The profound physiological changes that are associated with adolescence are primarily external: teens experience growth in their bodies that is unpredictable, intense, emotionally affective, and, particularly in their extremities, unsettling. Balance becomes more problematic; there is a loss of coordination that affects large muscle movements and that contributes to the use of the adjective “gangly” in relation to pubescent males and females.
   Although the outward bodily transformation might appear to be somewhat similar between boys and girls, the alterations occurring in the vocal tract are dissimilar and achieve markedly different results. Boys and girls both grow prodigiously during puberty; a male of sixty inches may reach a height of more than seventy-two inches; even more dramatic changes in height are not unknown. To a lesser extent, the same holds true for girls at this age.
   When examining the percent of growth in the larynx, however, a much larger—proportionally speaking—mutation takes place. A study of twenty cadaveric larynges of both genders, ranging in age from nine to eighteen years was made by Joel C. Kahane and reported in the American Journal of Anatomy in 1978. Not surprisingly, some findings supported empirical observation: “…overall pubertal dimensions were clearly larger than prepubertal counterparts in each sex, though within-sex differences were clearly greater in the male than in the female.”
   As any vocal professional will attest, prepubescent boys and girls have similar vocal ranges and tessitura, share an approximate lung capacity, and endurance and can sing identical repertoire. Gackle remarked on one striking difference between prepubescent boys and girls: “…the female voice is lighter in “weight” [than the male] because the volume potential is not as great…” Otherwise, in both physical appearance and vocal ability, prepubescent boys and girls can be said to share virtually identical vocal mechanisms.
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   This finding is confirmed by Kahane: “Prepubertal larynges shared a high degree of morphological congruence while pubertal larynges displayed clear sexual dimorphism, the male dimensions being significantly larger than prepubertal female counterparts. The marked differences in pubertal cartilage size result from dramatic growth of the larynx from prepuberty to puberty…” And: “…in either sex, no differences were seen in the length of the vocal folds before age 14…” By age sixteen, however, the larynges of males “…were larger than those of the female, which had attained adult size. The male vocal folds continued to grow in length to adulthood.” Kahane goes on to note “The dimensions of the prepubertal female larynx were significantly closer to adult size and weight than prepubertal male counterparts. Thus the prepubertal female larynx requires less growth per unit time to reach maturity.”
   Kahane noted the particular growth relationship between the thyroid cartilages of prepubescent males v. pubescent males, and females; and differences between prepubescent males and females and pubescent males and females. “In the male thyroid cartilage significant regional growth appeared to take place in the anterior aspect of the thyroid cartilage. It was unparalleled in the other laryngeal cartilages or in the growth of the female larynx.” His drawings illustrate the distinct gender- and cross-gender nature of the mutation.