#precocious puberty

i’m afab, and in short one of my doctors thinks i may have NCCAH, and one of my doctors thinks i don’t and that i may have PMOS instead

generally my symptoms have been early puberty (starting growing body hair around age 7), LOTS of body hair, lots of acne, rapid growth as a child, irregular menstruation, clitoromegaly, and i’m not sure the official term for it but my urethral opening is like… inside the vaginal canal slightly. to the point where when i was menstruating i could not wear tampons comfortably and i get very frequent UTIs.

first doctor thinks i may have NCCAH because of the above symptoms, but the second one says there’s no way i do because in her words “it does not cause any difference to genitalia”, and also the fact that i am very tall, and she said adults with NCCAH generally have a shorter stature? and unfortunately i can no longer prove the clitoromegaly in any way as i have no pictures of it from before i went on T(a year and a half ago), and it has been dismissed as bottom growth.

does anyone else with NCCAH/PMOS/these symptoms have any insight?

The second one is just... lying...? Hell I've never heard of a doctor saying PMOS can cause genital differences but not NCAH. It's currently understood they don't cause genital differences because of symptoms becoming apparent after birth, but there's many anecdotes anyway of folks with only PMOS and/or NCAH reporting genital differences that can't be created after birth (i.e. labial fusion, urinary variation). The reason folks with (n)CAH tend to end up short is because of the hyperandrogenism, which generally causes more androgens to aromatize into more estrogens thus the growth plates close quicker because of extra estrogens floating around, and additionally precocious puberty in general increases the chances you'll turn out shorter because you stop growing earlier than non-precocious peers. But uh. It's... that's. Not everyone aromatizes the same, nor will everyone respond the same way to the same amount of estrogens???? Like... genetic diversity, bro. Some people can still end up a certain way despite their environment because their genes said so.

-a lot of adults are not equipped to help children deal with puberty and will not soften your experience

-people don’t get the non-physical aspects of puberty, especially aspects to do with sexuality

Not only cuz it caused me to have huge tits in fuckin elementary school but cuz it also REALLY stunted my growth.

My mom's side of the family is all about 5'7 - 6'3 my mom said my bio fathers side is all 5'8+ I am 5'4 and stopped growing at 10 years old. I could've been at least 5'6 hell maybe even 5'8 like my mom but NO

I didn't get the option of blockers either so (no so) little 10 year old me didn't fit at my desk, towered over everyone, was ignored during recess, and was made fun of and sexualized cuz I had almost D cups in 3rd grade that only got bigger (before top surgery I was a 44G)

Also ppl say 5'4 is like average female height but almost every woman I've ever met has been at least 5'6

Basically, my puberty was really off. I developed body hair and odor really early (5 years old), got my period early as well (one day after turning 10) grew really early and fast (5'3" by 10, stopped growing at 12 with 5'7")

I remember having to go to the doctor frequently because of this. I almost had to puberty blockers, went through ultrasounds to see if my uterus was developing properly, etc.

So in terms of puberty I fit 100% into NCAH symptoms, but then afterwards not so much?

Only signs of hyperandrogenism I have is extra body hair (legs, thighs and lower abdomen but not facial), acne and very oily skin/hair. My periods were regular and painless my whole life.

So I feel in a sort of limbo between "you're overthinking out of nothing and co-opting intersex issues!" and "actually a lot of stuff that happened to you was wacky, go to the doctor!" and I'm just like... Wanting some guidance on which side I should listen to. If like, this is anything that I should actually look into/go to the doctor for or not really.

Thanks for the help!

Thank you for sending in your question.

Not everyone with NCAH is going to experience hyperandrogenism and that is just one of the symptoms it may have. With many medical conditions, there are a wide range of symptoms one CAN have and no two experiences are going to be exactly alike. And not everyone experiences hyperandrogenism in the same way as everyone's bodies process testosterone differently.

Regardless of what your specific diagnosis or variation could be, all of your experiences are something I and many others would see as inherently intersex (your early puberty, early growth, medical experiences to check on proper sex characteristic development, nearly going on puberty blockers).

You are not co-opting intersex issues whatsoever. Your experiences do fall out of the expected perisex experiences. I encourage you to use the intersex identity if it is something you wish to.

I do think this is something you should look into more IF you want to. You do not need to if you don't want to (unless it is something that could be causing health concerns, and even then, that is your personal choice). But you do not ever need a proper diagnosis or anything to be intersex, especially since the medical field is inherently intersexist and many doctors are individually intersexist.

Your symptoms definitely remind of NCAH and you can also look into precocious puberty.

I have PCOS and recently discovered I had a precocious puberty that wasn't dealt with at all as a child. I kinda have a lot of unpacked issues with that and all. Essentially, having symptoms of a male puberty way..way way too young (age 6) that were like ignored because my mom was looking for signs of "female" puberty. Basically, my puberty wasn't acknowledged until I was 10. I was frankly really upset when I realized this. But I don't blame my mom because I don't think the doctor who diagnosed me with PCOS at 6 even told her I was essentially experiencing a puberty which was contributing to some of my emotional outbursts.

I know there's some debate on wether or not PCOS is considered an intersex condition. I'm just feeling rather lost. I'm sorry if I use some wrong terminology or if I rub anyone the wrong way with this. I really just wanna know if I belong with the intersex community or I should just do my best as an ally.

Elsie Carson-Holt at LGBTQ Nation:

South Carolina Gov. Henry McMaster (R) signed a law that bans gender-affirming care for transgender people under the age of 18 on Tuesday, making the state the 25th state to do so. Under the new law, healthcare workers may not prescribe puberty blockers or hormone treatments or perform gender-affirming surgeries for minors, even though such surgeries are almost never performed on minors. The law also says that school principals or vice principals would be required to out trans or nonbinary students to parents if their child wants to use a name, nickname, or pronouns that do not correspond with their sex assigned at birth. It does include some exceptions: mental health counselors can discuss the banned treatments and share where they are legal. It also includes a stipulation allowing doctors to prescribe puberty blockers for conditions that afflict cisgender youth, such as precocious puberty.

See Also:

The Advocate: South Carolina governor McMaster signs extreme gender-affirming care ban into law, effective immediately