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Table 223.1

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   Staging Criteria for Secondary Sexual Development

Male
Genital stageSize of testesScrotumPhallus (length)
G1≤2ccPrepubertalPrepubertal (4–8 cm)
G23–6ccBecomes reddened, thinner, and largerMinimal or no enlargement (4–10 cm)
G36–12ccGreater thinning and enlargementIncreased length (6–14 cm)
G412–18ccColor darkens and further enlargementIncrease length, circumference, and gland size (8–15 cm)
G5>18ccAdultAdult (10–18 cm)
Female
BreastBreastAreola and papilla (nipple diameter)
B1PrepubertalPrepubertal (1.3–4.5 mm)
B2Budding—elevation above chest wall by mound of subareolar breast tissueAreola widens Papilla erect
B3Larger and more elevationFurther widening of areola (1.5–6.7 mm)
B4Larger and more elevation (does not occur in all females)Areola and papilla form a mound projecting from the breast contour (4.5–10.9 mm)
B5Adult (size variable)No mound; areola and breast in same plane (7.1–12.7 mm)
Male and Female
Pubic hair stageAreaAmountType
PH1Male0
Female0
PH2Male; base of phallus and/or scrotum+Long (straight or curly), slightly pigmented, and downy
Female; labia majora and/or mons veneris
PH3Male; spread to mons veneris+ +Increased curl, coarseness, and pigmentation
Female; increased area veneris+ +
PH4Male; greater area of mons veneris+ + +Greater curl and coarseness
Female; almost entire mons veneris+ + +
PH5Male and female; entire mons veneris and medial aspect of the thighs+ + + +Adult

Source: Portions of this table derived from Rohn R. Papilla (nipple) development during female puberty. J Adol Health Care 1982;2:217. Reprinted by permission of Elsevier Science Publishing Co. and the author.