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Answer to Case Study #3:What Ms. Owa’s daughter is experiencing (barring trauma) is appropriate for her age; female hormones are stimulating growth of breast tissue, and development is often asymmetrical. Breast sensitivity is a natural side effect of the increased hormones. Ms. Owa can expect her daughter to develop fine, delicate pubic hair around this time. Over the next three to four years, her daughter’s breast buds will enlarge, and her breasts will form mounds, taking on the adult woman shape by ages 14 to 17. Her daughter’s pubic hair will increase in the center, darken, and become coarser. In approximately two years, her pubic hair will form a triangle, and hair will develop under her arms. During this time, Ms. Owa’s daughter will begin menstruating. This would be a good time for Ms. Owa to explain the bodily changes to her daughter, including the impending onset of menstruation. Inform Ms. Owa that the size of her son’s genitalia will begin to enlarge between ages 10 and 13. The current size is normal for his age. As his genitalia begin to enlarge, he will also develop fine hair at the base of his penis. Between 12 and 14, his penis will lengthen; the penis, scrotum, and testes will continue to grow; and his pubic hair will grow, darken, and become coarser. By the time he is approximately 14 to 17, his penis will be its full adult size.
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