An 11-year-old boy has small genitals. Puberty in boys
The running of time cannot be stopped; its inexorable movement is especially noticeable when children begin to grow up. Until recently, the son was happy with his mother’s hugs and responded enthusiastically to her kisses, but now he has become rude and restrained. The most important period has arrived - puberty in boys, which appears a little later than in girls, but is just as inevitable. The body of a teenager has to experience a colossal load, because along with physical changes, colossal psychological changes occur.
What is puberty
Puberty is characterized by the appearance of secondary sexual characteristics. During normal development, the body reaches the phase of biological puberty. Signs of puberty manifest themselves externally as rapid body growth, the pubis and armpits become covered with hair, but then boys and girls continue to grow up each in their own way, turning into men and women. Hormones make themselves felt, and therefore, in addition to the average statistical norm, early, late development and a significant delay in puberty occur.
When does adolescence begin and how long does it last for boys?
The changes that are taking place can confuse or even frighten a teenager, because the process of puberty begins at the age of 10 or a little later. For now, all the most important things were laid down at the level of the pituitary gland, preparing the boy’s body for the changes that would ultimately turn him into a man. But with a brittle voice, increased work of the sweat glands, enlargement of the testicles, penis, muscle mass and the appearance of a number of other signs comes the period of puberty, which lasts up to 18 and sometimes 20 years.
Prepubertal period
The development of a child at this stage is not much different from the maturation of peers. From the moment of birth until the day the son goes to school, parents have almost no problems with upbringing, and health issues are often associated with colds. After smooth growth, muscle mass may also gradually appear, but by the age of 10, the body has already laid down future changes. If there is no delay, then the prepubertal period is replaced by the next stage of development.
Puberty
From about the age of ten, those changes begin to occur when a boy matures and begins to turn into a young man. The amount of hormones produced causes rapid growth with the simultaneous development of the gonads. Gaining momentum, the process inevitably leads to the fact that the teenage penis increases along with the size of the testicles. By the age of 15, upon examination, hair growth is noticeable in the armpits and pubic area; external signs are the appearance of mustaches and acne, and the puberty period ends at about 20 years of age.
Features of sexual characteristics in adolescence in boys
Hormonal changes in the body affect the growth of not only hair, but also genital organs. A boy's penis grows until he is about 16 years old, and spontaneous or nocturnal emissions appear. An increase in male hormones affects the development of muscles, skeletal bones, especially the shoulder joint. Voice mutation, the so-called voice break in boys, is considered one of the most obvious signs of the important process of puberty. Proper development is indicated by the appearance of acne, hair on the face, chest, thighs, groin area, and under the arms.
Primary
The presence of these signs is determined genetically, and they are nothing more than genitals. The formation of the prostate, scrotum, vas deferens, penis, testicles occurs at the stage of intrauterine development. Early puberty can speed up the process of transformation into a young man, but one way or another, any development occurs under the control of hormones.
Secondary
This group of features has an equally important role. Nature assigns a different mission to secondary sexual characteristics - determining sexual maturity and attracting a partner, because they do not directly participate in reproduction. What characterizes their appearance? Voice mutation in boys, male-pattern hair growth, rapid growth, broad shoulders, erection and Adam's apple.
Boys' height
If the process of puberty in boys is not disrupted, then a sure sign that the child has begun to grow up is rapid growth. A characteristic feature of this period is that the process does not go smoothly, but in jumps, which sometimes causes health problems. With all the individual characteristics of the body, the fastest period of growth occurs in the period from 12 to 16 years, when a boy can stretch 10 cm per year and lose a lot of weight. After reaching adulthood, young men almost stop growing and can stretch a maximum of another 3 cm.
Precocious puberty
It is customary to talk about this phenomenon - false or true - if the boy has not yet reached the age of 10. Externally, early sexual development can be judged by the facts that the boy looks older than his peers, the first pimples appear, and body odor changes. If the right and left eggs develop, this is the true beginning of the process. If they remain immature, this means that early puberty is false.
Psychology of a teenager
Along with a serious physiological restructuring of the body, a teenager has to overcome problems of a psychological nature. The appearance of acne on the face, pollution, and increased work of the sweat glands require a more careful approach to the issue of hygiene, which can cause irritation in a teenager. External changes and angularity take time to adapt, but it is difficult for a child to cope with this, especially if he becomes an object of ridicule at school.
Shyness, shyness, withdrawal into oneself, exaggeration of even an insignificant fact, for example, an unsuccessful photo - all these are manifestations of psychological signs of growing up. When girls get their period, boys' reproductive system also reaches a new level of physiological development. Since puberty is associated with the desire to gain more freedom in one’s actions, parents need to tell the boy about contraceptive methods.
Psychologically, puberty in a teenager can manifest itself as unmotivated aggression, frequent mood swings, irritability and depression, and harsh statements or criticism can push them to rash actions. It is necessary to continue raising a teenager, only adults need to create a favorable atmosphere, show tolerance, wisdom, and be tactful, so that the period of puberty ends for the boy with the formation of a beautiful male figure and a correct understanding of worthy behavior.
Video about puberty in teenage boys
Is your son already 11 years old? The girls in his class, most likely, sometimes already begin to use cosmetics, quickly gain height, and in general no longer look like little girls, but like full-fledged girls. Boys, most likely, are still boys, playing “war games”, and so far they look at girls only from the point of view. What is the most convenient way to pull the pigtail? It’s okay, soon our little boys will enter puberty (usually for boys it begins one and a half to two years later than for girls).
Physical aspect and quantitative measurements
In boys, puberty usually begins at the age of 11-12, sometimes, however, it can be delayed up to 14-15 years.
The muscles and skeletal system noticeably increase, the voice breaks, the figure changes. The muscles of the shoulder girdle develop. The genitals also become enlarged. At seven years of age, the length of the testicles on average reaches 2.7 cm, and the length of the penis in a calm state is 3-3.5 cm; by the beginning of puberty, these figures increase slightly: 2.8-3 cm for the testicles and 3.8 cm for the penis .
During puberty, the dynamics of growth of the genital organs is much higher, because there is an intensive production of male sex hormones. At the age of 13, these important indicators will be 3.6-3.7 for the testicles and 6.3 cm for the penis, by 15 - 4 cm and 6.7 cm, respectively. Of course, these are average readings, and a step to the right or left does not count as an escape (unless, of course, it is a giant step).
Puberty is also marked by the appearance of hair, primarily on the pubic area. By the age of 14-15, hair appears under the arms and - hurray! - youthful fuzz on the upper lip and chin.
Simultaneously with the appearance of hair, the voice breaks and, unfortunately, your child’s face often becomes covered with acne. Some people have more acne, some lucky people have less or none at all. If acne bothers you a lot, you can contact a specialist. And, of course, monitor the healthy lifestyle of your growing “baby”: sports, proper nutrition, keeping the skin clean - all this can significantly reduce the number of these nasty acne. Although, of course, by the age of 16-17 they will disappear on their own.
Around the same time (age 14), the first wet dreams may appear. This means that the sperm is already ready and your “baby” is quite physically capable of making you a grandparent. It's time to talk about "pistils and stamens" if you haven't already. And, naturally, about responsibility for the girl and (pah-pah) for a possible child. And about contraception.
Another very important indicator of puberty for a boy is height. Usually there are two leaps: the first comes at 10-11 years (the boy grows 10 centimeters). The next leap is 13 years, the boy gains another 7-8 centimeters.
Parents should know that all signs of puberty may well be delayed for a year or two, there is nothing wrong with that. The main thing is to support your son if he is worried that he still does not have facial hair and is shorter than everyone else in his class.
But sometimes, to correct some disorders, the help of specialists is required. So if the signs of puberty are delayed, visit a urologist or andrologist, because, as you know, prevention is easier than treatment, and at the age of 12-13, if there are any problems, it is much easier to correct everything.
Personal hygiene rules are changing
Don’t forget to teach your son the basics of personal hygiene, because uncleanliness can lead to balanoposthitis and other diseases. Daily toilet, frequent change of underwear is a mandatory item in the personal care program not only for girls, but also for boys. Don’t forget that a boy’s sex glands are more active and, naturally, an unpleasant odor appears. The boy himself may not notice this, but his classmates and friends (and, of course, girls) will definitely notice. Don’t forget to pay attention to this and - again - “long live scented soap” and neutral deodorants.
Psychology of a growing boy
So, the boy changes not only physically, although, of course, it is physical changes that entail psychological maturation. Your son becomes shy, gets upset over the slightest defect in appearance, exaggerating its significance. The boy’s movements are angular, because his body is growing so quickly that it takes time to adapt to it.
A teenager is easily offended, his mood often changes: now he feels like an adult, and after 5 minutes he is a baby again and wants to be close to mom and dad.
In addition, unclear sexual desires also create confusion. At this time, boys (and girls too) have idols: teachers, movie characters, etc. etc., at first usually of the same sex as the child. A little later, an idol of the opposite sex appears, while he is also a movie star, or a popular musician. And then it slowly turns out that the classmate is also quite okay, and can be an object of sympathy. True, open expression of emotions is still a long way off.
In addition, during puberty, a teenager fights for his freedom from parental care and insists on his rights and independence, but this does not mean that parents should “bend” to these demands. As a rule, a child fights for freedom, but at the same time is afraid of it: psychologists working with teenagers, they say that many teenagers admit that they would like their parents to be stricter and teach them what is good and what is bad.
If the parents' decision is reasonable, then the teenager accepts it, so do not forget to trust your child and discuss moral standards with him. As a rule, a healthy upbringing and confidence in the trust and attention of parents is exactly what a young man needs.
Discussion
In America, where everyone is obsessed with sexual harassment, they have gone so far that in the state of Colorado, a six-year-old boy was expelled from school and charged with sexual harassment for kissing the hand of his classmate!
Comment on the article "Puberty of boys: anxieties and problems"
Puberty of boys: worries and problems. Early puberty? What do you think? Puberty occurs in girls at 12.5 - 13 years, in boys - at 14 - 15 years. At this age, girls begin to menstruate and boys begin to have wet dreams.
Discussion
I can't tell by height.
In terms of hair growth, at the age of 8, hair began to grow on our pubis and armpits, and the smell of sweat also became pungent. We went to an endocrinologist and a gynecologist, took hormones in their direction, and said that this is the norm, about 20% of children begin to mature normally like this.
But it’s better to go to an endocrinologist - there will definitely be no harm from donating blood for hormones.
I, bio - 158, my youngest is a year shorter than the accepted height. That is, by the age of 8, she finally approached a height of 122 cm (the norm for 7-year-olds; and this happened every year). Accordingly, by the age of 9, according to the forecast, she will have a height of 128 - just like yours.
Everything is within normal limits.
Section: School problems. Academic achievement and puberty. 13 years old. My son studies at a serious school with a technical focus. Comments about the computer: “In general, my husband and I recently remembered ourselves, and he and I spent days playing games in the same way in our youth.
Discussion
Montessori pedagogy takes these features into account. The traditional one is aimed at some abstract children.
Tutors know exactly and explain.
I don't know what to do. In family education, this issue is simply resolved. You can wait it out, you don’t have to put pressure, you can negotiate and it usually goes away more painlessly.
puberty of boys. Mommies, tell me at what age do boys begin to mature? My son is 8.5 years old and already has quite noticeable hairs on his scrotum; if he plays sports, then he looks so masculine. Is this normal for his age?
Discussion
noticeable hairs - still vellus hairs, although noticeable, or rod-shaped (like in adults)??? If they are fluffy, then it’s okay, if they are rod-shaped, then it’s too early; premature sexual development is considered to be the appearance of secondary sexual characteristics before the age of 9 years. What's wrong with armpit and pubic hair?
puberty of boys. Mommies, tell me at what age do boys begin to mature? My son is 8.5 years old and already has quite noticeable hairs on his scrotum; if he plays sports, then he will look like this. Unfortunately, we had hormonal problems.
Discussion
Nowadays this is very common after the age of 8, my friend’s daughter also has a cannon in her armpits. They say that children eat well, there are a lot of hormones in their food, so it all starts earlier. I’m really waiting for the apologies to begin, maybe our bronchitis will be easier, the body clearly doesn’t have enough hormones to overcome this.
Don't panic! Everything goes as usual.
Thank you very much girls for fixing my brain. I will act according to the situation :) Thanks again :)
Puberty of a boy: approximate timing. Today's parents understand that the genitals of boys and girls need to be addressed. Puberty of boys: anxieties and problems. Puberty of a girl 9.5 years old. Early maturation, porn, etc. - needed...
Discussion
Sorry, maybe I missed it, but haven’t you talked to a psychologist about this topic?
You know, here, in my opinion, the moment of transition from natural to pathological interest is more important.
If he watches normal porn, without sadism or any kind of perversion, and his social life does not suffer, then there is no need to focus on this. If a teenager has an active social life, has interests and hobbies other than porn, then so be it... You see, if he is interested in this, then prohibitions will not protect him from interest. And one more thing... If you convince him that this is shameful or something else, that he needs to fight this, then he will have to fight, excuse me, with his libido. And here we get the birth of a neurotic. It is difficult to predict what will come of this.
All of the above is my personal opinion based on my own experience.
If this bothers you greatly (and, as I see, it does), I would recommend consulting with a good teenage psychologist or reading relevant books. Secretly from the boy, of course.
I don’t agree that he shouldn’t/too early.
Another thing is that “porn” is very far from reality; later in life you will look for women ONLY with silicone tits and only those who moan and “cum” from the first second you touch her.
I myself would have dug up a bunch of erotic films (there, unlike porn, the women are more real), some porn - something that is more or less real (if such a thing exists in nature, of course), magazines like "Playboy" used to publish rather soft erotica - now, I don’t know...
I would have a conversation on the topic “this is normal, it’s possible, everyone goes through it, masturbation is our everything” (and not a conversation “why not”)
I just have the same problem, all tests are normal. My daughter also has the same problem... a long-term low-grade fever of unknown origin. It’s been 3 years now... they took tests... they found herpes... they were treated... the temperature still persists... we continue the examinations...
Discussion
We have a very similar situation, we no longer know where to turn, have you solved this problem?
03/16/2019 11:46:46, Tatyana05But he has a deviated nasal septum, hence all sorts of sinusitis and chronic tonsillitis. Washing plugs, etc. doesn't last long.
Going to the pool in winter is bad + all sorts of Olympics are superimposed, I even feel sorry for the money :), but I cry :)
With just liquid-transparent winter snot (which, IMHO, is a manifestation of a cold allergy) and normal health - it’s worth walking, I washed out my nasopharynx with chlorine - everything is easier for the body :) At least I kicked out mine half an hour ago.
In general, at about Katya’s age, Egor was helped by aflubin in the mornings. I give it about 3 weeks, I don’t give it a week. Of course, he is criticized for the stress on the liver, but, IMHO, antipyretics 5 times a winter put no less strain. Incomparably no less :(
Over the last couple of years we switched to influcid tablets, but only during the epidemic. + our boy's imudon goes well when problems with gnorr begin.
A severe, non-speaking autistic boy began puberty and stimulation of the genital organs and molestation began. I thought about castration: I ask everyone, and especially the parents of adult boys, to answer the question why it is not customary to castrate severe...
Discussion
Sorry, but I remembered a joke - A patient complains to a therapist that he visited a surgeon and he recommended cutting off his ears so that they wouldn’t hurt. - These surgeons, just to pop something out, here are some pills for you, they will disappear on their own.
It’s the same story here - doctors know drugs that reduce the need + you need to distract with anything and explain where and how you can, but as I understand it, it’s problematic to do this here? ((Physical activity should also reduce the frequency.
Health. Teenagers. Education and relationships with teenage children: adolescence, problems at school But I also reached puberty a little later than average. First wet dream at 14 and a half. I didn't take any medications that speed up...
Discussion
Thank you very much to everyone for your support and information, you know how sometimes mothers worry about the health of their children. But it's better to be safe than sorry. We found a specialist who explained the situation to us in detail and calmed us down a little.
Calm down. At 14 and a half I was 147 cm tall. 11 centimeters shorter than your son!
Grew up like this:
14.5 - 15.5 +12 cm
15.5 - 16.5 +8 cm
16.5 - 17.5 +3 cm
17.5 - 18.5 +3 cm
18.5 - 19.5 +2 cm
Now 175. Stopped growing at 20.
In a parallel class there was a boy who, at 15 years old, was a head shorter than me. In my second year he was a head taller than me.
But I also reached puberty a little later than average. First wet dream at 14 and a half.
I didn't take any growth enhancing medications. Even vitamins and microelements. This didn't exist then.
Otherwise it could be at least 180.
And your son will easily grow to 185, but where more?
Puberty is the period of a person’s life during which his body reaches biological sexual maturity. This period is called puberty and is characterized by the appearance of secondary sexual characteristics (see), the final formation of the genital organs and gonads. The time of onset of puberty depends on many factors - nationality, climatic conditions, nutrition, living conditions, gender, etc. On average, in boys it begins at the age of 15-16 years, in girls from 13-14 years and ends at the age of 20 and 20, respectively. 18 years old. It should be emphasized that there are significant individual deviations in the timing of the onset of puberty. Physiologically, this period is characterized by the maturation and onset of functioning of the gonads. In the adrenal cortex, androgens begin to be intensively produced (see), the secretion of pituitary gonadotropins increases (see Gonadotropic hormones), which accelerates the development of the gonads. In girls, with increased function of the ovaries, which produce, the mammary glands, external and internal genital organs: uterus, labia begin. At the age of 14-15 years, sometimes earlier, the formation of the menstrual cycle occurs (see). An objective criterion for the maturity of the gonads is menstruation in girls and (see) in boys. The most common sequence of appearance of sexual characteristics is presented in the table.
| Age in years | Signs of puberty | |
|---|---|---|
| girls | boys | |
| 8 | The pelvis becomes wider, the hips become rounded | |
| 9 | Increased secretion of sebaceous glands | |
| 10-11 | Beginning of mammary gland development | Beginning of growth and testicles |
| 12 | Appearance of hair on the genitals, enlargement of the genitals | Growth of the larynx |
| 13 | The alkaline reaction of the vaginal secretion becomes sharply acidic | Enlargement of testicles and penis. Slight appearance of hair on the genitals. The beginning of formation according to the male type |
| 14 | The appearance of menstruation and the appearance of hair in the axillary depressions | Change in voice (breaking), slight enlargement (swelling) of the mammary glands |
| 15 | Pronounced changes in the size of the pelvis and its proportions according to the female type | scrotum, the appearance of a mustache and the appearance of hair in the axillary cavities. Significant enlargement of the testicles |
| 16-17 | Menstruation occurs regularly, with ovulation (see). | Increased hair growth on the face and body; male type of pubic hair. The appearance of wet dreams |
| 18-19 | Skeletal growth stops | Slower skeletal growth |
Often normal puberty occurs in a slightly different sequence. In these cases, it is sometimes very difficult to find a clear boundary between normality and pathology. One of the reasons for such deviations is disorders of hormonal systems; in other cases, the constitutional characteristics of a teenager during puberty, as well as psychogenic factors that can cause pronounced endocrine disorders, acquire a certain significance. It is extremely important to take these cases into account, since the irrational use of hormonal drugs during treatment can lead to significant damage to many systems. During puberty, small temporary deviations are sometimes observed, that is, variations in the normal development process. They are regarded as physiological phenomena. Girls may experience significant growth of the mammary glands (macromastia), and precocious puberty does not occur. Physiological variations of puberty also include juvenile uterine bleeding, amenorrhea (see). Painful menstruation is often observed, accompanied by headaches, vomiting, and weakness. These disorders are usually observed in girls with an unstable nervous system. Boys may have slight enlargement of the mammary glands (pubertal gynecomastia), which goes away completely.
Late(pubertas tarda) is considered puberty, observed in girls at 18-20 years old, in boys at 20-22 years old. For this pathology, therapeutic measures should be aimed at improving living conditions, nutrition and the introduction of male and female sex hormones and drugs containing pituitary gonadotropic hormones. Delayed sexual development and stunted growth are observed with infantilism (see). Underdevelopment of the reproductive apparatus and the absence of sexual characteristics of a given sex - hypogenitalisl (see) - are caused by dysfunction of the endocrine glands and, above all, the pituitary gland.
Early(pubertas praecox) is considered to be puberty, which occurs in girls under 8 years of age and in boys under 10 years of age and is characterized by the premature appearance of secondary sexual characteristics, rapid development of the genital organs and accelerated growth. In boys, this manifests itself in accelerated growth, and then an early cessation of growth (which subsequently leads to short stature), rapid growth of the genitals and the appearance of secondary sexual characteristics (hair growth, low timbre of voice, pronounced skeletal muscles). Wet dreams are also possible. In girls, growth accelerates, and then growth stops early, becomes wide, and the size of the uterus and ovaries increases. There are cases of menstruation in preschool age.
Early puberty in combination with accelerated growth, but a sharp disproportion of the skeleton, short stature and mental retardation is defined as macrogenitosomia praesox.
The question is closely related to the problem of puberty. This is a system of medical and pedagogical influences on adolescents with the aim of instilling in them certain norms of behavior in sexual life. The task of sex education is to create a physically healthy generation, whose sexual life should be subject to the moral norms of our society. The joint education and upbringing of boys and girls, their early involvement in public life, the combination of education with industrial work, and widespread development among young people create the basis for reasonable family education.
Puberty (lat. pubertas) is the process of growth and differentiation of the gonads, genital organs and secondary sexual characteristics. Puberty occurs with complex changes in the nervous, endocrine, cardiovascular and other systems of the body, as well as in physical development, and ends with the onset of puberty.
The hypothalamic region, which is in an inextricable functional relationship with the pituitary gland, plays a major role in puberty. During puberty, the activity of gonadotropic hormones of the pituitary gland noticeably increases, and the content of androgens and estrogens in the blood and urine increases. Estrogens synthesized by the ovaries cause enlargement of the uterus, vagina, labia minora, mammary glands and keratinization of the vaginal epithelium. Androgens cause sexual hair growth, growth of the penis and scrotum in boys, and the clitoris and labia majora in girls. Sex hormones, especially androgens, stimulate the growth and differentiation of bone tissue, promote the closure of growth zones, and enhance muscle development. In these processes, the protein-anabolic effect of sex hormones is manifested. The relationship between the various systems regulating puberty is shown in Fig. 1.
Rice. 1. Diagram of the relationships between various systems regulating growth and sexual development (from Gyllensvärd, according to Wilkins).
Puberty begins earlier in girls than in boys. During this period, urinary excretion of estrogens and gonadotropins increases noticeably in girls, and androgens in boys. Recently, in all countries, the timing of the onset of puberty has shifted to an earlier period. Thus, according to the observations of V.S. Gruzdev dating back to 1894, menstruation began at 15 years 8 months; Currently (1965) they usually begin at 13-14 years of age. In boys, the date of puberty is determined by the first ejaculations. The beginning and duration of the puberty period depend on family (constitutional) characteristics, body structure and environmental conditions (nutrition, climate, living conditions, etc.). Puberty begins in girls from 8-11 and usually lasts until 17 years, in boys - from 10-13 and up to 19 years.
During puberty, a hypertensive reaction and a hypotonic state, pulse lability, acrocyanosis, Trousseau spots, orthostatic albuminuria, spontaneous hypoglycemia, and sometimes mental disorders may be observed. The degree of puberty is judged by secondary sexual characteristics - hair growth on the pubis (11-13 years) and in the axillary region (12-15 years), in girls, in addition, by the timing of the onset of menstruation and the development of the mammary glands (10-15 years) , as well as using radiographs of the hand and distal ends of the forearm bones. The onset of puberty corresponds to ossification of the sesamoid bone, then synostosis appears in the first metacarpal bone and terminal phalanges; At the end of puberty, complete synostosis of the epiphyses of the radius and ulna occurs. It is necessary to be careful when assessing the degree of puberty in boys based on the size of the external genitalia, since their growth is often somewhat delayed.
Precocious puberty(pubertas praecox) can be true or false. When true, there is a relationship between the hypothalamic-pituitary region, the gonads and the adrenal glands. There are constitutional (essential) and cerebral forms of true puberty.
The constitutional form is almost always observed in girls and is apparently due to family predisposition. Secondary sexual characteristics appear early, even from birth, but more often at 7-8 years, and menstruation - at 8-10 years. Menstruation is ovulatory. In boys, secondary sexual characteristics can appear as early as 9-11 years of age, less often earlier. There is macrogenitosomia (premature enlargement of the external genitalia). At 12-13 years of age, puberty ends.
Initially, children with precocious puberty are ahead of their peers in physical development. However, later, due to the closure of growth zones, some of them develop short stature and disproportion - the lower limbs are relatively short in relation to the body (Fig. 2). The mental development of such children is often consistent with their age, and if it lags behind, then by approximately 2 years. In girls, urinary excretion of follicle-stimulating hormone and estrogen reaches puberty levels. The content of 17-ketosteropds in daily urine exceeds the age norm. With tumors of the adrenal gland and gonads, the level of hormone excretion is significantly higher. A vaginal smear confirms a normal menstrual cycle.
The prognosis for the constitutional form of premature puberty is favorable. There is no treatment.
In the cerebral form of true puberty, there are lesions in the hypothalamic region (tumors, hemorrhages, congenital brain defects, encephalitis) or a tumor of the pineal gland. Currently, most researchers believe that even with tumors of the pineal gland, premature sexual development is caused by secondary changes in the hypothalamus due to internal hydrocephalus. Children experience early and rapid development of genital organs and secondary sexual characteristics. Mature Graafian follicles and the corpus luteum appear in the ovaries. Interstitial cells form in the testes and spermatogenesis occurs. The content of gonadotropins, estrogens, and 17-ketosteroids in the urine corresponds to the pubertal period.
Precocious puberty is also observed with multiple fibrous dysplasia, in which there are changes in the skeletal system, skin pigmentation and increased activity of the thyroid gland.
False puberty (pseudopubertas praecox) occurs with pathological changes in the adrenal glands, ovaries or testicles. Ovulation and spermatogenesis are absent. After removal of the tumor, the development of secondary sexual characteristics is possible.
Delayed puberty(pubertas tarda) is characterized by late development of the genital organs and glands, as well as the appearance of secondary sexual characteristics. In boys it is diagnosed at 20-22 years old, in girls at 18-20 years old. Most often it occurs under the influence of a constitutional (family) factor, less often due to insufficient hygienic conditions and nutritional reasons. Delayed puberty is sometimes observed up to 15-16 years of age. At the same time, physical and often mental development lags behind. The differentiation of the skeletal system also lags behind, usually by 2-4 years. In the coming years, most children will reach the same age level as their peers in sexual development.
Assessment of puberty must be carried out on the basis of a number of signs and especially radiological data on the differentiation of the skeletal system. Correspondence of ossification processes to actual age, as a rule, excludes delays in puberty.
Variations in Puberty. Premature development of the mammary glands (premature thelarche) in girls may be the only sign of deviation. The absence of secondary sexual characteristics, estrogenic changes in the vaginal smear and enlargement of the internal and external genitalia makes it possible to distinguish this process from true puberty. It is believed that premature telarche is based on an increased reaction of mammary gland tissue to estrogens. In the future, this reaction may disappear. No treatment required.
Boys often experience pubertal gynecomastia (see), expressed more often on the left and disappearing without treatment. Treatment with male sex hormones is contraindicated.
Premature secondary hair growth (premature pubarche) develops on the pubis, in the armpits without other signs of virilization and is more often observed in girls. Only from 10-12 years of age is it combined with enlargement of the mammary glands, external and internal genital organs. Later, children develop normally. Urinary excretion of 17-ketosteroids corresponds to the age norm or slightly exceeds it. Children with precocious puberty require medical supervision and should be examined periodically.
During puberty, there is sometimes an enlargement of the thyroid gland of degree II and III without dysfunction. In this case, no treatment is carried out. Often, especially in boys, acromegaloid phenomena (also physiological) develop. There may be a predominance of masculine or feminine principles. The prognosis is favorable. During the same period, the so-called pseudo-Freulich type of obesity is sometimes noted, somewhat similar in appearance to obesity in adipose-genital dystrophy (see). At the same time, the distribution of fat is uniform with some predominance in the chest, abdomen and thighs. Arms and legs are often shortened. Body length and bone differentiation correspond to actual age. Hypogenitalism is absent or slightly expressed. The excretion of 17-ketosteroids and 17-hydroxycorticosteroids in urine is normal. The basal metabolism is reduced or normal. Puberty occurs at normal times or is somewhat delayed. No drug treatment is required.
During puberty, girls with symptoms of basophilism (the basophilic cells of the pituitary gland function intensely) experience female-type obesity, and stripes appear on the hips, buttocks, and breasts. Blood pressure is often elevated. However, sexual development is not impaired or even accelerated. Menstruation occurs on time, and the cycle is preserved. The prognosis, as with the types of obesity described above, is favorable.
Pubertal exhaustion is observed mainly in girls. The first symptoms: lack of appetite, abdominal pain, belching and vomiting, often repeated. The skin is dry, wrinkled. Bradycardia, muffled heart sounds, arterial hypotension, and amenorrhea are noted. Unlike pituitary cachexia, there is no atrophy of the mammary glands and hair loss. The basal metabolism is reduced. The function of the thyroid gland is not impaired. The content of 17-ketosteroids in the urine is reduced, and after the administration of ACTH it reaches normal levels. Follicle-stimulating hormone in urine is often absent or reduced. The prognosis is usually favorable. Treatment requires careful care, aminazine, protein-anabolic steroids. Methandrostenolone (or Nerobol) 5 mg per day, Nerobolil intramuscularly 25-50 mg once a week (4-6 injections).
Diagnosis, prescription of medications, especially hormones, as well as prognosis of diseases and conditions during puberty must be approached with caution.
Rice. 2. Girl 2.5 years old: early sexual and physical development (height 110 cm).
Sexual development of boys
Many sexual deviations have their roots in childhood or adolescence, but this area of human life is still so little studied that it is premature to talk about it and give any specific recommendations. To avoid such deviations, proper sex education of the child is necessary, which will be discussed in the next section.
Prenatal period
Strictly speaking, a boy’s sexual development begins from the moment of fertilization, when a sperm carrying the Y chromosome, which determines the sex of the unborn child, penetrates the egg. The creation of the reproductive system in the process of embryonic development is determined by the correct implementation of the genetic mechanism for the formation of a male individual, the presence of the appropriate hormonal background of the fetus and mother, and the absence of damaging influences from the external environment.
In the early stages of embryogenesis, the reproductive system has the anlages of both female and male external genitalia. Under conditions of autonomous development, both female and male embryos always develop according to the female type. The uterus, fallopian tubes, and vagina are formed. Thus, nature always strives to create "woman". In order for the male genetic code to be realized, it is necessary to have a full-fledged embryonic testicle, which secretes a special protein substance that suppresses the development of female genital organs. In the female body, the ovary does not determine the development of the genital organs. The external genitalia are formed from the 12th to the 20th week of intrauterine development. For the correct development of male genitalia, the normal functioning of the embryonic testicle is necessary. The seminal vesicles, vas deferens, penis, scrotum, and male urethra are formed only when there is a sufficient amount of androgens (male sex hormones, mainly testosterone) produced by the testicle. During this period, the concentration of testosterone in the blood of the fetus reaches values characteristic of adult men. The high concentration of testosterone continues after the birth of the child, and from 3 months of age begins to gradually decrease.
Violation of the normal functioning of the fetal testicles leads to various defects and diseases of the male reproductive system. Therefore, children with testicular pathology (cryptorchidism, monorchidism, decreased testicular size) should be examined and observed by a specialist to exclude concomitant pathology of the genital area.
Brain structures also take part in the regulation of sexual development: the hypothalamus, pituitary gland and pineal gland.
The pituitary gland (a small spherical endocrine gland located in the sella turcica of the skull and connected by a stalk to the hypothalamus) produces the main hormones that regulate the development and normal functioning of the human reproductive system: follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin. The secretory activity of the pituitary gland is controlled by the hypothalamus.
The hypothalamus is the highest vegetative center of the brain, controlling the activity of all organs in the implementation of plant functions of the body (nutrition, respiration, reproduction, excretion, etc.). The nerve cells of the hypothalamus receive signals from the higher parts of the brain. It produces substances that regulate the release of hormones by the pituitary gland. In turn, androgens produced by the testicle regulate the function of the hypothalamus by feedback type: a high level of testosterone in the blood inhibits the production of hormones in the pituitary gland.
Another, still mysterious, formation of the brain takes part in the process of sexual regulation - the pineal gland, or pineal body, which is sometimes called the “third eye” in popular scientific literature. The pineal gland (an endocrine gland located in the posterior part of the brain, in the region of the third ventricle) produces melatonin. Melatonin is produced at night and is involved in regulating seasonal changes in fertility in regions characterized by significant variations in day length. The longer the dark period of the day, the higher the concentration of melatonin and, as a result, the lower the likelihood of fertilization. On the contrary, in high light conditions the concentration of melatonin decreases and the possibility of conception increases. Therefore, in the conditions of the middle zone, the summer months are the most favorable for conception. It is no coincidence that a large number of children are born in the spring (and not just because of the holiday period and good weather).
Period of relative rest
After a stormy intrauterine period and the first months after birth, a period of relative rest begins in the boy’s body until the onset of puberty. At this time, the reproductive system seems to be asleep. The external genitalia are infantile (not developed, childlike) (Fig. 1).
Infantile (children's) external genitalia of a two-year-old boy
Fig.1. Infantile (children's) external genitalia of a two-year-old boy
The scrotum and penis are small in size. The volume of the testicles can vary from 0.7 to 3 cubic meters. cm, and the length of the penis is from 2.5 to 5.5 cm. The growth of the penis and scrotum is proportional to the increase in the size of the child himself. Pubic hair is completely absent. During this period, the seminiferous tubules in the testicle do not have a lumen, which is filled with immature cells - the precursors of sperm. The cells in which testosterone is produced, having fulfilled their initial role in the proper formation and development of the male body, almost completely degenerate by the age of one year.
The biological clock ticks, and between the ages of 6-8 years the male reproductive system begins to gradually awaken. The growth of the testicles begins, a lumen appears in the seminiferous tubules, the process of differentiation of cells, the precursors of sperm, begins, and the number of cells producing testosterone increases.
Puberty
The most rapid processes of sexual development occur during the so-called puberty period (from Latin - puberty). The period of puberty is a time when miraculous transformations occur in a child’s body over the course of several years, like a stormy spring, as a result of which the child becomes an adult, a man capable of producing offspring. This period is one of the most important, if not the most important, in a person’s life. In a short period of time, the genitals reach their final development, secondary sexual characteristics are formed, and the body acquires its final proportions and shapes. Nature makes, if not the last, then the most important stroke on the individual portrait of a developing personality. During this same period, profound psychological changes occur. The restructuring of a teenager’s inner world is enormous and, as a result, vulnerable and sensitive. Growing up is one of the most difficult and vulnerable periods of life for both a teenager and his parents. The onset of puberty in a child is largely genetically determined. In addition to the genetically programmed individual, racial and national characteristics of the puberty period, its course is to some extent influenced by the economic, social, and cultural level of the child’s life.
The complex transformation of a boy’s body into a man’s body takes a period of 10 to 18 years. A boy's sexual development is a strictly individual process. The time of onset of puberty, its duration and intensity are individual. Therefore, we can only speak conditionally about the timing of the appearance of various sexual characteristics. A delay or advance in the appearance of a particular symptom for up to two years is within the physiological norm and does not require treatment. However, in this case, a visit to the doctor will not be superfluous and will help rule out more serious problems of puberty.
Nowadays, for most children of the European race, the onset of sexual development occurs in the 11th year of life. The first sign that the process has begun is a significant increase in the size of the testicles. The increase in testicular size is the result of increased growth of seminiferous tubules - structures responsible for spermatogenesis. Despite the fact that during this period testosterone production by the testicle increases 10 times, the contribution of cells producing the hormone to the overall size of the testicle is insignificant, since they occupy less than 10% of its volume. Testicular growth continues throughout puberty, and the testicles reach their final size by 17–18 years. In parallel with the enlargement of the testicles, the scrotum also grows (Fig. 1).
Rice. 1. The onset of puberty is characterized by enlargement of the testicles (11 year old boy)
The onset of puberty is characterized by enlargement of the testicles (11 year old boy)
Behind the testicles, with a delay of 6 months to 1 year, the penis begins to grow. First, the penis grows in length, then, in parallel, it increases in diameter. Penile growth ends at approximately 16 years of age. Along with the enlargement of the testicles and the growth of the penis, pigmentation of the penis and scrotum appears. The skin of the scrotum becomes folded, sebaceous and sweat glands develop. For most adolescents, growth of the external genitalia ends by age 16. After this age, the size of the penis remains virtually unchanged.
Rice. 2. Beginning of pubic hair growth (12 year old boy)
Beginning of pubic hair growth (12 year old boy)
At 12-13 years old, pubic hair begins to grow (Fig. 2). At first it is single, straight, long hair at the base of the penis, then the hair becomes thicker, more wavy and gradually spreads to the pubis, taking on the shape of a triangle, pointing downwards.
By the age of 16-18 years, the development of pubic hair reaches the severity characteristic of adult men (Fig. 3).
Rice. 3. External genitalia of a 14-year-old boy
External genitalia of a 14 year old boy
For most men, hair growth continues. Like a victorious army led by its commander-in-chief - testosterone, the hair over time takes over the inner thighs and spreads along the linea alba. This process is individual in nature, and the absence of such pronounced hair growth is not evidence of androgen deficiency or any abnormalities in the male body.
At the age of 13-14 years, hair growth in the armpits begins. This process also goes through several stages: from single and straight hair to thick and curly hair that occupies the entire armpit. Most children already have significant axillary hair growth by the age of 16.
The last, but most noticeable evidence of a teenager’s maturation to others is the growth of a beard and mustache. This process is long. The first vellus hair above the upper lip can appear in a boy at the age of 14, and the final formation of facial hair growth occurs by the age of 20 and even later.
At about 14 years of age, a normally developing boy begins to experience wet dreams (involuntary ejaculation of seminal fluid in men, usually during sleep). By the age of 15, half of adolescents have them, and by 16, the majority have them. Wet dreams are a very important sign of normal sexual development, indicating the maturation of the fertile (fertility, ability to bear children) function of the testicle.
In parallel with the external genital organs, the internal ones also develop: the prostate and seminal vesicles.
Simultaneously with puberty, the boy’s physical development also occurs. Moreover, the processes of body growth and muscle mass increase are closely related to the degree of sexual development of the child. During puberty, the more pronounced a boy’s secondary sexual characteristics are, the more physically developed he is, as a rule. The proportions of the body change, the belt of the upper extremities develops - the teenager “sounds out in the shoulders”, the timbre of the voice decreases, and it “breaks”. Growth continues as long as epiphyseal cartilages are present, due to which the tubular bones increase in length. Under the influence of testosterone, growth plates gradually close, which occurs on average at 21 years of age.
Rice. 4. Gynecomastia in a 12-year-old boy
Gynecomastia in a 12 year old boy
Sometimes during puberty, a teenager's mammary glands may enlarge, which is temporary and does not require treatment. Any visible or palpable enlargement of the mammary gland in boys is called gynecomastia (Fig. 4). As a rule, the process is two-way. Occasionally, enlarged glands may be accompanied by painful sensations. With physiological teenage gynecomastia, there is no discharge from the nipples. In very rare cases, with large glands or long-term gynecomastia, leading to a change in the psycho-emotional state of a teenager, surgical removal of the enlarged glands is resorted to. Negative manifestations of puberty include the appearance of acne on the face.
Omitting the complex biochemical processes that occur in the body of a teenager during puberty, we can simply say that the transformation of a boy into a man (this includes the reproductive system and physical development) occurs under the influence of testosterone, the main male hormone. Under the influence of testosterone and its metabolites, the development of the penis, prostate, growth of facial hair, increase in muscle mass, formation of the male larynx, etc. occur.
Puberty disorder
Disturbance of puberty is one of the main reasons for the formation of mental disorders in adolescents.
Delayed sexual development of 1.5-2 years due to constitutional, national, family characteristics is not a pathology and in most cases does not require treatment. Delayed sexual development in 70% of cases is genetically determined. Remember how your puberty proceeded, when your first menstruation or wet dream appeared, pubic hair; If possible, ask your parents and brothers and sisters, and you will know approximately what awaits your offspring. By the way, if there are cases of delayed puberty in a family, this primarily affects the development of boys, in whom disorders occur 2.5 times more often than in women. And men, as we regret to say, are more “to blame” for the genetically unfavorable burden, for the improper development of the genital organs in boys, than the female half of their relatives. When collecting your family history, it is advisable to find out whether there have been cases of cryptorchidism, infertility, various anomalies in the structure of the genital organs, and menstrual dysfunction in your family. In such adolescents, as a result, although with a delay, all the signs of an adult man develop and, as a rule, the ability to bear children and hormonal function do not suffer. Moreover, the final expression of sexual characteristics, the size of the penis, the ability to have sex and conceive children do not depend on the speed of sexual development.
However, some children with delayed sexual development, as they say, “withdraw into themselves,” become withdrawn, try to avoid groups of peers, washing together in a bathhouse, or swimming in a pool. Difficulties arise in communicating with parents. Comparing themselves with normally developed classmates, such children consider themselves defective, inferior, freaks, the only ones in the world. For such a teenager, the whole world and all thoughts are focused on the small size of the penis and the lack of pubic hair. This group of children often has suicidal thoughts, and if the people around them are careless, suicidal attempts are also possible. Another part of the children become, on the contrary, aggressive, trying to prove their masculinity to themselves and others. Teenagers start smoking and drinking alcohol early. As an external manifestation of masculinity, they often get tattoos and are prone to a disdainful attitude towards the opposite sex, masking their inner vulnerability with external rudeness. The pain suppressed by such behavior and the hidden feeling of inferiority can sometimes break through (especially after unsuccessful sexual intercourse) by attempting to die.
If during this period of a teenager’s life no help is provided (by parents, teachers, a doctor), then disturbances in the formation of the child’s personality may develop. And if in the future, most likely, he will catch up with his peers in sexual development, the genitals will develop, and sexual activity will begin, then mental problems will haunt him throughout his life. In many ways, a person’s fate is determined by these few years, called puberty. The male psyche is structured in such a way that the basis of a successful life is consistency in the sexual sphere.
Even if disorders of puberty are programmed genetically, the degree of formation of the disease largely depends on the external influence of various unfavorable factors. Everything that is beneficial to the body as a whole has a beneficial effect on the reproductive system, and the negative influence of the environment primarily affects the reproductive organs most strongly. As trivial as this may sound, we will again talk about proper nutrition, the dangers of alcohol and tobacco, and first of all we need to start with the parents. Unfavorable factors affecting the development of the male body include various stresses during pregnancy and infectious diseases (especially those occurring in the first half of pregnancy). The presence of occupational hazards among parents (working with paints, herbicides, pesticides, etc.) has a negative impact. The strongest factor influencing the development of a child’s reproductive system is parental exposure to radiation. According to our data, 13% of children who had serious genital defects had fathers who worked with rocket fuel or ionizing radiation immediately before conceiving the child.
With a decrease in the hormone-producing function of the testicles, a boy may develop a pathological condition - hypogonadism, the clinical manifestations of which are underdevelopment of the external and internal genital organs and secondary sexual characteristics. Previously, such conditions were called eunuchoidism (eunuch - eunuch, castrate; castrated servant in a harem). Now this term is not used, but it allows us to better understand the causes and external manifestations of this condition. Before the onset of puberty, if there are no pronounced changes in the external genitalia, it is difficult to diagnose hypogonadism. Such boys are practically no different in development from their peers. During sexual development, they gradually develop a typical appearance. The external genitalia remain infantile: the length of the penis is less than 5 cm, the volume of the testicles is less than 5 cubic meters. see. Absent or weakly expressed pubic and axillary hair. There is no folding or pigmentation of the scrotum, the voice remains high. There are no wet dreams. The appearance of such patients is characteristic. Growth, as a rule, does not suffer, even above normal. The limbs are long, the waist is high. The hips are wide, exceeding the size of the shoulder girdle. The deposition of subcutaneous fat is characteristic of the iliac crests, lower abdomen, and mammary gland area. Adolescents with constitutionally determined delayed sexual development, which does not require treatment, may have the same appearance. However, in 50% of cases it is characteristic of true hypogonadism. Such children must be observed by specialists for differential diagnosis. The effectiveness of treatment for disorders of puberty in hypogonadism decreases with the age of the child.
Many cases of sexual dysfunction in adulthood associated with infertility, impotence, and neuropsychiatric disorders are probably the result of hypogonadism missed in childhood and untreated.
In addition to the delay, sexual development may be ahead of the physiological norm. In boys, the appearance of secondary sexual characteristics before the age of 10 is considered premature. Early sexual development leads to a rapid increase in body length and closure of bone growth zones, which leads to short stature in such children. They need careful examination and treatment.
Like delayed sexual development, its acceleration can be constitutional, familial, or genetically determined. In this case, secondary sexual characteristics appear in boys at 10-11 years of age. Such children develop normally in the future; they do not require treatment, but observation is necessary.
Hermaphroditism
A separate group of patients consists of children with a disorder of sexual differentiation, in which the structure of the external genitalia has features of bisexuality (i.e., elements of both the male and female reproductive systems are present simultaneously), the so-called patients with hermaphroditism (Fig. 1).
Rice. 1. External genitalia of a patient with one of the forms of hermaphroditism. Along with the penis there is a rudimentary vagina
External genitalia of a hermaphrodite
Such boys may exhibit derivatives of the female reproductive system:
- the fallopian tubes,
- uterus,
- vagina
- bisexual external genitalia.
This pathology is rare, heterogeneous in its composition, difficult to diagnose and treat, and there is no point in talking about it in detail in this book.
Normally formed genitals do not mean that the boy has turned into a normal man.
Correct anatomy must be complemented by male psychological characteristics. The presence of a Y chromosome in the embryo, in its genetic makeup, does not mean that it will develop into a psychosexually correctly formed male personality. The concept of "gender" is not as simple as it may seem -
at first glance. In addition to genetic, there is also gonadal, hormonal, anatomical sex, depending on which gonads will develop in the embryo, how they will function and what appearance the genitals will acquire. And besides this, they also distinguish between civil gender (the gender of the child recorded in documents), mental gender (in which gender the individual feels himself), and social gender (the gender of his upbringing). With hermaphroditism, there are cases when a person of male genetic sex, based on female external genitalia, is registered in another gender, receives a passport as a woman, but mentally identifies himself as male. Moreover, when in such or similar cases at the birth of a child, a council of doctors decides in which sex to register, raise and treat the baby, the last thing they pay attention to is its chromosomal sex. The defining point is the possibility of correction of the external genitalia.
Hermaphrodite (Louvre)
Rice. 2. Hermaphrodite (Louvre)
In Greek mythology, a hermaphrodite was the name given to the son of Hermes and Aphrodite, united by the gods with the nymph Salmacis so that their bodies formed one whole (Fig. 2).
In the future, if a boy is raised as a girl and he receives appropriate hormonal treatment, he feels himself in the female gender with the ensuing female gender role behavior. The child chooses girlish games, feminine character traits are formed, and sexual attraction to the male sex develops. However, such a transformation from one sex to another is possible only in very early childhood, until the child has formed an idea of his gender. This usually occurs by age 3. At first, the baby determines his gender by the method of urination (boys pee while standing, and girls while sitting), without relating to anatomical differences and considering it possible to change his gender. By the age of 4, the child already accurately distinguishes the gender of the children around him by the external attributes of gender: differences in clothes, toys, etc. A period of “gender” exploration of oneself and the world around him begins. At this time, children are characterized by games with spilling, playing "doctor", studying their genitals and interest in the external genitalia of the other sex. Gradually, the child accumulates data in a form accessible to him about the structure of the male and female body, pregnancy, childbirth, and sexual life. By the age of 6-7 years, a child already understands that he will remain a boy or a girl for the rest of his life, he is precisely aware of his gender, and knows the sex-role and anatomical features of each gender. During adolescence, the psychosexual orientation of a teenager is formed. It is largely determined by hormonal levels, but sexual interests are largely determined by sex education and the environment.
It is still not entirely clear how a child’s sexual consciousness is formed. There are only theories of such formation. Perhaps the child unconsciously imitates the behavior of an adult of the same sex, especially his parents.
Gradually, this behavior becomes fixed in the mind. According to another theory, a child’s self-awareness in his or her gender is achieved through social learning by parents and surrounding people. It all starts with choosing a name. The child dresses according to his gender, and appropriate toys are bought for him.
Parents constantly reward gender-specific behavior and react negatively to gender-inappropriate actions: - “boys don’t cry,”
- "they don't play with dolls"
- "Girls don't fight."
Such encouragement and condemnation leads to the fact that the child tries to behave “as it should,” which is gradually consolidated and formed into stable gender-role behavior characteristic of a given gender.
However, in our opinion, such and similar theories describe only part of the mechanism of a child’s psychosexual development. We know from life that already 5-6 month old children exhibit behavioral signs of one gender or another. And if we draw an analogy with the animal world, then the flawed nature of such theories becomes obvious. Apparently, genetic makeup and, more importantly, hormonal levels are essential components of sexual development.
With all this, we should not forget that man is a social being, and therefore, upbringing and the influence of the surrounding society plays a primary role in the formationgender role behavior.
Child sexology as a science is just beginning to develop. Basically, information about childhood sexuality is obtained by collecting anamnesis from adult patients with sexual deviations. At the same time, in the practice of an andrologist, children and adolescents with various forms of sexual deviations are often encountered.
Transsexualism
Transsexualism is a persistent awareness of one’s belonging to the opposite sex, despite the correct formation of the external and internal genital organs and secondary sexual characteristics. Transsexualism is characteristic of the male sex and occurs in 1-3 cases per 100 thousand male population. The causes of this condition are unknown.
In childhood, transsexualism manifests itself as a violation of gender-role behavior. Such boys choose games of the opposite sex, try to wear girlish clothes, and come up with feminine names for themselves. Already at the age of 5-7 they are clearly aware of the imbalance between their own sexual identity and their place in society. During adolescence, contradictions intensify. For such children, it is real torment to be in a field in which they do not feel themselves. Their desire to change their destined gender is incredible. The goal of life becomes the need to form an outer shell corresponding to their inner content. Such boys secretly or openly dress in women's clothing and use cosmetics. The struggle begins with anatomy that does not correspond to their ideas. The penis is bandaged to the leg so that it does not stand out, and facial hair is carefully shaved. Their dream is to surgically change their gender, remove the penis they hate, and get mammary glands.
Sexual desire in such adolescents corresponds to their psychosexual state. Genetically and externally correctly formed men experience attraction to their own, but mentally opposite, male sex.
This is the fundamental difference between transsexualism and homosexuality, in which an individual experiences sexual attraction specifically to a member of his own sex.
How to help such children?
There is only one way out: undergoing sex reassignment surgery, changing one’s civil and social status. It has now been proven that such a life transition is optimally carried out precisely at puberty in order to save the teenager from sometimes many years of suffering.
Violation of the psychosexual orientation of boys can be expressed in so-called temporary teenage homosexuality. This condition is fundamentally different from true homosexuality, is temporary in nature and is associated with the complexity of psychological restructuring during adolescence.
During the puberty period, characterized by hypersexuality, sexual desire in boys is so intense that the line between the sexes is partially erased and the child begins to experience interest in his own gender. A similar condition occurs in 30-40% of young men. However, homosexual attraction exists only in the form of attraction, without an active search for and implementation of homosexual contacts.
Interest in girls remains (this is different from true homosexuality). Teenage homosexuality is especially typical in closed boy groups: camps, sports sections, special schools. The impossibility or prohibition of communication with the opposite sex, associated with the cultural characteristics of the family, plays a role.
Adolescent homosexuality is temporary, but it is important that this psychosexual orientation is not fixed for life. For this, a teenager urgently needs communication with the opposite sex. It is also necessary to protect the child’s still unformed psyche from contact with homosexual culture: adults with homosexual inclinations, books and pornographic films with corresponding content.
Just recently, your child was flexible and kind. And suddenly everything changed! The teenager suddenly began to behave strangely: you hear harshness and rudeness, he gets offended at the slightest reason and for no reason. It is immediately noticeable that something strange is happening to the teenager, his character is changing. There is no need to worry; most likely, your child is going through puberty.
In order to finally dispel all doubts and cause for concern, you need to know what puberty in boys is like. Having the necessary information, you will give your child advice on what to do and how to behave, and protect him from useless troubles and worries.
Active phase of puberty for boys lasts several years, which consists of several stages. However, the active stages are preceded by several initial stages, without which the transition to the active phase is simply impossible.
Let's look at the initial and active phases of puberty in boys in more detail and step by step.
Initial stages
There are two initial stages - development inside the mother's womb and initial puberty.
- Development inside the womb. Approximately between the twelfth and sixteenth weeks, the final formation of sexual characteristics occurs, thanks to which it is possible to distinguish the sex of the child. In boys, the scrotum and penis are formed, and the testicles remain in the abdominal cavity until the end of the mother’s pregnancy and descend into the scrotum in the last weeks before birth.
- Initial puberty. The stage is also called the infantile period or “childhood”. Its duration ranges from nine to eleven years from birth. However, sometimes the period can last longer, lasting between fourteen and fifteen years. During this period, as the boy grows, the size of the penis and scrotum increases. Simply put, normal physiological growth of the skeleton and genital organs occurs. The emotional behavior of a teenager is stable, without sudden outbursts of emotions and mood swings.
Active puberty
The stage consists of three smoothly transitioning periods: initial puberty, the process of puberty and the final stage of puberty.Initial puberty. The period is called puberty. Puberty precedes the infantile period and usually begins after eleven years of age. As mentioned above, in some cases the period may be later and begin in a teenager at the age of fourteen. Puberty is a very important period in the process of puberty. It is during this period that the boy’s body prepares for the next stages of puberty.
The pituitary gland begins to produce much more hormones, such as somatotropin, follitropin. Hormones affect muscle and bone tissue in the body, that is, its growth accelerates. Hormones also affect the sex glands, under the influence of which the growth of the penis, scrotum and testicles accelerates.
It is the increase in the size of the penis, scrotum and testicles that is the most important point of this period. There is the appearance of small hairs in the pubic area, and hair is not yet growing in the armpits and on the face.
The secretion of the sweat glands increases - more sweat is released in hot weather and during physical activity, and the sweat acquires a characteristic odor.
Very often, changes frighten a teenager and can lead to irritability, aggression, or, on the contrary, a teenager can withdraw into himself, become uncommunicative and timid. At this stage, it is necessary to explain what is happening to him - this is an absolutely normal process of physiological development.
The process of puberty. Initial puberty is completed and approximately by the age of fourteen the second stage begins - the direct process of puberty. Sex hormones - androgens and estrogens - begin to be actively produced. Moreover, androgen is a male sex hormone and is produced in greater quantities than estrogen, a female sex hormone. Under the influence of androgen, the growth of the penis, scrotum and testicles increases significantly, the barely noticeable fluff on the pubic area is replaced by dark and coarse hair. An excess of estrogen leads to swelling and slight pain in the nipples. However, there is no need to be afraid, since these changes are short-term and disappear completely after a few months.
Under the influence of hormones, intensive production of semen occurs in the testicles and seminal fluid in the prostate gland. That is, the teenager’s body begins to produce sex cells. Moreover, during sleep, involuntary release of semen occurs, called emission.
Hormonal changes affect the sebaceous glands, thereby producing excess sebum. As a result, the skin becomes oily and pimples and blackheads form on it. Particular areas where the rash occurs are the face, back and arms.
In a teenager, changes in the skeleton are visible, especially the structure of the pelvic bones changes dramatically - the pelvis lengthens and becomes narrower. The humerus becomes more massive, the jaw lengthens.
The proportion of adipose tissue in the body decreases significantly and can amount to no more than twenty percent of the total body weight, so adolescents in this period are thin and do not gain weight even with intensive nutrition.
In addition, during this period, teenagers have an incredible appetite: some time after eating a large meal, they are hungry again. The reason for this is excessive hormonal activity of the thyroid gland and excess sex hormones in the blood, which instantly burn vitamins and microelements obtained from food intake.
The period ends at fifteen to sixteen years. A teenager’s genitals reach their final size, the teenager’s height increases significantly, hair appears in the armpits, and fuzz begins to grow on the face.
The final stage of puberty. By the age of seventeen or eighteen, puberty ends. However, for some teenagers it ends by age twenty-two. The formation of the reproductive system is completely completed: the genitals no longer grow and no longer differ in size from adult men.
Facial features take on a different shape: they become masculine from rounded outlines. Hair grows like men: on the pubic area, inner thighs, face, chest, arms. 
During puberty, special attention should be paid to the mental aspect of the teenager. During this period, the psyche goes through transformations and changes and, as a result, is not stable. A teenager is characterized by increased irritability and impressionability, frequent mood swings are noticeable, and depression and aggression often occur for no reason. You should be very careful in your statements, since the teenager takes almost everything literally.
During puberty, a teenager is actively developing his character and views. The choice of a future profession and one’s behavior in society is laid down precisely at this time.
To summarize what has been said, we add that puberty in boys usually begins at the age of ten and continues on average almost five years. However, there are cases of early puberty. There are several reasons for this – genetic predisposition or diseases that cause disturbances in the body’s hormonal system. In the second case, you should not neglect visiting a doctor, since although this happens extremely rarely, the reason may lie in the early stages of tumor formation in the brain.
