Health · Free tool
Tanner Stages
Pubertal development is staged 1 (pre-pubertal) to 5 (adult). Age ranges differ between girls (faster) and boys. Significant deviation flags precocious or delayed puberty — pediatric consult recommended.
| Stage | Age (boys) | Age (girls) | Description |
|---|---|---|---|
| 1 | 0 — 9 yrs | 0 — 8 yrs | Pre-pubertal. No secondary sexual characteristics. |
| 2 | 9 — 12 | 8 — 11.5 | Onset of puberty. Breast budding (girls); testicular enlargement (boys). |
| 3 | 12 — 13.5 | 10 — 12.5 | Visible breast development; penile growth; pubic hair coarsening. |
| 4 | 13 — 15 | 11 — 13.5 | Areola raised separately; full pubic hair pattern; menarche typical (girls). |
| 5 | 14+ | 12.5+ | Adult sexual maturity reached. |
How it works
The Tanner Sexual Maturity Rating (SMR), developed by Prof. James Tanner in 1969, grades pubertal development from Stage 1 (pre-pubertal) to Stage 5 (adult). For girls the markers are breast bud (B2), pubic hair (P2), peak growth velocity and menarche; for boys, testicular volume >4 mL, pubic hair, voice break and facial hair. We estimate the stage from observed physical milestones; bone age (Greulich-Pyle X-ray of left wrist) is the clinical gold standard for confirmation.
Worked example
An 11-year-old girl in Chennai with breast budding (B2), sparse pubic hair (P2), 6 cm growth in the last year and no menarche maps to Tanner Stage 2-3 — typical for Indian girls, where mean menarche age is now 12.3 years (down from 13.7 in 1990s, attributed to improved nutrition and obesity). A 9-year-old with B3 development would be flagged as precocious puberty, needing endocrinology workup at AIIMS, CMC Vellore or any paediatric tertiary centre for GnRH-stimulation testing.
When to use this
- Parents tracking expected milestones before consulting a paediatric endocrinologist
- School health check-ups in 5th-10th standard during routine annual screening
- Confirming whether observed development is precocious (<8F, <9M) or delayed (>13F, >14M)
For nutritional adequacy during the growth spurt, see our TDEE calculator.
FAQ
My child seems delayed — should I worry?
Below 5th percentile age = constitutional delay (often catches up by 16-17). Also check growth velocity. Pediatric endocrinologist consult if family history of late puberty + child seems socially affected.
Precocious puberty — when to consult?
Tanner 2 before age 8 (girls) or 9 (boys) = precocious puberty. Causes range from idiopathic to McCune-Albright syndrome to brain lesions. Get tested.
Bone age vs chronological age?
Bone age (X-ray of left hand) shows skeletal maturity. Differences of 1-2 years are normal; greater differences may indicate growth disorders.