Abstract
A 7-year-old Black girl presented with her mother for evaluation of breast development and concern for precocious puberty. Pediatricians told them that breast development before 8 could be abnormal. A bone age (an X-ray of the hand to interpret skeletal maturation) was 9 years, advanced compared to her age; this and laboratory testing led to a pediatric endocrinology referral for abnormally advanced puberty. At the clinic visit, the child seemed attentive and visibly distressed. The mother was less concerned, noting other young girls in their neighborhood have breast development and asked, “Isn’t my daughter normal?”
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