Childhood Sexual Abuse and Early Timing of Puberty

J Adolesc Health. 2017 Jan;60(1):65-71. doi: 10.1016/j.jadohealth.2016.09.008. Epub 2016 Nov 8.


Purpose: The purpose was to examine whether the timing of puberty, indexed by breast development and pubic hair development, was earlier for sexually abused females compared with a matched comparison group of nonabused females, controlling for key alternative confounds.

Methods: A cohort of sexually abused females and matched comparisons was followed longitudinally at mean ages 11 through 20 years. Sexually abused participants (N = 84) were referred by protective services. Comparison participants (N = 89) were recruited to be comparable in terms of age, ethnicity, income level, family constellation, zip codes, and nonsexual trauma histories. Stage of puberty was indexed at each assessment by nurse and participant ratings of breast and pubic hair development using Tanner staging-the gold standard for assessing pubertal onset and development. Cumulative logit mixed models were used to estimate the association between sexual abuse status and the likelihood of transitioning from earlier to later Tanner stage categories controlling for covariates and potential confounds.

Results: Sexual abuse was associated with earlier pubertal onset: 8 months earlier for breasts (odds ratio: 3.06, 95% CI: 1.11-8.49) and 12 months earlier for pubic hair (odds ratio: 3.49, 95% CI: 1.34-9.12). Alternative explanations including ethnicity, obesity, and biological father absence did not eradicate these findings.

Conclusions: This study confirms an association between exposure to childhood sexual abuse and earlier pubertal onset. Results highlight the possibility that, due to this early onset, sexual abuse survivors may be at increased risk for psychosocial difficulties, menstrual and fertility problems, and even reproductive cancers due to prolonged exposure to sex hormones.

Keywords: Female; Puberty; Sexual abuse.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cohort Studies
  • District of Columbia
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Puberty*
  • Sex Offenses*
  • Time
  • Young Adult