How Do Doctors Evaluate Delayed Puberty in Boys?

Our evaluation of your son’s delayed puberty begins with a discussion about your son’s signs of puberty and a physical exam. If your son has signs of delayed puberty, we will have him get an X-ray of his left hand and wrist called a bone age. A bone age tells us how much his bones have matured. It can also help us figure out much he has left to grow.

Your son might have an early morning blood test to help us measure his hormone levels. Hormones, like testosterone, are at their highest levels first thing in the morning. Additional blood testing done at the same time might include FSH, LH, cortisol, ACTH, thyroid hormone studies, growth factors and a prolactin level. We also do genetic evaluations if they are needed. Depending on the results of the laboratory testing further radiology testing may include a head MRI.

What are the Differences Among Sex, Gender Expression and Gender Identity?

Sex, gender expression and gender identity might sound similar, but they are actually very different terms.

  • Sex refers to the biology (chromosomes [DNA], genitalia and hormones) that a person is born with.
  • Gender identity refers to how a person identifies, such as male, female, transgender or a number of other terms.
  • Gender expression refers to how a person expresses their gender through their appearance (clothing, hair, makeup, etc.), behavior, names, etc.

The language around gender changes all the time. If you are not sure what to call someone, just ask! Gender was once referred to as binary, or simply male and female. This is not true anymore. Gender is a spectrum and there are many terms a person can use to refer to their gender. Gender is also a lifelong process of self-discovery and expression.

At MGHfC, we welcome patients of all genders and sexes. If you have questions about gender and/or sex and how it relates to your child’s pubertal development, ask the care team.

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