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Precocious Puberty in Children and How it Impacts the Mental Health of Young Girls

Early puberty, also called precocious puberty, refers to the premature onset of puberty in children. The stages of puberty include body and hormone changes that allow the body to reproduce. These changes can include the growth of pubic hair, breast development, voice changes and more. Early onset puberty can have negative effects on the mental health of children.  

What is early puberty or precocious puberty? 

Generally, puberty before the age of nine in boys or the age of eight in girls is considered early or precocious puberty. The average age of puberty onset has been decreasing over time in the U.S., with some research pointing to estrogen in cosmetic products, diets high in fast food, and childhood obesity as common risk factors for early onset puberty. Girls are also at a higher risk of precocious puberty.

What are the mental health impacts of early puberty? 

Children who experience early puberty can experience increased risks of depression, substance use and early sexual behaviors, and it can be difficult psychologically – especially girls. There is more research on early pubescence in girls than for boys, since there are clearer indicators of puberty such as menstruation and breast growth.  

Increased Risk of Anxiety & Depression 

Research shows girls with precocious puberty may be more vulnerable to anxiety and depression, and that they can carry that risk for several years. The onset of puberty is marked by significant rises in hormones and the development of primary and secondary sex characteristics. These changes can create real or perceived rejection, conflict and sensitivity, as well as depression, which could continue into adulthood.  

Negative perceptions of physical appearance and changes 

During pre-adolescence and adolescence, acceptance and “fitting in” socially are important to children. Starting puberty brings on physical changes that can be obvious and can set children, especially girls, apart from their peers. Physical changes brought on during early puberty can cause a variety of issues with girls’ physical appearance and perception of it including: 

  • New or increasingly common comparisons of differences with peers 
  • Decreased confidence and body image issues 
  • Increased awareness of sexual characteristics; emphasized by others 
  • Kids may seek out older friends who look similar, and engage in risky behaviors 
  • Authority figures may grant more freedom or independence than appropriate

Ways parents can help their children manage early or precocious puberty

Parents of a child exhibiting signs or symptoms of early or precocious puberty should take their child to their care team to get tested for precocious puberty. Signs or symptoms parents should be aware of in girls younger than eight years old and boys younger than nine can include: 

  • Acne 
  • Breast growth and first period in girls
  • Pubic or underarm hair 
  • Rapid changes in height 
  • Testicle and penis growth, facial hair, and a deeper voice or voice cracking

Parents concerned about early onset of puberty or precocious puberty, should visit with their child’s care team. Puberty can be caused early by a variety of issues, including genetics, but also hormonal conditions or some tumors, so bloodwork and imaging are often used in diagnosis.  

Parents can help their child through the onset and treatment of early puberty by learning more about it. 

Some of the most common resources or approaches for parents of precociously pubescent children include: 

  • Peer-to-peer support from other parents of children with early puberty 
  • Ongoing patient education and awareness 
  • Social work or mental health professional help 
  • Therapy and emotional regulation 

Dr. Kristyn Gregory, D.O., is a medical director of behavioral health at Blue Cross Blue Shield of Michigan. For more health information and tips visit

A Healthier Michigan
Author: A Healthier Michigan

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