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Research Letter
July 7, 2020

Divergence in Timing and Magnitude of Testosterone Levels Between Male and Female Youths

Author Affiliations
  • 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
  • 2Duke University School of Law, Durham, North Carolina
  • 3Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
JAMA. 2020;324(1):99-101. doi:10.1001/jama.2020.5655

Data on testosterone levels in children and adolescents segregated by sex are scarce and based on convenience samples or assays with limited sensitivity and accuracy. Such data would be useful in evaluating children with pubertal or androgen disorders and dichotomizing male and female youths participating in sport. Thus, we analyzed the timing of the onset and magnitude of the divergence in testosterone in youths aged 6 to 20 years by sex using a highly accurate assay.

Testosterone concentrations from separate cohorts of male and female youths collected during 2 periods of the National Health and Nutrition Examination Survey (NHANES; 2013-2014 and 2015-2016) were pooled into 1 data set for analyses. Briefly, NHANES uses a multistage probability design to randomly sample US residents from all 50 states. The overall response rate in the 2 data collection cycles was 70.4% in youths, and 80% of those responders elected to participate in the collection of biospecimens for testosterone analyses. All procedures accessed public, deidentified information and did not require ethical review as determined by the Mayo Clinic Institutional Review Board.