Sexual maturity rating (Tanner stages) of secondary sexual characteristics

Boys – Development of external genitalia

Stage 1: Prepubertal

Stage 2: Enlargement of testes and scrotum; scrotal skin reddens and changes in texture

Stage 3: Enlargement of penis (length at first); further growth of testes

Stage 4: Increased size of penis with growth in breadth and development of glans; testes and scrotum larger, scrotal skin darker

Stage 5: Adult genitalia

Girls – Breast development

Stage 1: Prepubertal

Stage 2: Breast bud stage with elevation of breast and papilla; enlargement of areola

Stage 3: Further enlargement of breast and areola; no separation of their contour

Stage 4: Areola and papilla form a secondary mound above level of breast

Stage 5: Mature stage: Projection of papilla only, related to recession of areola

Boys and girls – Pubic hair

Stage 1: Prepubertal (the pubic area may have vellus hair, similar to that of forearms)

Stage 2: Sparse growth of long, slightly pigmented hair, straight or curled, at base of penis or along labia

Stage 3: Darker, coarser, and more curled hair, spreading sparsely over junction of pubes

Stage 4: Hair adult in type, but covering smaller area than in adult; no spread to medial surface of thighs

Stage 5: Adult in type and quantity, with horizontal upper border

Graphic 55329 Version 10.0