Get access

Correspondence Between Gonadal Steroid Hormone Concentrations and Secondary Sexual Characteristics Assessed by Clinicians, Adolescents, and Parents


  • The authors are very grateful to Jan Clavey for her administrative, technical, and editorial support. We acknowledge funding support from 1R01DA01965, NIDA, and NIH for this study, and to intramural programs between NICHD and NIMH that supported the parent study.

Requests for reprints should be sent to Bin Huang, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, MLC 5041, 3333 Burnet Ave, Cincinnati, OH 45229. E-mail:


Adolescent sexual maturation is staged using Tanner criteria assessed by clinicians, parents, or adolescents. The physiology of sexual maturation is driven by gonadal hormones. We investigate Tanner stage progression as a function of increasing gonadal hormone concentration and compare performances of different raters. Fifty-six boys (mean age, 12.7 ± 1.3 years) and 52 girls (mean age, 12.0 ± 1.6 years) were seen at baseline, 6 and 12 months. Estradiol and testosterone concentrations were determined from three morning serum samples and Tanner stage by three different raters (clinician, parent, and adolescent). Results confirm that Tanner criteria reflect gonadal hormone concentrations, and clinician rating provides optimal assessment. Detailed insight about the strengths and limitations of different raters is provided, augmenting the scientific understanding of pubertal development.