To determine the earliest signs of pubertal maturation, we followed 51
5 boys, aged 10 to 15 years at intake, every 6 months far 3 years. Cha
nges in age, height, weight, body mass index, and serum levels of sex
steroid hormones were significantly related to pubertal stage (PS), Th
e earliest clinical stage of pubertal maturation, designated PS2a, was
represented by the absence of pubic hair and a testicular volume 3 cc
or greater; 6 months later, further maturation had occurred in 82% of
these boys, Inclusion of PS2a as the earliest stage of puberty may he
lp allay concerns about boys with perceived delayed maturation, and ma
y allow more precise definition of early puberty.