Secondary sexual characteristics in boys: data from the Pediatric Research in Office Settings Network
Abstract
BACKGROUND: Data from racially and ethnically diverse US boys are needed to determine ages of onset of secondary sexual characteristics and examine secular trends. Current international studies suggest earlier puberty in boys than previous studies, following recent trend in girls. METHODS: Two hundred and twelve practitioners collected Tanner stage and testicular volume data on 4131 boys seen for well-child care in 144 pediatric offices across the United States. Data were analyzed for prevalence and mean ages of onset of sexual maturity markers. RESULTS: Mean ages for onset of Tanner 2 genital development for non-Hispanic white, African American, and Hispanic boys were 10.14, 9.14, and 10.04 years and for stage 2 pubic hair, 11.47, 10.25, and 11.43 years respectively. Mean years for achieving testicular volumes of ≥ 3 mL were 9.95 for white, 9.71 for African American, and 9.63 for Hispanic boys; and for ≥ 4 mL were 11.46, 11.75, and 11.29 respectively. African American boys showed earlier (P < .0001) mean ages for stage 2 to 4 genital development and stage 2 to 4 pubic hair than white and Hispanic boys. No statistical differences were observed between white and Hispanic boys. CONCLUSIONS: Observed mean ages of beginning genital and pubic hair growth and early testicular volumes were 6 months to 2 years earlier than in past studies, depending on the characteristic and race/ethnicity. The causes and public health implications of this apparent shift in US boys to a lower age of onset for the development of secondary sexual characteristics in US boys needs further exploration.
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The data for boys is less clear but suggest a similar trend of smaller magnitude.
“The data for boys is less clear but suggest a similar trend of smaller magnitude”
From Does puberty mark a transition in sensitive periods for plasticity in the associative neocortex? (2017) · cites this paper as Herman-Giddens et al., 2012
Cites
Variations in the pattern of pubertal changes in boys
Marshall, W. A., & Tanner, J. M. (1970) · Archives of Disease in Childhood · doi:10.1136/adc.45.239.13 · Cited by 5,147 · see citing works
Herman-Giddens, M. E., Slora, E. J., Wasserman, R. C., Bourdony, C. J., Bhapkar, M. V., Koch, G. G., & Hasemeier, C. M. (1997) · PEDIATRICS · doi:10.1542/peds.99.4.505 · Cited by 1,709 · see citing works
Self-citationSome Problems in Interval Estimation
Fieller, E. C. (1954) · Journal of the Royal Statistical Society Series B (Statistical Methodology) · doi:10.1111/j.2517-6161.1954.tb00159.x · Cited by 1,159 · see citing works
Link Between Body Fat and the Timing of Puberty
Kaplowitz, P. B. (2008) · Pediatrics · doi:10.1542/peds.2007-1813f · Cited by 710 · see citing works
Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings
Euling, S. Y., Herman-Giddens, M. E., Lee, P. A., Selevan, S. G., Juul, A., SØrensen, T. I. A., Dunkel, L., Himes, J. H., Teilmann, G., & Swan, S. H. (2008) · PEDIATRICS · doi:10.1542/peds.2007-1813d · Cited by 662 · see citing works
Self-citationNational Estimates of the Timing of Sexual Maturation and Racial Differences Among US Children
Sun, S. S., Schubert, C. M., Chumlea, W. C., Roche, A. F., Kulin, H. E., Lee, P. A., Himes, J. H., & Ryan, A. S. (2002) · PEDIATRICS · doi:10.1542/peds.110.5.911 · Cited by 544 · see citing works
Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index
Rosenfield, R. L., Lipton, R. B., & Drum, M. L. (2009) · PEDIATRICS · doi:10.1542/peds.2008-0146 · Cited by 499 · see citing works
Public health implications of altered puberty timing
Golub, M. S., Collman, G. W., Foster, P. M. D., Kimmel, C. A., Rajpert-De Meyts, E., Reiter, E. O., Sharpe, R. M., Skakkebaek, N. E., & Toppari, J. (2008) · PEDIATRICS · doi:10.1542/peds.2007-1813g · Cited by 497 · see citing works
Self-citationRecent changes in pubertal timing in healthy danish boys: associations with body mass index
Sørensen, K., Aksglaede, L., Petersen, J. H., & Juul, A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1478 · Cited by 393 · see citing works
Pubertal assessment method and baseline characteristics in a mixed longitudinal study of girls
Biro, F. M., Galvez, M. P., Greenspan, L. C., Succop, P. A., Vangeepuram, N., Pinney, S. M., Teitelbaum, S., Windham, G. C., Kushi, L. H., & Wolff, M. S. (2010) · Pediatrics · doi:10.1542/peds.2009-3079 · Cited by 348 · see citing works
The timing of puberty: is it changing? Does it matter?
Walvoord, E. C. (2010) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2010.05.018 · Cited by 277 · see citing works
Influence of obesity on timing of puberty
BIRO, F. M., KHOURY, P., & MORRISON, J. A. (2006) · International Journal of Andrology · doi:10.1111/j.1365-2605.2005.00602.x · Cited by 241 · see citing works
Normal ages of pubertal events among American males and females
Lee, P. A. (1980) · Journal of Adolescent Health Care · doi:10.1016/s0197-0070(80)80005-2 · Cited by 228 · see citing works
Biro, F. M., Lucky, A. W., Huster, G. A., & Morrison, J. A. (1995) · The Journal of Pediatrics · doi:10.1016/s0022-3476(95)70265-2 · Cited by 208 · see citing works
Secondary sex characteristics of girls 12 to 17 years of age: The U.S. Health examination survey
Daniel, W. A., Harlan, W. R., Harland, E. A., & Grillo, G. P. (1980) · The Journal of Pediatrics · doi:10.1016/s0022-3476(80)80647-0 · Cited by 203 · see citing works
Susman, E. J., Houts, R., Steinberg, L. D., Belsky, J., Cauffman, E. E., DeHart, G. B., Friedman, S. L., Roisman, G. I., & Halpern‐Felsher, B. L. (2010) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2009.261 · Cited by 196 · see citing works
Pubertal development in Swiss boys.
Rh, L., & Prader, A. (1983) · PubMed · Cited by 192 · see citing works
Foster, T., Voors, A. W., Webber, L., Frerichs, R. R., & Berenson, G. (1977) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/30.4.582 · Cited by 169 · see citing works
Effects of Environmental Endocrine Disruptors on Pubertal Development
Özen, S., & Darcan, Ş. (2011) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.v3i1.01 · Cited by 137 · see citing works
Karpati, A. M., Rubin, C., Kieszak, S. M., Marcus, M., & Troiano, R. P. (2002) · Journal of Adolescent Health · doi:10.1016/s1054-139x(01)00320-2 · Cited by 133 · see citing works
Trends in puberty timing in humans and environmental modifiers
Toppari, J., & Juul, A. (2010) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2010.03.011 · Cited by 127 · see citing works
PHYSICAL CHANGES ASSOCIATED WITH ADOLESCENCE IN BOYS
Reynolds, E. L. (1951) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1951.02040040549002 · Cited by 112 · see citing works
Secondary sex characteristics of boys 12 to 17 years of age: The U.S. Health Examination Survey
Harlan, W. R., Grillo, G. P., Cornoni‐Huntley, J. C., & Leaverton, P. E. (1979) · The Journal of Pediatrics · doi:10.1016/s0022-3476(79)80677-0 · Cited by 107 · see citing works
Ankarberg‐Lindgren, C., & Norjavaara, E. (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.1510747 · Cited by 95 · see citing works
Carlsen, E., Andersen, A., Buchreitz, L., Jørgensen, N., Magnus, Ø., Matulevicuus, V., Nermoen, I., Petersen, J. H., Punab, M., Suominen, J. J. O., et al. (2000) · International Journal of Andrology · doi:10.1046/j.1365-2605.2000.00240.x · Cited by 92 · see citing works
Association of Blood Lead Levels with Onset of Puberty in Russian Boys
Hauser, R. B., Sergeyev, O., Korrick, S., Lee, M., Revich, B., Gitin, E., Burns, J. S., & Williams, P. L. (2008) · Environmental Health Perspectives · doi:10.1289/ehp.10516 · Cited by 90 · see citing works
(2010) · doi:10.1001/archpediatrics.2010.223 · Cited by 89 · see citing works
Pubertal development timing in urban Chinese boys
Ma, H.-M., Chen, S.-K., Chen, R.-M., Zhu, C., Xiong, F., Li, T., Wang, W., Liu, G.-L., Luo, X., Liu, L., et al. (2011) · International Journal of Andrology · doi:10.1111/j.1365-2605.2011.01173.x · Cited by 81 · see citing works
Monteilh, C. P., Kieszak, S. M., Flanders, W. D., Maisonet, M., Rubin, C., Holmes, A. K., Heron, J., Golding, J., McGeehin, M. A., & Marcus, M. (2010) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2010.01168.x · Cited by 81 · see citing works
Liu, Y. X. (2000) · Acta Paediatrica · doi:10.1080/080352500750043918 · Cited by 79 · see citing works
Blood Lead Levels and Delayed Onset of Puberty in a Longitudinal Study of Russian Boys
Williams, P. L., Sergeyev, O., Lee, M., Korrick, S., Burns, J. S., Humblet, O., DelPrato, J., Revich, B., & Hauser, R. B. (2010) · PEDIATRICS · doi:10.1542/peds.2009-2575 · Cited by 70 · see citing works
Goldstein, J. (2011) · PLoS ONE · doi:10.1371/journal.pone.0014826 · Cited by 68 · see citing works
Liu, Y., Wikland, K. A., & KARLBERG, J. P. E. (2000) · Acta Paediatrica · doi:10.1111/j.1651-2227.2000.tb00356.x · Cited by 59 · see citing works
Management of the suicidal adolescent on a nonpsychiatric adolescent unit
Marks, A. M. (1979) · The Journal of Pediatrics · doi:10.1016/s0022-3476(79)80679-4 · Cited by 57 · see citing works
Measurement of pediatric testicular volume with Prader orchidometer: comparison of different hands
Karaman, M. İ., Kaya, C., Çaşkurlu, T., Güney, S., & Ergenekon, E. (2005) · Pediatric Surgery International · doi:10.1007/s00383-005-1470-1 · Cited by 52 · see citing works
Sexual maturation of Mexican‐American adolescents
Villarreal, S. F., Martorell, R., & Mendoza, F. (1989) · American Journal of Human Biology · doi:10.1002/ajhb.1310010113 · Cited by 44 · see citing works
Slora, E. J., Bocian, A. B., Herman‐Giddens, M. E., Harris, D. L., Pedlow, S. E., Dowshen, S. A., & Wasserman, R. C. (2009) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2009.22.4.291 · Cited by 42 · see citing works
Self-citationBona, G., Castellino, N., & Petri, A. (2002) · PubMed · Cited by 12 · see citing works
The Missing Politics and Unsettled Science of the Trend Toward Earlier Puberty
Sprinkle, R. (2001) · Politics and the life sciences · doi:10.1017/s0730938400005177 · Cited by 5 · see citing works
Herman-Giddens, M. E., Wang, L., & Koch, G. (2001) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.155.9.1022 · Cited by 2 · see citing works
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Boehm, U., Bouloux, P.-M., Dattani, M. T., de Roux, N., Dodé, C., Dunkel, L., Dwyer, A. A., Giacobini, P., Hardelin, J.-P., Juul, A., et al. (2015) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2015.112 · Cited by 874 · see citing works
Suicide Trends Among Elementary School–Aged Children in the United States From 1993 to 2012
Bridge, J. A., Asti, L., Horowitz, L. M., Greenhouse, J. B., Fontanella, C. A., Sheftall, A. H., Kelleher, K. J., & Campo, J. V. (2015) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2015.0465 · Cited by 303 · see citing works
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Fuqua, J. S. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1024 · Cited by 260 · see citing works
Herting, M. M., Gautam, P., Spielberg, J. M., Kan, E., Dahl, R. E., & Sowell, E. R. (2014) · Human Brain Mapping · doi:10.1002/hbm.22575 · Cited by 224 · see citing works
Does puberty mark a transition in sensitive periods for plasticity in the associative neocortex?
Piekarski, D. J., Johnson, C. M., Boivin, J. R., Thomas, A. W., Lin, W. C., Delevich, K., M. Galarce, E., & Wilbrecht, L. (2017) · Brain Research · doi:10.1016/j.brainres.2016.08.042 · Cited by 175 · see citing works
Parent, A.-S., Franssen, D., Fudvoye, J., Gérard, A., & Bourguignon, J.-P. (2015) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2014.12.004 · Cited by 175 · see citing works
A longitudinal study: changes in cortical thickness and surface area during pubertal maturation
Herting, M. M., Gautam, P., Spielberg, J. M., Dahl, R. E., & Sowell, E. R. (2015) · PLoS ONE · doi:10.1371/journal.pone.0119774 · Cited by 142 · see citing works
Ethnic and sex differences in skeletal maturation among the Birth to Twenty cohort in South Africa
Cole, T. J., Rousham, E. K., Hawley, N. L., Cameron, N., Norris, S. A., & Pettifor, J. M. (2015) · Archives of Disease in Childhood · doi:10.1136/archdischild-2014-306399 · Cited by 100 · see citing works
Beyond Pubertal Timing: New Directions for Studying Individual Differences in Development
Mendle, J. (2014) · Current Directions in Psychological Science · doi:10.1177/0963721414530144 · Cited by 82 · see citing works
Pubertal maturation and sex steroids are related to alcohol use in adolescents
de Water, E., Braams, B. R., Crone, E. A., & Peper, J. S. (2013) · Hormones and Behavior · doi:10.1016/j.yhbeh.2012.11.018 · Cited by 56 · see citing works
Influence of the body weight on the onset and progression of puberty in boys
Tomova, A., Robeva, R., & Kumanov, P. (2015) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2014-0363 · Cited by 41 · see citing works
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Steinbeck, K., Towns, S., & Bennett, D. (2014) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.12491 · Cited by 26 · see citing works
The psychology of puberty: What aren’t we studying that we should?
Mendle, J., & Koch, M. K. (2019) · Child Development Perspectives · doi:10.1111/cdep.12333 · Cited by 16 · see citing works
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Woelfle, J., Lindberg, A., Aydin, F., Ong, K. K., Camacho-Hubner, C., & Gohlke, B. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00054 · Cited by 12 · see citing works
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“Covariates were dichotomized to perform exact matching: sex, pubertal age (males ≥ 11.5 years [median age to attain testicular volume ≥ 4 mL [24]]; females ≥ 10 years [median age to observe Tanner stage II breast development in girls with BMI 10 – 84th percentile [25]]), longer diabetes duration (…”
Influential
- Authors
- Herman-Giddens, M. E., Steffes, J., Harris, D., Slora, E., Hussey, M., Dowshen, S. A., Wasserman, R., Serwint, J. R., Smitherman, L., & Reiter, E. O.
- Affiliations
- Departments of Maternal and Child Health, and
- American Academy of Pediatrics (US)
- University of North Carolina at Chapel Hill (US)
- Alfred I. duPont Hospital for Children (US)
- University of Vermont (US)
- Johns Hopkins University (US)
- Wayne State University (US)
- Tufts University (US)
- ORCID
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2012-11-01
- Volume
- 130
- Issue
- 5
- Pages
- e1058-e1068
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2016184699
- Cited by
- 392
- References
- 40
- Citations by year
- 2026: 7 · 2025: 23 · 2024: 37 · 2023: 18 · 2022: 37 · 2021: 30 · 2020: 34 · 2019: 27 · 2018: 36 · 2017: 19 · 2016: 38 · 2015: 30 · 2014: 21 · 2013: 27 · 2012: 8
- FWCI
- 32.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Academic Pediatric Association
- Genentech
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Keywords
- secondary sexual characteristics, boys, Tanner stages, testicular volume, pubic hair growth, racial and ethnic differences, African American boys, well-child care
- MeSH terms
- Adolescent, Age Factors, Black or African American, Child, Hispanic or Latino, Humans, Male, Puberty, Sex Characteristics, Sexual Maturation, United States, White People
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