How Do Doctors Evaluate Early Puberty in Girls?

Our evaluation of your daughter’s early puberty begins with a discussion about your daughter’s signs of puberty and a physical exam. If your daughter has signs of early puberty, we will typically have her get an X-ray of her left hand and wrist called a bone age. A bone age tells us how much your child's bones have matured. It can also help us figure out if your child should have further evaluation with blood tests.

Your child might have a blood test to help us measure your child’s hormone levels. This will help us figure out if your child is experiencing gonadotropin dependent or independent puberty. It will also help us figure out if there is a concern about the adrenal glands. Depending on the results of the laboratory testing further radiology testing may include a pelvic ultrasound or 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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Rev. 1/2015
MassGeneral Hospital for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.