Hearing Aids:

[Plain Text: Hearing Aids]

There are many different types of hearing aids. Which type someone uses will depend on their hearing curve, the features they want, and the type of hearing loss.

1. Receiver in Canal.

Receiver in Canal (RIC) hearing aids are the newest type, and currently the most commonly prescribed. They have a small behind-the-ear component with directional microphones and processors, and are connected by a thin clear wire to an in-ear speaker, which is covered by a piece called the dome.

RIC are most commonly prescribed for: mild to moderate hearing loss (although they can be useful for some people with severe hearing loss), high-frequency hearing loss, noise-induced hearing loss, tinnitus, and auditory processing disorder. RIC are also available over the counter.

Benefits: small and discrete, fairly powerful, best integrated noise filtering systems, highest mapping customizability.

Drawbacks: sizing is not infinitely customizable, not good for more severe deafness, usually don't come in fun colors, difficult to use with low dexterity.

There are several different dome types, as I mentioned. Domes are soft silicone or plastic pieces fitted in diameter to the ear canal, but come in a few different shapes depending on the type of hearing loss. I'll talk about the most common ones, but there are a few other rarer custom types.

Open/Vented domes have slits cut in the silicone. They are the weakest at keeping sound trapped, but have the lowest occlusion effect (hearing your own voice loudly). They are good for mild to moderate hearing loss, but they can cause a lot of feedback, especially at higher frequencies, so they're most useful for high-frequency hearing losses. The amount of vents in the dome can be adjusted to reduce leakage.

Closed domes do not have slits or have very few slits. They keep more sound trapped, but have higher occlusion. They are good for moderate broad-spectrum and low-frequency hearing loss, since they allow less high-frequency noise to escape.

Power domes have no slits and often have multiple layers for maximum amplification. They have the highest occlusion effect, although people using power domes typically have hearing loss in the range of 60-80 dB, so occlusion is often necessary to hear one's own voice. Power domes can make the ear pressure feel unbalanced since there are no vents.

2. In the Ear / Completely in Canal.

In the Ear (ITE) and Completely in Canal (CIC) hearing aids are a less popular, but available, type. They feature a solid combined processor and speaker that sits in the ear canal. There is usually a small wire or clear plastic loop that fits along the curve of the outer ear both to keep it in place and to pull it out.

ITE/CIC are most commonly prescribed for: mild-moderate hearing loss when RIC is not preferred or available.

Benefits: no behind the ear component can be more comfortable, microphones in the ear have highest directionality, subtle.

Drawbacks: fewer features available, higher occlusion effect, can fall out more easily.

(There are some ITEs that have a behind-the-ear component for volume/power control and structural support, but the processor, microphones, and speakers are all in the canal piece.)

3. Behind the Ear.

Behind the Ear (BTE) are the most powerful type of hearing aid. The microphones, speaker, and processor are all present in the behind-ear component, which is larger than other types of hearing aids. This component is connected by a replaceable plastic tube to a mold, which is custom-fit to the user's ear and allows for maximum sound retention/amplification. Like domes, there are several types of molds.

BTE are most commonly prescribed for: severe to profound hearing loss, moderate or higher low-frequency hearing loss, children.

Benefits: sizing is fully customized, easy to use with lower dexterity, good for athletics (less likely to fall out), highest aesthetic customization, most powerful amplification.

Drawbacks: larger size, high occlusion, higher risk of ear infections, molds must be replaced as ear shape changes, tubes must be replaced regularly.

There are lots of different mold types. An ear mold is custom fit by creating a cast of the user's canal and ear shell. More or less of the "shell" of the ear can be covered by the mold. All molds have a vent hole to allow moisture to escape, but some molds have more holes cut into them to allow airflow or reduce occlusion. Some molds are hollow, while others are solid. (Molds can also come in lots of fun colors, including marbled or glittery, although insurance won't always cover these.)

There are too many types of molds and considerations to really get into exact types here, but if you look up behind the ear hearing aids there are tons of references online. [One type of mold I've seen a lot in real life but that I can't find the name of online are sort of square-shaped solid (often colored) plastic with lots of holes in them. They remind me of a waffle.] In general, the more severe the hearing loss, the less "air space" there's going to be in the mold.

4. Bone Conduction.

Bone Conduction hearing aids (BCHA) are probably the closest-looking in real life to those headphone ones, although many of the over-the-counter devices calling themselves BCHAs that look like headphones are in fact just bone conduction headphones. Prescribed BCHAs are often two individual rectangular devices, attached via stickers or a headband. There are a few that go behind the ear, although no component of the aid is in the canal.

BCHAs are bone conduction rather than air conduction, which means they get the sound to the cochlea by vibrating the skull bones rather than sending sound through the middle ear. BCHAs are often temporary aids (see BAHA in the CI section of this post).

BCHA are most commonly prescribed for: severe conductive or mixed hearing loss, microtia/atresia, and young children.

Benefits: more powerful and safer long-term for conductive hearing loss, typically no in-ear or over-ear component.

Drawbacks: require an external component (stickers or headband) to stay attached.

5. Airpods / Actually just headphones

Did you know, Airpods were recently approved by the FDA as over-the-counter hearing devices? The noise filtering technology makes smart wireless headphones a possible alternative for mild hearing loss, auditory processing disorder, tinnitus, or anyone who can't get prescription hearing aids. These are not a long-term solution, nor are they used by audiologists, but for people who just need a bit of a boost, having their headphones in all the time might be their way of navigating the world.

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All hearing aid types have their benefits and drawbacks, and no aid will ever be perfect for someone. Even the best hearing aids available can't make someone become Hearing. Some people who are severely to profoundly deaf report hearing aids giving them around 60-80% of what a hearing person can hear, and this number improves with decreasing severity of hearing loss. Still, nearly all d/Deaf/hoh people struggle to some degree with auditory processing. They may use hearing aids to give them general awareness of background noise (eg fire alarms), or for a boost while lip-reading, even if they don't help in understanding noise more generally. Hearing aids can also die or malfunction, removing the benefits they provide.

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Cochlear Implants:

[Plain Text: Cochlear Implants]

Cochlear Implants, or CI, are surgically implanted devices that stimulate the cochlea.

More on CI in one second, because I promised a return to BAHAs, which are a type of surgically implanted hearing aids. They get to go in this section because they are implants.

BAHA stands for bone anchored hearing aid (as opposed to BCHA, which stands for bone conduction). BAHA are the long-term alternative to BCHAs. A titanium plate is anchored to the skull, and an external hearing aid component attaches to the plate and vibrates it.

BAHA are most commonly prescribed for: severe to profound conductive hearing loss, microtia/atresia. (One of the major use cases for BAHA is Treacher-Collins Syndrome, which often causes bilateral microtia. Since the hearing loss is purely conductive, and traditional hearing aids do not typically fit people with microtia even without atresia, BCHA/BAHA are the best aids.)

Back to CIs. Unlike BAHAs, cochlear implants are implanted into the cochlea to directly stimulate the auditory nerve. They bypass the outer, middle, and inner ear systems, so they are useful for any type of hearing loss.

In order to qualify for a CI, one needs profound hearing loss across all or most frequencies, and the presence of both the cochlea and the auditory nerve (CI won't work without those structures). Someone can qualify for a CI in one ear but not the other; even if someone is qualified to receive implants in both ears, they're expensive and the surgery has risks, so many bilaterally deaf people have only one implant.

In the United States, CIs are approved starting at 9 months old, but not any younger. (This is a problem for auditory development--although CI are often billed as a "cure" or "complete treatment" to deafness, the reality is that even bilateral CI users who received speech and auditory therapy from the moment their devices were programmed still lag behind hearing peers in auditory development, because they are deaf. But that's part of a larger conversation regarding deaf development and audism.)

CIs have a small disc that magnetically attaches to the skull near the implant site. That disc transmits the sound through the bone, which is then transmitted to the auditory nerve. Usually, the disc is connected to a wire, which runs to a behind-the-ear processor piece. CIs have a couple different types, just like hearing aids. I'll run through them pretty quickly.

1. "Button" CI.

These are fairly new. They only have the magnetic disc; all the processors and microphones are inside it. They're less visible, but less powerful.

2. Behind the ear microphone.

The BTE component contains the microphones and processors. There is a hook to keep it in place on the ear, but no part of the CI goes into the ear canal. These have similar directional power to BTE hearing aids.

3. In-ear microphone.

The processors are on a behind-the-ear component, but they receive signal from a microphone positioned at the opening of the ear canal. These give the best directional sound filtering, since they receive the auditory input from the same place as a hearing person, often with the benefits of the shape of the outer ear.

4. Mixed type CI + hearing aid.

These are also very new! Previous CI techniques, and many surgeons today, destroy residual hearing, so when the CI processor is disconnected, the user receives no auditory input, even if they had some before getting a CI. However, some new techniques can preserve residual hearing, and the cochlear implant can be combined with a hearing aid. This device looks like a BTE hearing aid with either a mold or power dome, but also connected by a wire to the magnetic disc of a CI.

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What type of CI a person has depends on the technology when they were implanted, what sound quality they want, or what they can afford.

The sound from CIs don't match how hearing people hear things. CI have way fewer neural connections than the cochlea has. Bilateral CI is often more effective for oralism than unilateral, but even then, CIs do not replicate natural hearing.

A CI can be implanted at any age, although it's most "effective" in infancy or adults with new-onset hearing loss, rather than people who have grown up d/Deaf. Getting a CI in adulthood is a very personal choice and can have a lot of meaning for a Deaf person.

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Gene Therapy:

[Plain Text: Gene Therapy]

This post has gone on long enough, and this isn't a hearing assistive device, but it is something to consider in a sci-fi or post-modern setting, and something we (the Deaf community) have to deal with right now.

There are currently new therapies (around 3 years in trial) that target OTOF mutations that cause severe to profound congenital deafness. OTOF mutations cause the loss of a protein that turns cilia movement in the cochlea into neural signals. The gene therapy introduces the gene that codes for this protein into the inner ear.

A small study on around 20 children, teens, and young adults with profound hearing loss (>100 dB) saw hearing curves change to 56 dB +/- 30 dB. I couldn't get the raw data because I couldn't access the study, but that means the average participant is still moderately hard of hearing and still needs hearing aids and accommodations. Depending on the metrics for calculating that error, there was likely at least one participant who remained severely to profoundly deaf after the gene therapy, and no participants became medically hearing.

We still have no data on if this gene therapy lasts forever or what kind of side effects it has. It also only works for a specific class of OTOF mutations, which account for many cases of congenital genetic deafness, but not all. Every single study on the gene therapy is produced by one company. This technology has not yet been peer-reviewed or tested for long enough. Nevertheless, hearing people are treating this as a cure, that the Deaf community doesn't want.

If a deaf person wants access to a technology like this, that is again their choice. Forcing this onto infants and children without autonomy or the ability to make an informed decision is horrible. The push to "cure" deafness goes hand-in-hand with the destruction of Deaf culture. It is eugenics. If you're going to include gene therapy or some other magical "fix" to deafness in your story, think about that.

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Keep writing, and keep sending in your questions!

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The members of CORTIS have never seen their hyung so excited since their debut. Martin is told by James multiple times to clean the dorm, even if it means keeping the other members awake at 4 a.m. with his loud vacuuming. Keonho and Seonghyon are told by James all week to tone it down before Y/N's arrival, whatever that means. Juhoon is told that he has to put his book collection on a shelf instead of leaving books scattered around the dorm, including in the bathroom.

No one is allowed to leave a dish in the sink, which is strange for the CORTIS dorm.

Martin isn't allowed to play Fortnite that week. Then, on Friday before Y/N arrives, he needs a break from all his work in the studio, which leads to him practically begging on his knees for the oldest member to let him play at least one game.

The twins aren't allowed to go crazy at the convenience store and bring back greasy food. James claims that Y/N is sensitive to certain smells. He never tells his members that his best friend wears hearing aids and relies heavily on their other senses.

Juhoon notices James turning on the TV captions in the settings one evening. He never mentions it to the other members, although he really wants to question his hyung about his strange behavior.

James spends every free moment between recording sessions and work checking to see whether Y/N's plane has landed safely at Incheon International Airport.

Y/N has no idea that James does all this preparation before they arrive in Korea. The flight from Taiwan to Korea is awful. First, the left hearing aid falls out before takeoff, and a flight attendant delays the flight by twenty minutes while helping find it between the seats. Then, the child sitting behind starts screaming just as Y/N opens their favorite book to read.

They can never sleep on planes. Able-bodied hearing people always assume taking out the hearing aids helps them relax, but it only makes things worse because they aren't deaf. They're hard of hearing and can still hear plenty of background noise without the hearing aids.

Lastly, Y/N tried to order an Asian herbal tea to calm their nerves, but the child behind starts crying again, and they completely forget about the tea.

By the time the plane lands, they're more than ready to escape the noisy airport and rant to James about the entire flight. He's their listener, their person, their best friend, their shoulder to cry on, and so much more.

The moment Y/N steps off the chaotic flight, they turn on their phone to see if James has arrived at the airport. All they want is to see him again and hug him.

His last visit to Taiwan was two years ago, when he called his mom in tears because he didn't want to be a trainee anymore. Y/N is there through it all, encouraging him to return to Korea and continue training at HYBE, where he's now living out his dream.

The airport is loud, and even with their hearing aids in, Y/N can't hear much.

What they don't expect is a text message from someone named Martin saying that a car is waiting to take them to HYBE, where James is recording.

Y/N only knows Martin through text messages and voice notes where random noises constantly interrupt James' recordings. So when they finally spot a sign that reads, Car Ride from James, their jaw drops.

The entire walk to the parking lot is silent. The man carrying one of their bags never says a word. Y/N can't tell whether he's part of CORTIS's security team or simply the airport driver.

"I have so much to tell you."

They want to run over, hug James, and mess up his hair like they always do back in school.

But the thought disappears almost instantly.

He's an idol.

He dreams of this life.

You're just...you.

A person with hearing aids trying to navigate Korea for the first time.

-

Inside the recording studio, the twins are having a foam sword fight while Juhoon makes ramen in the HYBE kitchen. Honestly, it's the only thing he knows how to cook. Music blasts through the soundproof studio, where the acoustics are the best, and their manager hides away somewhere he doesn't want to be disturbed.

Before Juhoon can announce that the ramen is ready, their manager steps out of his tiny office and announces that the release of their second album has been moved from summer 2026 to spring 2026.

Keonho is the first to react, tossing aside his foam sword.

"I have a demo I want to share. Maybe it can help us."

Juhoon stays quiet.

He knows they're all overworked, and James desperately needs a break—a break with his best friend from Taiwan. He doesn't say anything because he watches James' grin slowly disappear into a frown.

Juhoon secretly notices every dorm preparation James makes for his guest, but he never brings it up.

"We should just have a sleepover at HYBE and finish everything before the deadline," Keonho suggests, sitting up from the beanbag while Martin continues working on a track and James stares at his phone.

"Our manager won't let us. I already asked," Martin replies, knowing an all-nighter would help him finish more work.

In the corner of the small studio, James quietly mumbles, "Y/N is here. I'll be back. I'm gonna give them a tour of the building."

No one hears him over Martin's demo.

James is so distracted thinking about his best friend that he completely forgets to tell the others that Y/N is hard of hearing and wears hearing aids.

Y/N stands the moment they see James step out of the elevator.

He looks different.

Taller.

Fresher.

He has a new haircut and expensive clothes.

Y/N has to remind themselves that he isn't the same James from school anymore.

He's an idol.

James ignores the receptionist staring at Y/N and rushes over, wrapping them in a hug.

"I have to tell you something."

Y/N can't hear him. His face isn't turned toward them, making it impossible to read his lips. Even with hearing aids, they still need eye contact to understand speech in loud places.

"Welcome to HYBE. I'm working with the guys right now, but I promise we'll grab something to eat and catch up afterward."

James finally faces them and smiles.

Y/N's smile immediately fades.

Their best friend is already busy.

They should have expected this.

"So...can I finally meet the famous producer Martin?" they ask with a forced smile, unaware of just how loud the studio is.

"I thought you missed me?" James pouts.

"Martin texted me at the airport that my ride was waiting." Their voice hesitates. They come to Korea for James, but they're also excited to finally see where he works with his group.

"Oh, right. I was recording some ad-libs for our album. I told him to do it," James says, turning toward Y/N as they wait for the elevator. A loud ping echoes through the hallway as the doors slide open.

The second they walk into the CORTIS studio, James immediately leaves Y/N's side.

All five members are talking at once.

The overlapping voices make Y/N feel like a lost child in a crowded mall.

A tall boy—who they assume is Martin—is playing a beat on his computer, while someone they recognize from James' TikToks stands inside a makeshift recording booth.

The room is so overwhelming that all they want is to ask James to take them back to the dorm and sit with them in silence.

Instead of admitting the studio is far too loud, Y/N quietly sinks into a beanbag in the corner and waits for James to finish.

-

James' schedule is non-stop. You should’ve expected that before you told him you would come and visit during your university spring break. 

“Um, hi. I bought you a snack and a cold water,” a brunette boy approaches you all of sudden when James is out of sight while you're waiting on a couch in a hallway of a recording studio.

You glance up at the handsome boy, and notice that it is one of the boys you saw in the studio earlier before you found a chair to relax in and put your hearing aids back in their case.

“I’m Juhoon. The other quiet one of the group. You must be James Hyung's friend from Taiwan. Sorry I didn’t properly introduce myself, we have been recording our second EP.,” You stare at his lips and try to read them even though your hearing aids aren’t in your ears.

You hear about 80% of what he says, and instead of asking him to repeat it, you decide he’s friendly and kind enough to notice you weren’t your wearing hearing aids and holding the case. So you take the tiny hearing aid case out of your purse and place the small pieces in your ears while he watches you, studying your face.

“Y/N, my name is Y/N,” You decide to say while putting your hand out for him to shake. 

You want to include that your James' best friend from Taiwan. But that seemed kinda awkward considering that he wasn't there. 

Juhoon didn’t say anything about Y/N’s hearing aids. In fact, he kept quiet and sat down on the couch in the break room and grabbed a bag of chips to eat with Y/N.

“Are you gonna ask me about my hearing aids or why am I here?” You stop mid bite and ask Juhoon, politely. 

“No, that’s rude to ask someone about their disability. James hyung has been talking about you all week. He’s prepared the dorm for your arrival. His side of the room is even decked out in pink and flowers. You should see it soon, it’s like he totally forgot about boundaries,” Juhoon faces Y/N to respond so that she can hear him and acts dramatic during his small rant because James turned his room into a guest room and shoved him out. 

You don’t have anything else to say, so you change the subject. You know and trust James but sleeping in a dorm with 5 guys wasn’t what you came here for. It was as if your best-friend totally forgot to tell the members that you wore hearing aids, but still had some ability to hear without them at night. That’s why you booked a hotel room.

“Um, can you not tell the others about my disability? Only James knows and I don’t know any form of sign language. It becomes weird when people try to sign towards me and notice my hearing aids,” You whisper in a lower voice feeling insecure already in a music studio where there's sound everywhere. 

“Pinky promise. You’ll get a chance to talk to James somewhere quieter soon. I have to go back before the boys joke about my stomach issues.” The younger boy walked away with your secret in mind knowing that too much noise was not your forte. 

You smile slightly and wait for the boys to finish recording vocals. Assuming that after this you’ll get a moment with your best friend, 

-

After a quick stop at the CORTIS dorm to change your outfit, you get directed to a separate car with two boys who look alike. Not James, though. You frown for the second time that day, realizing that James didn’t even introduce you to the members at any point in the day. He completely forgets about your disability and acts like you can hear everyone in the studio.

At dinnertime, you expect to have a private moment with your best friend. The teppanyaki restaurant the CORTIS staff chooses is loud, though.

Not as loud as the HYBE studio, but loud enough that Y/N hears everyone in the restaurant talking over the members.

James is far too busy with his members to notice that Y/N is sitting alone at a table, picking at chopsticks that aren’t even broken, away from the CORTIS staff.

All you want to do is take your hearing aids out and pretend you aren't at the restaurant anymore. But you have to wait until a server comes around and hopefully asks for your order. You haven't had anything to eat since scavenging through the studio break room for snacks while James is recording.

You glance over at the table where the members are shooting some sort of TikTok video and smile at your best friend, who seems to be living his best life. Maybe he doesn't need you anymore, you think to yourself. He has his brothers if he ever needs a shoulder to cry on in Korea.

After they finish shooting the video, the members finally settle back into their seats and begin looking over the menu, chatting excitedly as they decide what they want to eat. The servers weave through the restaurant, stopping at table after table to take orders. You wait patiently, figuring someone will come by in a minute. They never do.

One by one, plates of sizzling meat, fried rice, and vegetables begin arriving at the members' side of the table. Laughter fills the air as they reach across one another to steal bites and joke about whose order looks the best. The noise of the restaurant blends together until it becomes a dull roar in your hearing aids, making it impossible to separate one voice from another.

You sit quietly, your menu still closed in front of you. No one asks what you want. No server ever comes over to take your order, and with everyone caught up in their own conversations, no one seems to notice that you're still waiting.

At first, you tell yourself they'll realize eventually.

Then another round of food arrives.

Your stomach twists—not just from hunger, but from the sinking feeling that you've somehow become invisible.

You lower your gaze to your lap and take a slow breath. If James notices, he doesn't show it. He's laughing with the members, completely absorbed in the moment, and you don't have the heart to interrupt him. You don't want to make a scene. You don't want everyone to stop talking just because of you.

So, without a word, you push your chair back as quietly as possible.

No one looks up.

You slip away from the table and find one of the CORTIS staff members near the entrance and let them know you're leaving. Keeping your voice calm, you ask if someone can drive you to the inexpensive hotel you booked before flying to Korea—a backup plan you make just in case the CORTIS dorm is too loud for you.

The staff member nods without asking too many questions and calls for a company car.

Before you shut the car door, you spot Juhoon running out of the expensive teppanyaki restaurant holding a takeout bag filled with several boxes of food he secretly orders for you and doesn’t eat. Inside the bag is a note with his phone number in case you need anything, and at the bottom it says he pinky promises not to tell anyone your secret, and that he told the members that he had constipation so he had an excuse to leave the table. 

A few minutes later, you're sitting alone in the back seat, watching the bright Seoul lights blur together outside the window. The restaurant disappears behind you, along with the laughter that never once includes you.

The silence inside the car is almost comforting.

With a tired sigh, you reach for your hearing aid case out of your purse and carefully slip your hearing aids out, one after the other. The overwhelming noise of the restaurant fades instantly, replaced by a familiar quiet that wraps around you like a blanket. You rest your head against the cool window and close your eyes, letting the city pass by in muted flashes of light as the driver takes you to your hotel.