Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Abstract

Objective To compare self-report and physician assessments of sexual maturation against serum hormone markers to evaluate the hypothesis that the validity of self-assessed sexual maturation is underestimated in traditional validation studies. Study design We adapted a self-assessment instrument that 248 Mexican children and adolescents, age 8–13 years, completed. Participants were examined by a trained pediatrician and provided fasting blood samples for measurement of reproductive (testosterone, estradiol, sex hormone-binding globulin (SHBG), Inhibin B) and other hormones (C-peptide, insulin-like growth factor 1 (IGF-1), leptin, dehydroepiandrosterone sulfate (DHEA-S)) known to change during adolescence. Spearman correlations (r) were calculated among the average rank of all hormones, self-, and physician-assessed Tanner stage. The method of triads was used to assess validity of self-reports by estimating correlations between self-assessments and true, but unobservable, sexual maturation based on all available data. 95% confidence intervals (CI) were constructed using bootstrap sampling. Results Validity of self-reported genitalia staging for boys was modest (r[95%CI]=0.50[0.31–0.65]) and inferior to physician assessment (0.75[0.56–0.93]). Breast stage was well reported (0.89[0.79–0.97]) and superior to physician assessment (0.80[0.70–0.89]). Pubic hair stage reported by boys (0.91[0.79–0.99]) and girls (0.99[0.96–1.00]) were superior to physician assessment (0.79[0.57–0.97] and 0.91[0.83–0.97], respectively). Conclusion Self-assessment can be validly used in epidemiologic studies for evaluation of sexual maturation in children. Physician assessment may be necessary for accurate assessment of genitalia development in boys.

Outcomes of pubertal development in girls as a function of pubertal onset age

“…Nonetheless, this research used a highly reliable protocol for assessing pubertal development based on instructions from the American Academy of Pediatrics Assessment of Sexual Maturity Stages in Girls (22). Moreover, it was recently confirmed that self-assessment can be validly used in evaluating sexual maturation in children (23). A second limitation is that assessments of the subjects in SECCYD were done until age 15.5 years.…”

Phthalate and bisphenol A exposure during in utero windows of susceptibility in relation to reproductive hormones and pubertal development in girls

“…Two pediatricians (CB-G and AM-G), trained according to standard methods (Chavarro et al 2017), evaluated Tanner staging in female offspring using standardized protocols. We used breast developmental stage (BD) as an indicator of puberty and pubic hair stage (PH) as an indicator of adrenarche, with stage 1 corresponding to no development and stage 5 corresponding to full development (Marshall and Tanner 1969).…”

High Step-Up Resonant DC/DC Converter With Balanced Capacitor Voltage for Distributed Generation Systems

“…Pubertal development was measured using physician-assessed Tanner staging, ranging from 1 (no development [preteen]) to 5 (mature stage [adult]). [50][51][52] Consistent with prior research, 53 we used the average Tanner score for physician-observed pubic hair development and breast development to measure pubertal development in girls and the average Tanner score for physician-observed pubic hair development and genital development to measure pubertal development in boys.…”