Adolescents' Self-Assessment of Sexual Maturation

TLDR

Pubertal timing varies, so stage of sexual maturation is preferred over age for assessing adolescent biology and behavior, yet the need to undress teens has limited its use in research. The study had 66 adolescents self‑rate Tanner stages, which were then compared to physician assessments. Adolescents accurately self‑assessed Tanner stages with high agreement to physician ratings (kappa 0.81–0.91), comparable to professional interrater agreement, supporting the use of self‑staging in research and providing teens an objective way to track development.

Abstract

The variability in time of onset and progression of puberty warrants the use of stage of sexual maturation rather than chronologic age in assessing biological and behavioral measures during adolescence. The necessity to undress the teenager has seriously curtailed the application of stage of sexual maturation to behavioral and developmental research. This study demonstrates that adolescents can accurately assess their own developmental stage according to Tanner's standard photographs. Self-ratings by 43 females, aged 9 to 17, and 23 males, 11 to 18, were compared to those based on physical examination by one of the investigators. Agreement with the physician rating occurred for breast stage in 37/43, for female pubic hair stage in 40/43, and for male combined pubic hair and genital stage in 21/2 (kappa coefficients: 0.81, 0.91, 0.88). The excellent agreement between physician and adolescent's assessment compared favorably with the interrater agreement of professionals. This study suggests the value of utilizing adolescent self-staging in research. In addition, this exercise provides teenagers with an objective way to understand the wide range of normal pubertal development and to follow their own sexual maturation.