What is normal puberty?

Normal puberty is when a child’s body starts to grow and develop into a young adult body. There are 2 stages of puberty:

  • Adrenal puberty is when the adrenal glands (small glands on top of the kidneys) cause the first signs of puberty.
  • Gonadal puberty is when the pituitary gland (pea-sized gland in the brain that controls other glands in the body) makes hormones that tell the gonads (testes in boys, ovaries in girls) to make sex hormones (testosterone in boys, estrogen and progesterone in girls). There are 2 types of gonadal puberty: gonadotropin dependent puberty and gonadotropin independent puberty.

What is early puberty?

Early puberty is when a child goes through earlier than expected for their age. Boys go usually through puberty between ages 9-14. Girls usually go through puberty between ages 8-13. In some cases, early puberty is normal. In other cases, a child should see a doctor.

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.

Rev. 3/2018. 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.