We explore the intrinsic ambiguity of speaking up in a multinational healthcare subsidiary. A culture change initiative, emphasizing learning and agility through encouraging employees to speak up, gave rise to paradoxical effects. Some employees interpreted a managerial tool for improving effectiveness as an invitation to raise challenging points of difference rather than as something ‘beneficial for the organization’. We show that the process of introducing a culture that aims to encourage employees to speak up can produce tensions and contradictions that make various types of organizational paradoxes salient. Telling people to ‘speak up!’ may render paradoxical tensions salient and even foster a sense of low PsySafe.