Do Women Have an Adam's Apple?
Yes, women do have an Adam's apple (laryngeal prominence of the thyroid cartilage), but it is typically much less prominent than in men due to anatomical differences in thyroid cartilage size and angle.
Anatomical Basis
- All humans possess a thyroid cartilage that forms the laryngeal prominence commonly called the "Adam's apple," regardless of biological sex 1
- The thyroid cartilage prominence is identified as a characteristic feature of male sex, with males having a markedly more pronounced prominence compared to females 1
- The difference in prominence is due to the effects of testosterone during male puberty, which causes enlargement and anterior projection of the thyroid cartilage 2
Sex-Based Differences in Prominence
- In natal males, the thyroid cartilage develops a more acute angle and greater anterior projection during puberty under the influence of androgens, creating the visible "Adam's apple" 1, 2
- In natal females, the thyroid cartilage remains smaller with a less acute angle, making the laryngeal prominence minimally visible or imperceptible in most cases 2
- Some natal women may have a more pronounced thyroid cartilage prominence than typical for their sex, and may request reduction procedures to refine their neck contour 1
Clinical Relevance in Transgender Medicine
- Reduction laryngochondroplasty (thyroid cartilage reduction or "tracheal shave") is commonly requested by transfeminine patients to reduce this marker of male sex 3
- Conversely, thyroid cartilage augmentation using autologous rib cartilage can be performed to create a visible Adam's apple in female-to-male transgender patients seeking facial masculinization 2
- Feminizing hormone therapy with estrogen does not reduce the laryngeal prominence in trans women, as this physical characteristic induced by prior male puberty does not change with hormone therapy alone 4
Important Anatomical Considerations
- The true vocal cords attach at a level corresponding to approximately halfway up the thyroid cartilage, making surgical procedures on this structure technically demanding to avoid vocal cord injury 1
- The thyroid cartilage is a fully mobile structure that translocates up and down with swallowing, whether in its natural state or after surgical modification 2