Differences Between Deaf and Hard of Hearing

The Definitions Depend on Who You Ask

Teenage girl with father, using sign language
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What does it mean to be deaf and how does that differ from being hard of hearing (HOH)? The answer depends on who you ask and what perspective you're looking at it from. The medical community, for instance, has a strict definition, but people within the deaf or HOH community can have an entirely different opinion.

Medical Definition

Medically, hearing loss is defined by the results of a hearing test. There are parameters set out to classify someone as either deaf or hard of hearing. A complete hearing test examines how loud sounds across the frequency range have to be in order for you to detect them. It also gauges how well you can understand speech. 

If you are unable to detect sounds quieter than 90dB HL (decibels Hearing Level), it is considered a profound hearing loss for those frequencies. If the average of the frequencies at 500Hz, 1000Hz, and 2000Hz is 90dB or higher, the person is considered deaf. 

A person who is hard of hearing can have a range of hearing loss from mild to severe. It should be noted that amplification technology is available for people with mild to profound hearing loss. 

Cultural Definition

The cultural definition is much different than the medical definition. According to the cultural definition, being deaf or hard of hearing has nothing to do with how much you can hear. Instead, it has to do with how you identify yourself. Do you relate more closely to hearing people or deaf people? Many medically hard of hearing people consider themselves culturally deaf. 

Sometimes, this difference between cultural deafness and those with profound hearing loss can be indicated in the way the word "deaf" is written. For example, if you see "Deaf" with a capital D, it typically indicates deaf culture. On the other hand "deaf" spelled with a lowercase d indicates hearing loss and the person may not necessarily consider themselves part of deaf culture. 

Psychological Definition

There are also those who are medically and functionally deaf who insists, "I'm not deaf, I'm hard of hearing." This statement is often made by people with hearing loss who are in denial about the degree of their hearing loss. They may not be ready to admit the severity of their hearing loss.

Additionally, advances in the technology of cochlear implants are blurring the lines even more. Many people with profound hearing loss are now able to communicate orally and participate as a hearing person.

For these reasons, the way someone identifies themselves in terms of their hearing loss is often more about personal perception or choice than anything else. 

Dual Definition

Are people with cochlear implants whose hearing losses are reduced to as little as 20 dB hard of hearing or deaf? In the author's layperson opinion, the answer is, "both." 

When a person with a cochlear implant has the implant on and can hear well, they are hard of hearing. When the implant is off and they can not hear anything, they are deaf. The same is true for hearing aids. Long ago, the author would say that she was "on the air" when wearing her hearing aids and functioning like a person with hearing loss, but "off the air" when not wearing the hearing aids and unable to hear anything.

A Word From Verywell

As you can see, there is no singular definition that tells us whether someone is deaf or hard of hearing. Though the medical definition may pertain to everyone, anyone's personal perception of their hearing loss and how they fit (or don't) into the deaf culture are just as important to consider. In reality, there is no right or wrong answer that fits every individual. It is often best to ask what someone prefers before making assumptions.

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