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Puberty enables the body to mature from a child into an adult capable of sexual reproduction through the activation of the body’s reproductive organs and the development of independent functioning resulting from brain maturation in areas that regulate judgment, impulse control, and emotional understanding.
Why, yes, there are!
(underline has corresponding impact on adolescents experiencing gender dysphoria)
Shorter adult height: Early puberty causes bones to mature and stop growing sooner. Even though children may be tall early on, they often end up shorter than average as adults.
Hormonal imbalances: Early activation of sex hormones can strain the body and may point to underlying medical issues, such as hormonal disorders, brain abnormalities, or tumors.
Health risks: Some studies suggest early puberty may increase risks later in life for conditions like obesity, type 2 diabetes, or certain cancers (breast cancer in girls).
Body image and self-esteem: Children may feel self-conscious or confused about their developing bodies, especially when peers are not experiencing the same changes.1
Increased anxiety or depression: Emotional changes tied to hormones can appear before a child has the maturity to manage them.2
Behavioral issues: Early exposure to hormones can lead to mood swings, irritability, or risk-taking behaviors earlier than expected.3
Peer relationships: Children who mature early may feel “out of sync” with friends and face teasing or social isolation.4
Unwanted attention: Especially for girls, early physical development can attract attention from older peers or adults, which can be confusing and distressing.
Pressure to act older: Others may treat them as more mature than they are, emotionally or cognitively, and are prepared to be.
Precocious puberty can be a symptom of other conditions such as a brain tumor, congenital adrenal hyperplasia, or thyroid problems.
1. For trans/nonbinary children, these feelings amplify into a sense of horror as their bodies move further from alignment with their identity.
2. Lacking parental support or access to gender affirming care, anxiety and depression increase due feelings of being powerless to pause the changes.
3. Absence of identity affirmation can lead to self-harm and other risk-taking acts out of desperation.
4. Envy related to seeing peer development in others that corresponds with their gender identity enhances feelings of ‘being different’, leading to feelings of shame, and social isolation.
In 1968, the DSM-II (Diagnostic and Statistical Manual of Mental Disorders) did not yet include gender identity issues,
but homosexuality was still classified as a disorder.
By DSM-III (1980), “Gender Identity Disorder (GID)” was introduced, marking the first formal recognition of gender identity conditions in psychiatry. This diagnosis focused on cross-gender identification and distress, often framed as a psychiatric illness.
After 1966 in the United States, endocrinologists like Harry Benjamin and surgeons like Elmer Belt, and Stanley Biber advanced the medical model of care for “transsexualism,” emphasizing hormone therapy and surgery as valid treatments for adults.
Treatment of adolescents through hormone therapy was not included, despite generations of transgender adults informing care providers they first experienced gender dysphoria in early childhood, with increasing trauma and suicidal ideation as a result of the onset of pubertal development that did not correlate to their gender identity.
By the 1990s, activism by transgender communities, scholars, and clinicians challenged existing pathologizing language.
As a result, while the DSM-IV (released in 1994) retained the GID diagnosis, it began emphasizing that distress was the key issue, not identity itself.
Growing social awareness reframed transgender identity as a natural aspect of human diversity rather than as a pathology.
The evolution from “disorder” to “dysphoria” represents one of the most significant shifts in modern psychiatry — from pathologizing identity to supporting well-being and autonomy.
A healthcare provider (usually a pediatrician or endocrinologist) visually inspects and, if appropriate, palpates certain physical characteristics that indicate sexual maturity.
No glandular tissue; prepubertal
No pubic hair
Breast bud under areola; slight enlargement
Pubic hair is sparse, lightly pigmented, straight hair along labia
Further enlargement, no contour separation (from rib cage)
Pubic hair darker, coarser, starting to curl and spread
Areola and nipple form secondary mound
Pubic hair is adult-like, limited in area
Mature breast, areola recessed to contour
Pubic hair is adult in type and quantity, speading to thighs
Pubertal testes (<4mL)
No pubic hair
Testes enlarge (4-8 mL), scrotum reddens and thins
Pubic hair is sparse, lightly pigmented at the base of the penis
Penis lengthens, tests continue to grow
Pubic hair darker, coarser, curlier
Penis enlarges in length and width, glans develops
Pubic hair is adult-like, but not fully distributed
Adult genitalia
Pubic hair is adult-type distribution extending to thighs
Dr. Jack Turban – Evidence Backed Information
What Youth Transition Actually Looks Like
Early Transition with Parental Support
The Objective Safety of Puberty Blockers
Washington University (St. Louis) Debunks Myths
Precocious Puberty Assessment & Treatment