A 12-year-old boy is brought to the office for a yearly physical and has recently noticed enlargement of his testes and scrotum. When counseling the boy about what to expect next in pubertal development, which change is likely to occur first?

A 12-year-old boy is brought to the office for a yearly physical and has recently noticed enlargement of his testes and scrotum. When counseling the boy about what to expect next in pubertal development, which change is likely to occur first?

• A. The penis will grow in length
• B. The penis will grow in width
• C. Facial hair will appear
• D. Changes in voice will occur

Answer: (A)

Pubertal development in boys starts with gonadarche, when the testes enlarge due to rising gonadotropins and testosterone. After this initial sign, the next physical change typically seen is growth of the penis in length, driven by testosterone. Only later do changes like penile widening, facial hair appearance, and voice deepening occur. So, as this boy has already noticed testicular enlargement, the next expected change is the penis growing longer. Width growth, facial hair, and voice changes generally appear later in puberty.

Pubertal development in boys starts with gonadarche, when the testes enlarge due to rising gonadotropins and testosterone. After this initial sign, the next physical change typically seen is growth of the penis in length, driven by testosterone. Only later do changes like penile widening, facial hair appearance, and voice deepening occur. So, as this boy has already noticed testicular enlargement, the next expected change is the penis growing longer. Width growth, facial hair, and voice changes generally appear later in puberty.