Abstract
Tanner sexual maturity ratings (SMR) done by physicians and by 39 boys and 17 girls with delayed puberty were estimated every 3 months for 8 visits during a placebo controlled, randomized, double blind, crossover, clinical trial of treatment with testosterone or estrogen using doses approximating early, middle and late pubertal levels. Agreements between physicians and patients at each visit were estimated using concordance correlations (CC range-1 to +1). For boys pubic hair development (PH) there was agreement at 6 of 8 comparisons (visits1-6); CC [mean(M)± SD for all 8 visits] M=.45±.10; Range(R) =.37-.58) and for genital development (G) for only 3 of 8 comparisons (visits 1,5, 6).;CC-M=.28±.13, R=.27-.48). At earlier visits boys scored themselves higher and at later visits lower than physicians when there were disagreements. For girls breast development (B) there was agreement 5 of 8 visits (1-5); CC-M=.77±.10 R=.56-.77) and for PH for 8 of 8 comparisons (CC-M=.55±.19 R=.62-.89). For B girls scored themselves significantly lower than physicians when there were disagreements These data suggest that boys with pubertal delay poorly estimate their state of PH and G maturation. Girls poorly estimate B development. PH ratings for boys and girls have higher CC than G or B ratings suggesting that G or B development may be more salient than PH development in adolescents with delayed puberty. Treatment with testosterone or conjugated estrogen does not change their self-estimates as they progress through puberty. Boys and girls with pubertal delay are less accurate than normals (reported in the literature) in estimating their SMR suggesting that self-perceptions of pubertal maturation in adolescents with delayed puberty are disturbed. Boys' CC are lower than girls' CC suggesting that boys' perceptions may be more affected than girls' perceptions.
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