Men and women both have Adam’s apples. The difference is size: testosterone causes the male larynx to grow significantly during puberty, pushing the thyroid cartilage outward and creating that visible bump on the throat. In women, the same cartilage exists but meets at a wider angle, making it flatter and harder to see.
What the Adam’s Apple Actually Is
The Adam’s apple is the front edge of the thyroid cartilage, the largest of nine cartilages that make up the larynx (your voice box). During embryological development, two plates of cartilage grow toward each other and fuse in the midline of the throat. The point where they meet is what you see and feel as the Adam’s apple. Its job is straightforward: it acts as a shield for the vocal cords sitting just behind and below it.
In biological males, those two cartilage plates meet at roughly a 90-degree angle, forming a sharper, more pointed edge. In biological females, they meet at about 120 degrees, creating a flatter, rounder shape that sits closer to the throat. Both configurations protect the vocal cords equally well. The difference is purely geometric, and it’s driven by what happens during puberty.
How Testosterone Reshapes the Throat
Before puberty, boys and girls have similarly sized larynxes. That changes around age 12 to 14, when a surge in testosterone triggers a growth spurt in the male larynx. The cartilage enlarges, the vocal tract lengthens, and the vocal cords themselves get significantly longer and thicker. By the end of puberty, male vocal cords average about 1.6 cm in length compared to about 1.0 cm in females, and the male vocal tract stretches to roughly 16.9 cm versus 14.1 cm in females.
This happens because vocal cord cells contain androgen receptors, both in the cell’s outer compartment and its nucleus. Testosterone binds to those receptors during puberty, directly stimulating the tissue to grow. The result is a larynx that’s bigger in every dimension, with the thyroid cartilage projecting further forward. That projection is what makes the Adam’s apple visible through the skin.
Males also undergo what’s called a secondary descent of the larynx, a further drop of the voice box in the throat that’s unique to male puberty. This descent lowers the position of the larynx and contributes to a deeper resonance. Voice breaking, the most obvious sign that these changes are underway, typically happens as a distinct event during late puberty, often around age 14 to 15, as the vocal cords catch up with the rapid growth of the surrounding cartilage.
Why a Bigger Larynx Means a Deeper Voice
Longer, thicker vocal cords vibrate at a lower frequency, the same principle that makes a bass guitar string sound lower than a treble string. During normal speaking pitch, male vocal cords range from about 8.9 to 11.3 mm in functional length, while female vocal cords range from about 7.0 to 10.1 mm. That physical difference translates directly into the pitch gap between male and female voices.
The relationship between cord length and pitch isn’t perfectly linear, though. Within a person’s range, the vocal cords stretch longer as pitch rises, at least through the spoken voice range. At higher pitches, including falsetto, other mechanisms take over and cord length stops being the main way the body controls pitch. But for everyday speech, the size of the larynx is the dominant factor.
An Evolutionary Signal
The deep male voice appears to be more than a side effect of growth. Research suggests it functions as a secondary sexual characteristic, similar to facial hair or broader shoulders. Studies have found that women tend to prefer voices with lower fundamental frequencies, possibly because voice depth correlates with testosterone levels and may signal hormonal and immune system quality.
There’s also a competing (and possibly complementary) explanation rooted in competition between males. The secondary descent of the larynx isn’t unique to humans. Other species have it too, and researchers have proposed that its original advantage was allowing individuals to produce vocalizations that mimic a larger body size. In humans, a deeper, more resonant voice may have helped adult males sound more imposing relative to females and younger males, giving them an edge in social competition.
Why Some Women Have a Visible Adam’s Apple
Since every person has thyroid cartilage, some women do have a noticeable Adam’s apple. Body composition plays a major role: women with less subcutaneous fat around the neck will show more of the underlying cartilage structure. Individual variation in cartilage size and angle matters too. A woman whose thyroid cartilage meets at a slightly sharper angle, closer to the male average, will have a more prominent bump. Hormonal variation, including naturally higher androgen levels, can also contribute to a somewhat larger larynx.
None of this is medically significant. A visible Adam’s apple in a woman is simply a reflection of her individual anatomy, not a sign of a hormonal disorder or any health problem.
Surgical Reduction of the Adam’s Apple
For people who want to reduce the prominence of their Adam’s apple, a procedure called chondrolaryngoplasty (commonly known as a tracheal shave) removes the projecting portion of the thyroid cartilage. Surgeons shave down the cartilage that extends forward, stopping just short of the inner lining to avoid damaging the vocal cords underneath. The goal is to create a smoother, flatter throat profile.
This procedure is most commonly sought by transgender women, for whom the Adam’s apple can be a source of gender dysphoria. But it’s not exclusive to them. Some cisgender men and women also choose the surgery for cosmetic reasons. The operation is relatively minor, typically performed under general anesthesia through a small incision in a natural skin crease of the neck.