From 1977 to 2013, the average age of thelarche, the first sign of puberty in girls, decreased by nearly 3 months per decade. This trend, along with rising rates of precocious puberty in girls, has significant implications for girls’ physical and psychosocial development, especially because early puberty has been linked to future health risks.2,3 

In 1997, the Pediatric Research in Office Setting study introduced race into the discourse surrounding pubertal timing trends. In a study of approximately 17 000 girls, Black girls at every age had more advanced breast development compared with White girls. Breast development had begun at age 6 years for 6.4% of Black and 2.8% of White girls and, by 8 years, 37.8% of Black and 10.5% of White girls. Because of these findings, the Pediatric Endocrine Society Drugs and Therapeutic Committee recommended new race-based criteria for defining precocious puberty.5...

You do not currently have access to this content.