My experience with Microtia, v2!
A (hopefully) educational post!
I wrote the original version of this post back in 2021! I've learned more things since then + I've gotten better at writing, so I thought it'd be nice to remake it with some updates! So, let's get into it :)
Microtia is a congenital facial difference that affects the outer ear, where the outer ear doesn't fully develop during pregnancy like it should.
Microtia comes in four "grades" depending on how developed the ear is. At higher grades, it may also include atresia, which is the lack of an external opening to the ear canal. The highest grade, grade 4, is also known as anotia, and that means there is no external ear present at all.
Microtia can be present on its own, or it can be a part of the wider conditions Hemifacial Microsomia, Goldenhar Syndrome, and Treacher-Collins Syndrome.
If you'd like more fancy clinical information, I'm gonna direct you to this website :) I'm not a doctor.
What effects can microtia have?
Probably the most obvious effect of all is that microtia is a visible difference. People will notice, and they will wonder about you. When I was younger, I was asked more than once by my peers if I had been in a fire! To which, hey, it's none of your business!
I know most adults, at least, understand that it's rude to ask, but I still wear my hair down near-constantly, just to avoid any attention getting drawn to my ears. I've never gotten them pierced, for the same reason.
If atresia is present, then microtia can also be a cause of deafness. Whether a person with microtia is involved with the d/Deaf community may vary (I am not), but it's still pretty hard to hear when there's no way for the sound to actually get to your inner ear.
Some people opt for reconstruction to change this- essentially, plastic surgery to open up the ear canal and make the ear appear more "normal". Others get a bone-anchored hearing aid, aka BAHA– sound can be conducted through bone, so a BAHA delivers sound as vibration directly to the bone. Still others (like me) choose not to change it– I feel my ears are fine as they are, and I would rather the people around me simply be accommodating! (More on this in a bit!)
I, specifically, have microtia in both my ears, with atresia on my right side. This means I am unilaterally deaf. Unilateral hearing loss requires some different considerations than bilateral hearing loss– I can still generally hear and understand others, but I have trouble with a few things, which I'm going to give their own subsection right here.
People standing on my right side– I generally call it my "bad side" but that's definitely not the most neutral thing to call it and it'll vary person to person what they're comfortable with. If someone stands on my bad side I will struggle to understand and keep track of them, and I may not even realize they are speaking to me if I didn't expect it.
Due to this I try to always stay to the right of others and stand at a little bit of an angle.
Unilateral hearing loss causes a loss of what we call "distance perception", much like how loss of vision on one side causes a loss of depth perception– my brain can't compare inputs from both ears to tell where a sound is coming from and what sounds to prioritize.
This means that I am bad at Marco Polo, buuut it also means that noisy areas can be especially overwhelming and I can struggle to follow conversations there. I hated my high school cafeteria with a burning passion.
The little things! I can't wear earbuds in my right ear, and they get uncomfortable quickly in my left. I need the earpieces of my glasses bent further so they stay on right, and I can't wear face masks that go over my ears. If I get earwax or water in my left ear, I will really struggle to hear at all. It's a pain in the neck!
How can you (and/or your characters) be accommodating to someone with microtia?
Don't ask invasive questions! Seriously, it's really uncomfortable, they'll tell you on their own if they want you to know.
Stand and walk where they can hear you well! If you do this on your own it's really nice and shows you care.
Use the language they are comfortable with! There's not as much of a "person-first" versus "identity-first" thing with microtia– I mean, I guess I could be called a "microtia-having individual", but it'd just feel really clunky. But I'm not the spokesperson for every person with microtia out there! So respect the language they'd like you to use.
Be mindful of situations where they might be struggling to hear you, and make a conscious effort to include them in conversation! Remember how I mentioned the cafeteria? Yeah, I might not have hated it so much if the people I knew actually tried to have intelligible conversations with me. Also, please just repeat stuff if we ask, it just feels like you're purposefully leaving us out if you say "never mind".
This is the most important part of this whole guide to me!
The thing is, I've never seen a character with microtia in media, and only once or twice in art. As much as I would love to see characters who look like me, that just doesn't happen.
Yeah, microtia is rare– it occurs in somewhere between 1/6000 to 1/12000 births– but even by that logic, for every 60 to 120 redhead characters, there should be one with microtia! And I know a LOT of redheads in pop culture.
Furthermore, even the discussion of microtia online is pretty heavily focused on family and what they can do to "fix" microtia. And while I won't bash people who did go that route– if its right for you, it's right for you!– I see my ears in a neutral light and would rather just treat them as a part of my body like any other.
I want to be able to have conversations with people like me and commiserate about how annoying it is to have someone try to talk to me and be unable to understand them, or how convenient it can be when someone is apparently being annoying off to my right side and I don't have to listen to them!
So, I hope this little guide post of mine inspires you to include microtia in your artwork, or for that matter, to include other lesser-known differences! I'm sure there are other people out there hoping for the same thing I am. So go forth and talk to them, include them, and I bet they'll be really happy to see themselves, just as I'll be :)
If you've still here after this little ramble of mine, feel free to ask questions or provide suggestions if you have them! I'd love to hear what you have to say, too ^^
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