Lao WP, et al. - In this investigation, researchers presented the case of emergency intubation in a transgender male leading to severe postintubation tracheal stenosis. A 25-year-old, 5′9″, 60-kg, biologically female, male transgender patient on testosterone therapy was taken to the emergency department unconscious after being hit by a motor vehicle. The patient received intravenous proton pump inhibitors during admission and underwent airway inspection under anesthesia showing severe tracheal stenosis 2 cm in length beginning 3.2 cm below the vocal fold leading edge. Findings suggested that biological sex should be considered when applying algorithms for airway management to care for transgender people. Consideration of biological sex in choosing the correct endotracheal tube may prevent serious complications of postintubation.