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PubMed1982

Growth and development in sickle cell anemia. Preliminary report.

Historically, adults with sickle cell anemia were described as being short, thin, and eunuchoid in appearance with a particular body habitus. More current investigations in children have suggested decreased height, weight, and hypogonadism although Jamaican studies suggest supranormal heights in adolescence. All studies to date have evaluated children at one point in time. We evaluated children with sickle cell anemia longitudinally at six monthly intervals over 3 years to assess somatic growth and the development of sexual maturation. Our data support reduced height and weight as compared to National Health Statistic norms, with normal skin fold thickness. Bone ages were significantly retarded. When a patient's chronological age was replaced by his bone age and tanner staging was done, sexual development was appropriate for bone age, suggesting delayed sexual maturation. In addition, menarche was significantly delayed. Pituitary gonadotropins showed an appropriate increase with puberty. Gonadal end organ hormones supported normal responsiveness, although an occasional patient showed depressed levels. Longitudinal data is necessary to assess children with suspected delay in somatic and sexual development. Hormonal replacement does not seem warranted in the majority of patients.

Adolescent↗
PubMed1998

Measuring sexual harassment: development and validation of the Sexual Harassment Inventory.

Sexual harassment is a pervasive and damaging public health problem, yet the natural history is poorly understood, and research in this area has tended to focus on prevalence reporting. We describe the development and initial validation results of a survey tool, the Sexual Harassment Inventory, that may be helpful in future epidemiologic research. This 20-item instrument can be readily adapted for use in different populations and may be scored to measure the severity as well as the occurrence of sexual harassment. Routine use of this or some other standardized measurement tool would help clarify our understanding of the natural history and health costs of sexual harassment.

Data Collection↗
PubMed1998

Risk factors for development of sexually abusive behaviour in sexually victimised adolescent boys: cross sectional study.

OBJECTIVE: To identify factors that may increase the risk of a sexually victimised adolescent boy developing sexually abusive behaviour. DESIGN: Sexually victimised boys who had sexually abused other children were compared with sexually victimised boys who had not done so. SETTING: Social services departments in south east England were invited to refer sexually abused and sexually abusing boys to a London postgraduate teaching hospital. SUBJECTS: 25 adolescent boys aged between 11 years and 15 years and 11 months. MAIN OUTCOME MEASURES: Adjusted odds ratios estimated from unconditional logistic regression. RESULTS: Unadjusted odds rations for witnessing (8.1) as well as experiencing (18.0) intrafamilial violence and discontinuity of care (7.2) discriminated boys who had sexually abused from others who were solely victims of sexual abuse. Only the adjusted odds ratios for witnessing intrafamilial violence (39.7) discriminated the two groups. CONCLUSIONS: The risk of adolescent boys who have been victims of sexual abuse engaging in sexually abusive behaviour towards other children is increased by life circumstances which may be unrelated directly to the original abusive experience, in particular exposure to a climate of intrafamilial violence. Our findings have implications for the management of boys found to have been sexually abused and raise important questions about the possibility of secondary prevention of subsequent abusive behaviour in those at greatest risk.

Adolescent↗
PubMed2002

A critique of Bem's "exotic becomes erotic" theory of sexual orientation development.

A critique of Bem's "Exotic Becomes Erotic" theory (1996) on the development of male homosexuality was offered. Limitations were outlined in light of relevant research findings. The authors proposed an alternative model to explain male homosexuality, i.e., reparation of early boyhood trauma, which better accounts for significant psychodynamic elements and available research. Finally, comparisons were made between specific elements of the two models.

Adult↗
PubMed2001

[Sexuality in adolescence: development, experience, and proposals for intervention]

OBJECTIVE: To present a literature review of some aspects concerning the development of sexuality in the period between childhood and adolescence, and to work on some proposals for prevention and intervention. METHODS: Review of literature on relevant issues related to the process of psychosocial and sexual development during childhood and adolescence, and to the importance of prevention education. RESULTS: Differently from genitality, which is only concerned with biological aspects, sexuality encompasses emotional aspects, life history and cultural values. These factors contribute to the formation of general identity and to the components of sexual identity: gender identity, gender role, and sexual orientation. Psychosocial and sexual development, emotional balance, and social relations are based on sexual experience during childhood and adolescence. During adolescence, the relationship with family and social group go through marked changes: conflicts arise, and experimentation and risk behavior are enhanced. The family, school, and health systems represent important links of identification, support, and protection for children and adolescents before they reach maturity. CONCLUSIONS: Sexuality education, either individually or in group, allows adolescents to experience sexuality and their emotional relations in a satisfactory, creative, and risk-free manner, combined with mutual respect and absence of gender discrimination.

Journal Article↗
PubMed1988

Premature thelarche and central precocious puberty: the relationship between clinical presentation and the gonadotropin response to luteinizing hormone-releasing hormone.

Premature thelarche is a benign condition that affects young girls. In contrast, central precocious puberty is considered a more serious disorder that causes progressive secondary sexual development, accelerated growth and skeletal maturation, early epiphyseal fusion, and short adult stature. Differentiation between these 2 conditions is important, but may be difficult on clinical grounds, since patients with both disorders may present initially as isolated breast development. To examine the potential usefulness of gonadotropin measurements in distinguishing early central precocious puberty from premature thelarche, we measured basal and LHRH-stimulated plasma gonadotropin levels in 58 girls with idiopathic premature breast development. The girls were divided into six clinically distinct groups, based on the severity of clinical presentation, ranging from isolated breast development (group A) to complete secondary sexual development and accelerated growth and skeletal maturation (group F). The mean basal plasma LH levels and the peak LH response to LHRH stimulation were significantly less in girls with isolated thelarche (group A) than in girls with complete sexual development (group F). The mean basal plasma FSH levels did not differ between these groups, but the peak FSH response to LHRH was greater in girls with isolated thelarche than in girls with complete sexual development. Thus, girls with isolated premature thelarche had a FSH-predominant response to LHRH [mean ratio of peak LH to peak FSH, 0.29 +/- 0.10 (+/- SD)], while girls with complete sexual development had a LH-predominant response (peak LH/FSH, 4.16 +/- 1.80). All girls with isolated thelarche had peak LH/FSH ratios less than 1, and all girls with complete sexual development had a ratio greater than 1. Girls with early or intermediate manifestations of central precocious puberty, who had features of puberty in addition to breast development but lacked all of the features of group F, comprised groups B-E. These girls also had intermediate peak LH/FSH ratios, ranging from 0.29 +/- 0.10 (group B) to 3.35 +/- 2.66 (group E). We conclude that girls with early central precocious puberty frequently have LH and FSH responses to LHRH that are indistinguishable from the FSH-predominant responses of girls with isolated thelarche. These data are consistent with the hypothesis that premature thelarche and central precocious puberty may represent different positions along a continuum of hypothalamic LHRH neuron activation.

Breast↗
PubMed2005

Working with nonheterosexual youth to understand sexual identity development, at-risk behaviors, and implications for health care professionals.

This article outlines special issues related to being a nonheterosexual youth. Information is presented on the sexual development of homosexual youth and their unique challenges. Included are data about the average age of initial awareness and self-identification of gay, lesbian, bisexual, transgendered, and questioning youth. The average age of awareness of homosexual orientation is between 10 or 11 years, while the average for identifying or self-labeling is ages 13-15. This age range is consistent across studies. The special issues related to a unique sexual development, prejudices associated with being a nonheterosexually oriented youth, typical behavioral outcomes of dealing with discrimination, and major health concerns for this at-risk population are identified. Finally, implications for health care professionals working with these adolescents are outlined.

Adolescent↗
PubMed2004

Hormones and history: the evolution and development of primate female sexuality.

Sexual behavior is required for reproduction in internally fertilizing species but poses significant social and physical risks. Females in many nonprimate species have evolved physical and behavioral mechanisms restricting sexual behavior to when females are fertile. The same hormones producing female fertility also control these mechanisms, assuring that sex only occurs when reproduction is possible. In contrast to nonprimate mammals, hormones do not regulate the capacity to engage in sex in female anthropoid primates, uncoupling fertility and the physical capacity to mate. Instead, in primates, sexual motivation has become the primary coordinator between sexual behavior and fertility. This dependence upon psychological mechanisms to coordinate physiology with behavior is possibly unique to primates, including humans, and allows a variety of nonphysiological influences, particularly social context, to regulate sexual behavior. The independence between hormonal state and sexual behavior allows sex to be used for social purposes. This complex regulation of primate sexuality develops during adolescence, where female monkeys show both hormonally influenced sexual motivation and socially modulated sexual behavior. We present findings from rhesus monkeys illustrating how social context and hormonal state interact to modulate adolescent and adult sexuality. It is argued that this flexibility in sexual behavior, combined with a tight regulation of sexual motivational systems by reproductive hormones, allows sexual behavior to be used for nonreproductive purposes while still assuring its occurrence during periods of female fertility. The evolutionary pressures that produced such flexibility in sexual behavior remain puzzling, but may reflect the importance of sexuality to primate social attraction and cohesion.

Adolescent↗
PubMed2004

Abdominal-B is essential for proper sexually dimorphic development of the Drosophila gonad.

Sexual dimorphism requires the integration of positional information in the embryo with the sex determination pathway. Homeotic genes are a major source of positional information responsible for patterning along the anterior-posterior axis in embryonic development, and are likely to play a critical role in sexual dimorphism. Here, we investigate the role of homeotic genes in the sexually dimorphic development of the gonad in Drosophila. We have found that Abdominal-B (ABD-B) is expressed in a sexually dimorphic manner in the embryonic gonad. Furthermore, Abd-B is necessary and sufficient for specification of a sexually dimorphic cell type, the male-specific somatic gonadal precursors (msSGPs). In Abd-B mutants, the msSGPs are not specified and male gonads now resemble female gonads with respect to these cells. Ectopic expression of Abd-B is sufficient to induce formation of extra msSGPs in additional segments of the embryo. Abd-B works together with abdominal-A to pattern the non-sexually dimorphic somatic gonad in both sexes, while Abd-B alone specifies the msSGPs. Our results indicate that Abd-B acts at multiple levels to regulate gonad development and that Abd-B class homeotic genes are conserved factors in establishing gonad sexual dimorphism in diverse species.

Animals↗
PubMed2004

Psychosexual development among HIV-positive adolescents in Abidjan, Côte d'Ivoire.

Some 84,000 children with HIV/AIDS live in Côte d'Ivoire, where very little therapeutic or psychological help is available to them. The Yopougon Child Programme of the "Agence Nationale de Recherche sur le Sida" was launched in Abidjan in October 2000. It provides services for HIV-infected children and psychological consultations for children and their parents. This paper is about the psychosexual development of the HIV-positive adolescents in the Programme, 11 girls and 8 boys aged 13-17, their problems with HIV-related physiological and psychosexual changes, and relationships with their parents. The information was gathered in individual therapy sessions, group discussions and family support sessions. Bodily development was of major importance to these adolescents, particularly among those who had not yet developed secondary sexual characteristics and were shorter and weighed less than their peers. Those who had not achieved puberty were unable to participate in traditional rituals and worried whether they could ever marry or have children. In most cases, adolescents with HIV have been infected by a sexually transmitted virus without having had sexual relations themselves. They need support dealing with their sexual development and sexual feelings, along with medical care, in a context in which HIV infection is a secret, impossible to talk about with their peers.

Adolescent↗
PubMed2000

Complete androgen insensitivity syndrome: long-term medical, surgical, and psychosexual outcome.

Controversy concerning the most appropriate treatment guidelines for intersex children currently exists. This is due to a lack of long-term information regarding medical, surgical, and psychosexual outcome in affected adults. We have assessed by questionnaire and medical examination the physical and psychosexual status of 14 women with documented complete androgen insensitivity syndrome (CAIS). We have also determined participant knowledge of CAIS as well as opinion of medical and surgical treatment. As a whole, secondary sexual development of these women was satisfactory, as judged by both participants and physicians. In general, most women were satisfied with their psychosexual development and sexual function. Factors reported to contribute to dissatisfaction were sexual abuse in one case and marked obesity in another. All of the women who participated were satisfied with having been raised as females, and none desired a gender reassignment. Although not perfect, the medical, surgical, and psychosexual outcomes for women with CAIS were satisfactory; however, specific ways for improving long-term treatment of this population were identified.

Adult↗
PubMed1986

Gonadal failure following busulfan therapy in an adolescent girl.

A girl with Philadelphia chromosome-positive CML (Ph1-positive CML) was treated with busulfan from the age of 10 years 11 months to 16 years. Before treatment she had no evidence of pubertal development and no sexual development has occurred over the ensuing 5 years. Endocrine evaluation revealed that the child had ovarian failure. The pubescent female appears to be prone to develop gonadal failure with resultant lack of sexual development when treated with busulfan during this period in her life.

Adolescent↗
PubMed2003

Mom, dad, I'm straight: the coming out of gender ideologies in adolescent sexual-identity development.

Little attention has been given to how femininity and masculinity ideologies impact sexual-identity development. Differentiating violations of conventional femininity and masculinity ideologies as part of an overt process of sexual-identity development in sexual-minority adolescents suggested the possibility of a parallel process among heterosexual adolescents. Based on feminist theory and analysis of heterosexual adolescents narratives about relationships, the importance of negotiating femininity and masculinity ideologies as part of sexual-identity development for all adolescents is described.

Adolescent↗
PubMed2001

Natural history and incidence of premature thelarche in Puerto Rican girls aged 6 months to 8 years diagnosed between 1990 and 1995.

OBJECTIVE: To describe the natural history and estimate the incidence of premature thelarche in girls aged 6 months to 8 years living in Puerto Rico and diagnosed between 1990 and 1995. BACKGROUND: In the 1970s and 1980s, several pediatric endocrinologists, based on their clinical experience, acknowledged a dramatic increase in the number of cases of precocious sexual development in Puerto Rico. In 1987, the Puerto Rico Health Department developed the Registry of Premature Thelarche and Precocious Sexual Development, which began to operate in 1989. Data regarding the long-term outcomes of girls diagnosed with premature thelarche are insufficient. Knowledge about the natural history of this condition is relevant for predicting the long-term prognosis and therapeutic management of the affected population. METHODS: Of 2,716 cases of precocious sexual development reported to the Premature Thelarche and Precocious Sexual Development Registry, 1,916 (70.5%) were premature thelarche. The clinical characteristics and evolution during follow-up of premature thelarche cases were described and compared by age group at diagnosis. RESULTS: Incidences were 6.2 and 1.62 per 1,000 live births for girls aged < 2 years and 2 to 8 years, respectively. These estimates were 10 and 15 times higher than those reported in Olmsted, MN. When the average change in mammary tissue diameter during follow-up was evaluated, a slight reduction in girls aged < 2 years was observed; however, it remained constant for girls aged 2 to 8 years. CONCLUSIONS: The results of this study underscore the need to continue an active search of premature thelarche cases and to perform analytical investigations of precocious sexual development to expand the understanding of the etiology of this important public health problem.

Age Factors↗
PubMed1995

Puberty, sexual milestones and abuse: how are they related in eating disorder patients?

In order to assess the relationship pubertal development, sexual milestones and childhood sexual abuse in women with eating disorders, 44 patients with restricting anorexia nervosa (RAN), 26 with bulimic anorexia nervosa (BAN), 29 with bulimia nervosa and also with a history of anorexia nervosa (BN/HistAN), and 69 with bulimia nervosa but without a history of anorexia nervosa (BN) completed questionnaires on pubertal and sexual development and unpleasant sexual experiences. Forty-four female college students complete the sexual development questionnaire only. Different eating disorder groups were found to be similar in terms of their pubertal development. All eating disorder groups showed delays in aspects of their psychosexual development (age at first kiss, masturbation, genital fondling and first sexual intercourse) compared with the control group, although to a different degree. The RAN group was delayed on almost all sexual milestones whereas the other groups were delayed on only some. On some variables, most noticeably on first sexual intercourse, restricters also were more delayed than the other eating disorder groups. Similarly, the median number of sexual partners differed significantly between groups (RAN = 1, BAN = 2, BN/HistAN = 4, BN = 4, controls = 5, P < 0.0001). Eating disorder patients, in particular RAN patients, were less positive about sexual relationships than controls, but did not differ from controls in attitudes to masturbation, marriage, children or pregnancy. Of the eating disorder patients 22-31% had been sexually abused during childhood. A history of abuse affected attitudes to masturbation, but did not appear to affect sexual development.

Adolescent↗
PubMed1980

The effect of rearing under a long or short photoperiod on testis growth, plasma testosterone and prolactin concentrations, and the development of sexual behaviour in rams.

Two groups of 6 rams were maintained under constant photoperiodic conditions consisting of short days (8 h light: 16 h dark; Group S) and long days (16 h light; 8 h dark; Group L) from 4 to 20 months of age. Five other rams were reared under a photoperiod representative of that occurring naturally (Group N). Testis size, plasma testosterone and prolactin concentrations were monitored weekly and sexual behaviour tests were carried out at regular intervals. Over the treatment period Groups S and L did not differ in terms of testis growth or plasma testosterone. Both groups had a phase of testis growth and increased testosterone followed by a decline and the temporal patterns for the two groups were equivalent. Sexual behaviour was slower to develop in Group L than in Group S, indicating that photoperiod can affect the development of sexual behaviour irrespective of peripheral plasma testosterone concentrations. Plasma prolactin levels showed a cyclic variation in Group L and were significantly higher overall than in Group S rams. This, together with a trend towards negative correlations between prolactin concentrations and sexual behaviour in Group L, indicates that prolactin may be involved in the effect of photoperiod on sexual behaviour. The presence of a cycle of testicular growth and of hormone concentrations in young animals under constant photoperiod tentatively suggests that these cycles are endogenous. The constant photoperiod did, however, affect the animals because the cycles which occurred in Groups S and L were out of phase with those of Group N by about 4 months.

Animals↗