Characters with large noses were usually normalized, peripheral, and rarely acknowledged, while hoarseness was seen to be highlighted, explicitly addressed, and associated with empathy. In comparison, characters with facial scars were most frequently linked to discrimination, antagonism, and having negative outcomes. The two characters identified with hearing loss, both with hearing aids, were portrayed consistently as trustworthy and achieving positive resolutions. Most characters were human, male and peripheral, with their conditions implied and not explicitly addressed. Cohen’s ? demonstrated strong pairwise agreement for core identity traits such as gender, story resolution, human, role level. Fleiss’ ? was low for all traits.
Discussion:
Otolaryngologic conditions in animated films are common but largely portrayed as markers of “otherness”, often found in peripheral characters. This reinforces marginalization rather than centralization. Though most characters with otolaryngologic findings were portrayed neutrally without explicit recognition in the plot for their condition, facial scars were linked to discrimination and negative outcomes. We advocate for the need for more diverse representations in complex central characters.