What effect is most likely to be seen in an 11-year-old boy undergoing puberty, with a growth spurt, voice changes, and Tanner stages (Tanner staging system) G3PH3, compared to his peers?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 25, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Behavioral Effects of Puberty in Boys: Increased Aggression is Most Likely

Increased aggression is the most likely effect to be seen in this 11-year-old boy undergoing puberty compared to his peers.

Clinical Assessment of Pubertal Status

The boy presents with several key indicators of puberty:

  • Growth spurt in the past year
  • Voice changes
  • Testing his mother's patience (behavioral changes)
  • Tanner stages G3PH3 (indicating mid-puberty)
  • Testicular volume of approximately 8 mL

These findings are consistent with normal pubertal development in boys. Tanner stage G3 represents enlargement of the penis in length and circumference with some growth of the testes and scrotum, while PH3 indicates darker, curlier pubic hair extending laterally 1. The testicular volume of 8 mL confirms mid-puberty, as normal progression shows testicular development beginning between 9.5-13.5 years (mean 11.6 years) 1.

Hormonal Changes and Behavioral Effects

During puberty, boys experience a dramatic increase in testosterone production, with approximately a 30-fold increase 2. This significant hormonal change drives several physiological and behavioral effects:

  • Testosterone stimulates erythropoiesis, increasing hemoglobin levels by 15-20% 3
  • Testosterone influences brain development and function 3
  • Testosterone's effects on behavior include increased aggression 2

Evidence for Increased Aggression

Most cross-sectional studies of adolescent males have observed relationships between aggression and testosterone levels 2. While the one longitudinal study examining testosterone and aggression showed little relationship with concurrent changes in aggression, the preponderance of evidence from cross-sectional studies supports the association between testosterone and aggressive behavior during puberty 2.

The boy's mother noting that he is "testing her patience more" is likely a manifestation of this increased aggression, which is the most common behavioral change observed in pubertal boys with rising testosterone levels.

Other Behavioral Changes During Puberty

Other behavioral changes that may occur during puberty include:

  • Increased risk-taking behavior 2
  • More reported tiredness and irritability 4
  • Increased rule-breaking behaviors and substance use 4
  • Decreased fears and somatic complaints 4

However, these are generally less prominent than the increased aggression associated with rising testosterone levels.

Why Other Options Are Less Likely

B. Low self-esteem

  • Research shows that boys typically do not experience significant decreases in self-esteem during puberty 4
  • Girls are more likely to show increases in social uncertainty and depressed mood during puberty, while boys actually show a decrease in self-criticism 4

C. Increased dependence

  • Puberty is typically associated with increased independence rather than dependence 4
  • The normal developmental trajectory during puberty involves separation from parents and increased autonomy

D. Low confidence

  • Similar to self-esteem, confidence issues are not typically prominent in boys during puberty 4
  • The physical changes of puberty in boys (increased height, muscle mass) often contribute to increased rather than decreased confidence

Clinical Implications

Understanding that increased aggression is a normal part of pubertal development in boys can help:

  • Provide appropriate anticipatory guidance to parents
  • Distinguish normal developmental changes from pathological behavior
  • Develop appropriate behavioral management strategies

The boy's current pubertal development (G3PH3, testicular volume 8 mL) indicates he is in mid-puberty, suggesting these behavioral changes may continue or intensify before eventually stabilizing as he completes puberty.

References

Research

Variations in the pattern of pubertal changes in boys.

Archives of disease in childhood, 1970

Research

Testosterone and its effects on human male adolescent mood and behavior: a systematic review.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2014

Guideline

Puberty and Iron Requirements

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.