There are four stages. Still, the sequencing of these is constant. The median age for voice changes, is 13.4 years, though some boys experience voice change as early as 11 years and some late as 16 years. Because of these physical changes, there is a drastic increase in the young person's preoccupation with their body. Shortness in boys and tallness in girls may cause genuine concern.
Obesity commonly is a sensitive issue in adolscents of either sex.
In girls, being overweight may make them feel unattractive. Depending upon the distribution of body fat, it may suggest either infantile qualities or a physical sexual precocity which has no counterpart in emotional development. Acne, another affliction common during puberty, almost universally causes emotional difficulties.