What is Delayed Puberty in Girls?

Delayed puberty is when your daughter does not show the first signs of gonadal puberty by the time she is 13 years old.

What is Normal Puberty in Girls?

Normal puberty is when children’s bodies start to grow and develop into young adult bodies. Girls usually start to go through puberty between the ages of 8-13 years. When your daughter starts to go through puberty, her gonads (ovaries) and adrenal glands(glands that sit on top of the kidneys) release hormones. These hormones cause the first signs of puberty, which are breast development, body odor, underarm hair, pubic hair and acne (pimples). Over time, girls will develop later signs of puberty, such as a growth spurt followed by starting their menstrual periods.

There are 2 types of puberty that make up the entire pubertal process. These are:

  • Adrenal puberty
    This is when the adrenal glands make hormones that cause the signs of puberty including body odor, pubic hair, underarm hair and acne.
  • Gonadal puberty
    This is when the pituitary gland (a small gland in the brain that controls other glands in the body) makes the hormones FSH and LH, which tell the gonads (ovaries) to make the hormones estrogen and progesterone. These hormones are responsible for breast and uterine development, starting a monthly period, and growing taller.

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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