With puberty starting earlier than ever, doctors urge greater awareness and care

Jennifer Benton’s daughter was only five years old when a kindergarten teacher noticed something odd: she was developing breasts.

Benton, 39, said that the incident was “really alarming.” “She was a tall girl, but still a girl.”

The year was 2019. The little girl enjoyed playing with dolls and going for ice cream, as well as watching her favorite Nick Jr. show, “Bubble guppies.”

Benton recalled asking, “How can her body be older than her age?” Benton, at the suggestion of the teacher, took the girl to her Ashtabula doctor.

Benton was unaware of precocious adolescence at the time. Benton grew up in a Black community where early puberty is a common occurrence. She knew seven and 8-year old girls who had periods or required bras. Benton and her family were unaware that there was a medical diagnosis or that hormone treatments known as puberty blocks could be used to slow down the physical changes.

Benton stated that “Girls had been called ‘fast,’ or a ‘too mature age’ for girls. “I now know they were battling precocious puberty.”

Doctors say that, with puberty starting at a younger age, particularly among young Black girls, it is urgent to increase awareness and educate families who could face obstacles in accessing diagnosis and medical treatment.

Researchers warned in an article in 2022 in Pediatrics that early puberty bias had a significant impact on the physical and mental health of Black children.

The pediatricians at the Warren Alpert Medical School, Brown University, wrote that “race-based medicine” is not only a bad practice but also harmful.

When is a child too young to go through puberty?

According to a 2020 analysis of global data, the average age at which puberty begins in girls has decreased by three months each decade for the past 40 years.

Even more concerning, a growing number of children show signs of puberty, such as developing breasts, acne or pubic hair, or deepening their voice, even earlier than the average. Precocious puberty, or starting puberty before age eight for girls and age nine for boys, can have long-lasting effects on the child’s physical and mental development.

According to the National Institutes of Health, precocious puberty still occurs in a small percentage of Americans. The National Institutes of Health has not determined why this is happening more. However, possible causes could include diet, obesity, and genetics.

The society can treat kids who enter puberty early as if they are older. Early puberty has been linked to anxiety and depression, according to studies. It can also increase a child’s likelihood of developing an eating disorder. It can also prevent children from reaching their full height, as growth plates usually close at the end of puberty.

Aviva Sopher is an associate professor at Columbia University Irving Medical Center and a pediatrician.

Race and ethnicity are clearly associated with early puberty. In 1997, an extensive analysis published in Pediatrics found that 14.3% of Black girls had developed breasts or pubic hair by the age of 6, compared with only 3.7% of white 6-year-old girls. A study published earlier this year in the Journal of Adolescent Health found that Black girls are more than twice as prone to begin puberty before white girls. Hispanic girls are 1.16 times as likely to display signs of early puberty compared to white girls.

It is difficult to determine how many Black and Hispanic young children experience precocious menopause without receiving medical treatment or guidance compared to children of white race. Dr. Karen Klein is a pediatric endocrinologist in San Diego. She said that medical care for precocious onset of puberty remains unequal.

She said that there are “definitely access to care issues.”

Doctors are concerned that young girls who experience early puberty may be mistaken for older. Patra Rhodes Wilson said, “I am even more protective now.” Nakeya Brown from NBC News

The rise of precocious puberty

In the mid-19th Century, on average, girls began their period at 16.5, two years after showing signs of pubic or breast hair.

Typically, girls begin their periods between the ages of 12 and 14.

Researchers in Italy recently revealed that the rate of rapid progression of precocious onset puberty among girls increased during pandemic lockdowns. Similar trends have been reported in KoreaTurkey, and portions of China. The Journal of Pediatric Endocrinology and Metabolism published a smaller study in New York City that suggested stress, inactivity, and obesity could have contributed to the sharp spikes.

It’s difficult to prove that this is the cause, but there’s clearly been an increase,” said Dr. Roopa Shankar, a pediatric endocrinologist at Children’s National Hospital, Washington, D.C.

Precocious puberty in boys is less common than it used to be. A serious condition, such as a tumor in the gland responsible for hormone production, can cause a boy’s puberty to be much earlier than normal.

Sopher, a pediatrician at Columbia University, says that precocious puberty is often a mystery to girls.

Not all children require medical attention, but they and their parents may benefit from being aware of what is happening to their bodies. Pediatricians must take physical changes in children seriously and have access to expensive specialists and tests.

Signs that are dismissed as “baby fat.”

Benton brought her daughter Olivia, who was five years old, to the pediatrician. The doctor dismissed her changes as “baby weight.”

The doctor said that even though Benton had mentioned the girl’s crying was more than normal, she should not be concerned.

Benton claimed that she complained to Ohio’s Medical Board about the missed diagnoses after a specialist diagnosed her child with precocious onset of puberty. Benton then found that there was no mention of “precocious” puberty in the medical records or notes for her daughter, even though she had repeatedly asked about it.

Some doctors previously suggested that the age of diagnosis for early puberty for Black girls should be younger than for White girls. Shankar countered by saying that the age and race of a girl’s diagnosis for precocious pregnancy should not be considered. Instead, it is important to consider hormonal, physical, and psychological tests.

Shankar explained that “just because someone belongs to a particular race or ethnicity doesn’t mean that they shouldn’t be given a thorough, individual assessment as to whether they could benefit from treatment.”

She said doctors must be careful not to “overmedicalize.” Pediatricians should spend time getting to know the personality and circumstances of each child and not just rely on physical tests and scans. They can then decide who would benefit most from being reassured about their body changes rather than prescribing drugs that block the production of sex hormones.

The injection drugs have been shown to be safe in children who are intelligent with puberty. However, they can cause side effects such as reactions at the site of injection or weakening bones when given to kids who don’t need them.


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