Tanner Staging

The Tanner staging system is used to assess the sexual maturity of boys and girls. The system was developed by James Tanner, a British pediatrician, in the 1950s.

The stage of pubertal development is determined by the presence or absence of secondary sexual characteristics, such as pubic hair and breast development in girls, and testicular enlargement and genitalia changes in boys. Tanner staging is used to track the progression of pubertal development and to assess the risk of certain conditions, such as precocious puberty. In general, puberty begins between the ages of 9 and 14 in girls and between the ages of 11 and 16 in boys.

However, there is considerable variation in the age at which pubertal milestones are reached, and some children may experience precocious puberty, which is defined as the onset of pubertal changes before the age of 8 in girls and before the age of 9 in boys. Precocious puberty can have psychological effects on children and may be a sign of underlying medical conditions, so it is important to consult a doctor if pubertal changes are observed at an early age.

The five stages of the Tanner Classification System

There are five stages in the Tanner staging, which are often represented by Roman numerals.

Stage 1: In Stage I, there is no visible sign of puberty. The child’s body is prepubescent, with no visible signs of pubertal development.

Stage 2: In Stage II, breast development begins to occur, but the breasts are still small and buds are not yet present. The child begins to show signs of pubertal development, such as enlargement of the testicles or breasts.

Stage 3: In Stage III, both breast and pubic hair development are apparent, but the breasts are still relatively small. Further pubertal development occurs, such as growth of pubic hair or deepening of the voice.

Stage 4: In Stage IV, the breasts become larger and rounder, and the pubic hair becomes darker and coarser. Full pubertal development is present, with all secondary sex characteristics fully developed.

Stage 5: The child has completed pubertal development and is now considered a young adult. Finally, in Stage V, full adult development has occurred.

However, there is considerable variation from person to person, and some children may skip one or more Tanner stages altogether.

Female breast development. The Adolescent Period, 1951 Frank Kayley Shuttleworth (Public Domain)

Development of male genitalia. Attribution

Tanner Staging Mnemonics

A simple memory device or mnemonic for recalling Tanner Stages in Females.


  • No : No evidence of glandular tissue (no palpable subareolar tissue)
  • Breast : Breast Bud present. Palpable subareolar tissue
  • Except : Elevated breast papilla
  • Secondary : Secondary mound (areola and papilla)
  • Adult : Adult sized breasts

Pubic hair development: “NO DOWNY COARSE ADULT THIGHS”

  • No : No hair
  • Downy : Presence of thin, downy hair.
  • Coarse : Presence of thick, coarse and curly hair.
  • Adult : Pigmented and adult appearing hair with uninvolved thighs
  • Thighs : Adult hair extends laterally to the thighs

Important Concepts in Sexual Maturation

Puberty is a time of major physical and emotional changes, and the Tanner stages can be helpful in understanding what to expect during this time. However, it’s important to remember that everyone develops at their own pace, so don’t worry if your child’s development doesn’t match up exactly with the Tanner stages.

What is pubarche ?

Pubarche is the development of pubic hair, which is one of the earliest signs of pubertal development. It typically occurs around Tanner stage 2 in girls and Tanner stage 3 in boys.

What is menarche?

Menarche is the first menstrual period, which signals the beginning of fertility in girls. It typically occurs around Tanner stage 4.

what is adrenarche ?

Adrenarche is the development of the adrenal glands, which produce hormones that are responsible for pubertal development. It typically occurs around Tanner stage 2 in boys and girls.

What is growth spurt?

The growth spurt is a period of rapid growth that occurs during puberty. It typically happens around Tanner stage 3 in boys and Tanner stage 4 in girls.

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