Is It Possible for a Woman to Have an Adam’s Apple?

Yes, women have Adam’s apples. Everyone does, because everyone has a thyroid cartilage: the shield-shaped cartilage at the front of the voice box (larynx). The Adam’s apple is the forward point of that cartilage, known medically as the laryngeal prominence. It is a normal part of human anatomy in people of every sex and gender.

What differs is how much of it you can see. In women the Adam’s apple is usually smaller and flatter, because the larynx is smaller and the two plates of the thyroid cartilage meet at a wider angle^[1]. Some women have a clearly visible Adam’s apple, and that is a variation in normal anatomy rather than an abnormality. How prominent it looks depends on the angle of the cartilage, the size of the larynx and how much soft tissue covers it.

At Centre for Surgery, we frequently receive enquiries from individuals across the UK and beyond regarding their Adam’s apple. Some people are interested in reducing its size for a smoother neck contour, while others ask whether it can be made more prominent. The operation we offer is a tracheal shave (Adam’s apple reduction), which makes the Adam’s apple smaller; it does not make it larger.

Understanding that the Adam’s apple varies in size and visibility from person to person can be reassuring. It is a normal part of the anatomy that protects the vocal cords, and having one, visible or not, is natural for everyone.

What Is an Adam’s Apple Made Of?

The Adam’s apple is the forward projection of the thyroid cartilage, the largest of the nine cartilages that make up the larynx, or voice box. It is not bone, and it is not a gland. It is hyaline cartilage: firm, slightly flexible, and covered by a thin layer of skin and connective tissue with very little fat over it, which is why it shows so readily.

The thyroid cartilage is formed from two flat plates, called laminae, that meet at the front of the neck. The point where they join is the laryngeal prominence: the bump you can feel and see. Behind it, and slightly lower down, sit the vocal cords, which the cartilage helps to protect.

The name has nothing to do with anatomy. It is usually traced to the story of Adam and the forbidden fruit lodging in his throat, a piece of folklore that has stuck far more firmly than the clinical term.

What Is the Purpose of the Adam’s Apple?

The thyroid cartilage has two jobs, and neither is cosmetic.

It protects the vocal cords. The cords sit immediately behind the cartilage plates. Without that shield, the structures responsible for your voice and for closing your airway during swallowing would be exposed to direct injury from the front of the neck.

It houses the mechanism of voice production. The vocal cords attach to the inner surface of the thyroid cartilage at the front. The size of the larynx affects the length of the cords it contains, and cord length is one of the main factors in vocal pitch, which is why a larger larynx generally produces a deeper voice.

That relationship matters when considering surgery. Reducing the outer prominence of the cartilage is a different thing from altering the cords inside it, so a tracheal shave is designed to make the bump smaller without changing the voice. Temporary hoarseness is common after surgery, and a lasting voice change is uncommon but possible; the risks are explained in the tracheal shave section below.

Why Do Men Have a Bigger Adam’s Apple Than Women?

It is a common misconception that only men have Adam’s apples. Everyone has one, but in most men it is larger and sits further forward. A 2014 study that measured 100 larynges from adults over 40 found that every measurement was larger in men except one: the angle between the two plates of the thyroid cartilage, which was wider in women^[1]. A sharper angle pushes the join forward against the skin, and a wider angle gives a flatter, less visible contour.

These differences are not present from birth. In a CT scanning study of 120 children and young people, the larynx showed no difference between boys and girls up to the age of seven, while clear differences between the sexes were seen in those aged 14 to 20^[2]. The larynx responds to sex hormones, and the rise in testosterone during male puberty makes it grow, lengthening the vocal cords and deepening the voice^[3]. Girls go through puberty with much lower testosterone levels, so the larynx grows less and the angle stays wider.

For trans women who went through a testosterone-driven puberty, the larynx will already have grown, and a prominent Adam’s apple is one of the features some choose to have reduced, sometimes alongside facial feminisation surgery (FFS). If you are planning surgery, our guide on whether you need hormone therapy before facial feminisation surgery explains how hormones and surgery fit together.

Why Do I Have an Adam’s Apple as a Girl?

If you can see your Adam’s apple and wonder why, the answer is usually ordinary anatomy. Several things decide how prominent it looks.

The Angle of the Thyroid Cartilage

This is the main factor. Women’s thyroid cartilage plates usually meet at a wider angle than men’s^[1], but the angle varies from one woman to another. A woman whose plates meet at a narrower angle will have a join that sits further forward and shows more. The angle narrows as the larynx grows through childhood and the teenage years^[2], and a study of adults over 40 found no difference in larynx measurements between age groups^[1].

The Size of Your Larynx

A bigger larynx projects further forward regardless of the angle. Larynx size varies between women just as height and shoe size do.

A Slim or Long Neck

There is very little fat over the front of the larynx to begin with. A slim neck shows the cartilage far more clearly than a fuller one at exactly the same underlying size, which is why some people notice their Adam’s apple becoming more visible after weight loss, without anything about the cartilage having changed. A longer neck also displays the structure more openly, and head position changes the appearance considerably, which is why it often looks more pronounced in photographs taken from below.

Is an Adam’s Apple Genetic?

Possibly, in part, although there is little direct research on whether a visible Adam’s apple runs in families. The size and shape of the larynx depend on how it grows and on the hormones you were exposed to during puberty^[2][3]. Your general build, which is partly inherited, may also play a part. There is no single “Adam’s apple gene”.

Can Hormones Make a Woman’s Adam’s Apple Bigger?

Women produce testosterone too, at much lower levels than men, and natural variation in hormone levels during puberty may be one reason some women have a more prominent Adam’s apple. Conditions such as polycystic ovary syndrome (PCOS) raise androgen levels in many women, but there is little research showing that they make the Adam’s apple bigger. Very high testosterone levels in girls or women are uncommon and usually come with other signs, such as a deepening voice, increased facial or body hair, or irregular or absent periods. If you notice changes like these, see your GP.

You may also find our article on whether facial feminisation surgery is an option for cisgender women helpful if other facial or neck features bother you too.

Is It Normal for a Woman to Have a Visible Adam’s Apple?

Yes. A prominent laryngeal prominence is a variation in normal anatomy, not a sign of disease, and it has no effect on health, breathing, swallowing or voice. Some women have an Adam’s apple that shows when they turn their head, swallow or speak, and others only notice it in certain photographs.

Some women find it bothers them, particularly if they are often asked about it. That is a cosmetic concern rather than a medical one, and there are options if it affects your confidence, but there is no medical need to treat it.

Adam’s Apple or Thyroid Lump? When to See a GP

Not every bump at the front of the neck is the Adam’s apple. It is worth separating a laryngeal prominence you have always had from a lump that is new.

The Adam’s apple sits in the midline, at the top of the front of the neck, and moves upward when you swallow. The thyroid gland sits below the laryngeal prominence and also moves when you swallow, so movement on swallowing alone does not tell you what a lump is. Swelling of the thyroid gland (a goitre) or a lump within it (a thyroid nodule) can be mistaken for an Adam’s apple. Thyroid nodules are common, especially when the neck is scanned, and most are benign, but a small proportion are cancerous or grow large enough to press on nearby structures, which is why a new lump should be assessed^[4].

See your GP if:

• a lump has appeared where there was nothing before, or is getting bigger;
• a lump is off to one side of the neck rather than in the midline;
• you have a hoarse voice that does not settle, difficulty swallowing, or unexplained weight change alongside a neck swelling.

These warrant medical assessment rather than a cosmetic consultation. If you have a swelling in your neck and are finding it hard to breathe, or your breathing is noisy, call 999 or go to A&E straight away.

None of this describes the situation of most people reading this page, who have simply always had a more visible Adam’s apple than they would like.

What Is a Tracheal Shave (Adam’s Apple Reduction)?

A tracheal shave is an operation to reduce the prominence of the Adam’s apple. Despite its name, it does not involve the trachea (windpipe). It reshapes the thyroid cartilage, the structure that forms the visible bump. The medical term is chondrolaryngoplasty. It is most often performed for trans women, but cisgender women and men with a prominent Adam’s apple also have it^[5]. Our article Can You Remove an Adam’s Apple? explains why the cartilage is reduced rather than removed altogether.

How Is a Tracheal Shave Done?

In the usual technique, the surgeon makes a small incision in a skin crease of the neck, exposes the top of the thyroid cartilage and trims the projecting part at the top of the notch to create a smoother contour.

The vocal cords attach to the inside of the cartilage only a short distance below the notch, so the surgeon needs to know where they are before removing cartilage. Surgeons can look at the vocal cords with a thin flexible camera (laryngoscope) during the operation and pass a fine needle through the cartilage to mark where they attach, which guides how much can be safely removed^[6].

Can a Tracheal Shave Change Your Voice?

It can, which is why the technique above matters. A 2026 systematic review of 20 studies of trans women found that voice changes were reported in about one in eight patients (12.6%) overall, and much less often when the surgeon located the vocal cords during a neck-incision operation (2.8%) than when they did not (29.6%)^[7]. Newer operations through the inside of the lower lip, which avoid a neck scar, are also being studied^[7]. In smaller studies, most voice changes were temporary hoarseness that settled within a few weeks^[5][8]. Our article on whether a tracheal shave can affect your voice covers this in more detail.

What Results and Risks Should You Expect?

Most people who have a tracheal shave are pleased with their neck afterwards, but the evidence comes from fairly small studies. A systematic review of four case series (69 patients) reported high satisfaction in the two studies that measured it; the most common problems were hoarseness (36.2%), which settled within 20 days in almost all cases, and pain on swallowing (20.3%), while laryngospasm (a brief spasm of the vocal cords) occurred in 1.4%^[5].

In a 2018 survey of 112 patients, 60% were very or completely satisfied with the appearance of their neck, 13% still felt their Adam’s apple looked too prominent, and no one had a permanent voice change^[8]. Cartilage has to be left in place to protect the voice, so the reduction may not remove every trace of the bump, and the size or position of the scar was among the commonest concerns of less satisfied patients^[8].

Other risks include bleeding, infection, a visible or tethered scar and, rarely, a lasting change to the voice. If you are considering surgery, choose a GMC-registered surgeon who performs this operation regularly and can explain how they will protect your vocal cords.

Tracheal Shave at Centre for Surgery

At Centre for Surgery, tracheal shave surgery is carried out by GMC-registered surgeons at our hospital at 95-97 Baker Street, London. Centre for Surgery is registered with the Care Quality Commission and rated Good overall. Anaesthesia at Centre for Surgery is either TIVA (total intravenous anaesthesia) or local anaesthetic, with or without sedation, and your surgeon will explain which is suitable for you.

At your consultation, the surgeon will examine your neck, talk through what a reduction can and cannot achieve for you, and explain the risks, including the possibility of voice change. We recommend a two-week cooling-off period between your consultation and your operation, so you have time to decide. Our Baker Street hospital offers a discreet, comfortable setting for all consultations and procedures, and every patient’s care is planned around their own goals and needs.

Frequently Asked Questions

References

1. Jotz GP, Stefani MA, Pereira da Costa Filho O, et al. A morphometric study of the larynx. Journal of Voice 2014;28(6):668–672. doi:10.1016/j.jvoice.2014.03.008
2. Seo JH, Hwang SH, Kang JM, et al. Age-related changes of the larynx and trachea assessed by three-dimensional computed tomography in children: application to endotracheal intubation and bronchoscopy. Clinical Anatomy 2014;27(3):360–364. doi:10.1002/ca.22290
3. Zamponi V, Mazzilli R, Mazzilli F, et al. Effect of sex hormones on human voice physiology: from childhood to senescence. Hormones 2021;20(4):691–696. doi:10.1007/s42000-021-00298-y
4. Durante C, Grani G, Lamartina L, et al. The diagnosis and management of thyroid nodules: a review. JAMA 2018;319(9):914–924. doi:10.1001/jama.2018.0898
5. Therattil PJ, Hazim NY, Cohen WA, et al. Esthetic reduction of the thyroid cartilage: a systematic review of chondrolaryngoplasty. JPRAS Open 2019;22:27–32. doi:10.1016/j.jpra.2019.07.002
6. Vandenberg KN, Plocienniczak MJ, Spiegel JH. Chondrolaryngoplasty. Facial Plastic Surgery Clinics of North America 2023;31(3):355–361. doi:10.1016/j.fsc.2023.03.001
7. Abu Bandora E, Chaushu H, Icht M, et al. Transgender women’s voice outcome after laryngochondroplasty: a systematic literature review. OTO Open 2026;10(3):e70264. doi:10.1002/oto2.70264
8. Cohen MB, Insalaco LF, Tonn CR, et al. Patient satisfaction after aesthetic chondrolaryngoplasty. Plastic and Reconstructive Surgery Global Open 2018;6(10):e1877. doi:10.1097/GOX.0000000000001877

Related Articles

• Can You Remove an Adam’s Apple?
• Can a Tracheal Shave Affect Your Voice?
• Can Top Surgery Be Reversed?
• Tracheal shave (Adam’s apple reduction) — full procedure guide
• Facial feminisation surgery (FFS)
• Can Cisgender Women Have Facial Feminisation Surgery?