The Adam’s apple is made of cartilage, specifically the thyroid cartilage of the larynx (your voice box). It’s the largest piece of cartilage in the throat, formed by two flat plates that fuse together at the front of the neck. That bump you can see and feel is simply the point where those two plates meet.
The Structure of Thyroid Cartilage
Thyroid cartilage is hyaline cartilage, the same firm but slightly flexible tissue found in your nose, ribs, and the rings of your windpipe. It’s not bone, though in older adults it can gradually calcify and harden over time. The two plates of thyroid cartilage sit like an open book, joined at the front of the neck. The angle at which they meet determines how prominent the Adam’s apple looks from the outside.
In biological males, the two plates meet at roughly a 90-degree angle, creating a sharper, more visible point. In biological females, the angle is closer to 120 degrees, producing a flatter, less noticeable profile. Both men and women have this exact same structure. The difference is entirely one of size and angle.
What the Adam’s Apple Does
The thyroid cartilage isn’t just a bump on your neck. It serves as a protective shield around the larynx, guarding the vocal cords and airway from impact. Think of it as a casing: the vocal cords stretch across the inside of this cartilage framework, and the cartilage keeps them safe while giving them a stable anchor point to vibrate against.
Your vocal cords attach to the inner surface of the thyroid cartilage at the front and to smaller cartilages at the back. When you speak or sing, muscles adjust the tension on these cords by tilting and shifting the cartilage. The Adam’s apple moves visibly when you swallow because the entire larynx rises and falls during that motion, pulled upward by muscles connected to the jaw and skull.
Why It Grows During Puberty
The Adam’s apple becomes noticeable during puberty because testosterone triggers significant growth of the laryngeal cartilage and the muscles inside it. This isn’t testosterone alone. The growth happens through the combined effect of growth hormone and testosterone working together, which is why the larynx expands so dramatically in males during adolescence.
One of the most important changes is the lengthening and thickening of the vocal cords themselves. As the thyroid cartilage grows larger, the vocal cords stretch longer, and this lengthening is what drops the pitch of the voice. The added muscle mass in the vocal cords also changes the tonal quality, producing the deeper resonance of a typical adult male voice. In people who don’t experience a surge of testosterone at puberty, the laryngeal framework grows only in proportion to general body growth, and the voice stays higher.
In females, estrogen and lower levels of testosterone result in less dramatic growth of the larynx. The cartilage still develops, but the plates meet at that wider 120-degree angle, so the front of the throat stays relatively smooth. Some women do have a visible Adam’s apple, particularly if they have a thinner neck or slightly more prominent cartilage. It’s normal variation, not a sign of anything unusual.
Can It Be Made Smaller or Larger?
For people who want a less prominent Adam’s apple, a procedure called chondrolaryngoplasty (commonly known as a tracheal shave) reduces the cartilage. A surgeon carefully shaves down the protruding edge of the thyroid cartilage where the two plates meet. The critical step is identifying exactly where the vocal cords attach on the inside, because removing too much cartilage at that point could damage the voice. Surgeons typically use a small camera inserted through the nose to pinpoint the vocal cord location before and after reducing the cartilage.
The procedure is most commonly performed as part of gender-affirming care for transgender women, though anyone bothered by a prominent Adam’s apple can have it done. Recovery is relatively quick, and the scar sits in a natural neck crease where it’s difficult to spot.
Changes With Age
Thyroid cartilage doesn’t stay the same throughout your life. Starting around your 30s or 40s, the cartilage begins to ossify, gradually turning from flexible cartilage into harder, more bone-like tissue. This process is slow and usually causes no symptoms, but it can make the Adam’s apple feel firmer to the touch over the decades. In some older adults, the cartilage becomes almost entirely calcified. This ossification also shows up on neck X-rays and CT scans, which is why radiologists factor in a patient’s age when reading those images.