14 yo daughter, delayed puberty, doesn't want to go to a hospital appointment

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Hi all, I don't believe my daughter (14) has started any form of puberty yet, no pubic hair, no breasts, skin changes, mood swings or periods. I'm less concerned about the lack of periods as I know they can be much later, but its the lack of other physical changes that is worrying me.
I think she might need some hormone help to get things started.
So I took her to the GP who didn't offer any help but referred her to a paediatric dr.
My daughter was distraught during the dr appointment, she's embarrassed and hated it. She refused a physical examination. She is overweight and I think she just has moobs rather than actual breasts growing.
Anyway an appointment has arrived in a couple of months for a paediatric appointment at the hospital and she is refusing to go.
I've tried to explain that we just want to make sure everything is OK and on track, or get the help needed if not.
She doesn't see a problem.
Nothing I'm saying is working, she's saying she won't go to it and I'm not sure what to say to convince her.
Or even if I have other alternatives.
Anyone been through anything similar? Thank you

I’m very surprised a doctor attempted a physical examination of a distressed teenager.

Would your daughter agree to the appointment if you aren’t there? I don’t see the point of taking her if she doesn’t want to go.

If she understands the implications of not going she can make that decision. I would ring the consultant, explain and seek opinion. Advise her and leave it if she doesn’t want to go.

God I feel wretched for your daughter, the poor thing. So embarrassing for her. When did you start your periods?

I would try to call the paediatric doctor's office and ask them to tell you on detail what typically happens at these appointments. She is probably worried about being weighed or something, or has been worrying herself that something is wrong with her (and she is a freak, in 14 y o think). Please be very careful with her as I'm sure you are, but obviously the appointment is non negotiable isn't it. I might not discuss it til a bit nearer the time though.

I haven't myself, but a friend's dd had similar symptoms and was eventually found to have a chromosomal abnormality where the 2nd X chromosome (every woman has one X from her mum and one from her dad) is damaged or absent in her DNA. It's important to find out whether this is what's going on because the same genetic issues can also go hand in hand with greater risks of heart defects, diabetes and hyperthyroidism. Don't frighten he with those specifics but explaining to her that you won't be pushing her into any treatments she doesn't want, but that whatever is causing these more obvious delays might also be causing other problems inside that you can't know about without checking with an expert. Puberty is generally stressful and unpleasant for everyone but is particularly difficult for young women in the current cultural climate s I wouldn't be surprised if she's simply grateful to not have to go on that rollercoaster yet, so reassuring her that you won't force her to against her will may be all she needs.

Could an aunt/cousin take her instead? I remember when I broke my arm (12/13) and my mum insisted on helping me in the shower I wanted the ground to gobble me up.

She has to go although I totally get how mortified she is. I’d try to find out what will actually happen at the appt, so that she can go informed of what to expect (would there even be a physical exam as compared to blood tests etc?). I’d also try to speak to the dr in advance to give your perspective & then your DD doesn’t have to hear you say it on front of her (or write it out for the dr to read silently at the appt).

It’s so tough for her, but you’re doing the right thing in getting her seen. Good luck!

I've been wracking my brains and I do not know when I started. I wasn't young that I do know. But its not the periods I'm worried about just yet.
I've tried to be so careful with my wording when talking to her I don't want to make her feel bad about herself or think something is wrong.

A few have mentioned calling the consultants office and talking to them. I hadn't thought of that so will do that.

Well if it's not for a couple of months I would not worry too much yet, there is plenty of time for her think about it and get used to the idea. When the time does come, I would suggest that she goes along to at least see what they say and that she won't be forced to do anything she doesn't want to. You won't be able to force her to do anything anyway but a lot of doctors have a great way of talking to children and have success in getting them to agree to things that parents can't.

I disagree with all of that.

She doesn’t have to go. She’s fourteen, not four. She has to want to go to a medical appointment.

Talking to the doctor beforehand or giving the doctor a letter to read in front of the fourteen year old isn’t going to be helpful. It’s going to make her feel excluded from her own care.

My own dd has a once a month hospital appointment and right from the very start, when she was twelve the doctors and nurses talked to my dd and not to me. I wasn’t consulted, I wasn’t asked anything at all beyond practical stuff like ‘is Tuesday ok?’ I definitely wasn’t expected to explain the issue at the beginning. The follow up letters about what was said in the appointment and what’s happening next are sent to DD.

She needs the initial step to be taken on her behalf though @YarraValley and it’s up to the parents to make sure that happens. If nothing is done and it turns out to be very serious (or could have been easily fixed) then I’d much rather my DC got the treatment they need - she’s 14, not 18, so still absolutely the parents responsibility to make sure the help is sourced.

Yes I agree with you both @YarraValley and @Daytimetellyqueen. There must be a middle way but it is tricky. Good luck op.

It’s all very well saying ‘she doesn’t have to go’ ‘how embarrassing’ etc but this is potentially something that could negatively impact the rest of her life. It’s the kind of scenario in which in 3 year times the DD is shouting ‘why didn’t you make me go?’ At her mother.
At 14 I’d be worried with no signs of puberty. Average age for a first period is 12.

My dd was 16 before she got any form of anything. Why the label on 14?

I was 15 before I started periods and really developed. If anything girls are starting too early now. You definitely shouldn’t be looking for hormonal auditions for a child so young. Just leave it alone for awhile. It sounds like it’s more your issue than hers so to speak.

I’m surprised they’ve referred her at 14. My dtds have started this year since turning 14 and dd1 was nearly 16 - I started at 9!

With dd1 I spoke to a paediatric consultant friend and asked her for advice and she said that the breasts bud and they start 18 months later. It might be hard to tell if your dd is over weight but I’d leave it until closer to 16 before getting concerned and only move it earlier if she wanted me to.

That's such a weird post - as if girls are deliberately 'starting too early'?

Girls start their periods earlier because they are better nourished. Yes, there's a link between being overweight and early periods, and that is a concern. But the reason age of menarche has dropped over the last century or so is because young women are no longer stunted by not being properly fed. A girl who hasn't started her period by 14 might be absolutely fine but the OP isn't wrong to be concerned about a general lack of signs of puberty.

I really feel for her, though - very hard on her. It sounds as if the appointment has really upset her, which is such a shame. I don't think I would want to force her to go, but can you get to the bottom of what upset her so much and reassure her it won't happen again? Some medics have a terrible bedside manner and totally forget what it's like to be a shy teenager. I would have desperately wanted to know beforehand if I'd have to be in a gown, or if I could keep my clothes on, or whether there would be that 'modesty' tissue paper stuff to cover me up, or what - these things matter hugely when you are 14!

I disagree with PPS saying 14 is too young. If she were physically tiny, an elite athlete or very slim then maybe, but puberty is linked to body fat and an overweight child should show signs of puberty by 14. It could be that she has a genetic anomaly; at the very least that should be ruled out.

I would imagine she is embarrassed and scared. I would tell her that you aren't surprised she is finding it difficult because it probably does feel embarrassing and maybe even a bit scary, but these doctors see teens in her position every day , to them it's just ordinary everyday work, and they will be kind and matter-of-fact. It's worth going along as they might very well say "it's nothing, you will catch up", or they might say "we need to do a test, and then if it's this or that here is what we can do to help".

Fwiw my daughter was referred at 14 as she was 9 stone and had all signs of puberty but no menstruation. In her case her puberty was delayed by her illness (Crohn's) and by a flare-up. She started her periods naturally at 14 1/2 while waiting for first appointment at gynae.

I remember a young girl who was desperate to start her periods at age 14 as all her friends had and she felt different. She was stick thin but not unhealthy. No bodily changes visible when clothed and I never saw her unclothed- highly inappropriate and probably illegal.
Her gp said give it time. She regularly came to see me saying she just wanted her periods to start.
Aged 16 and 3 months she was so happy that the day had finally arrived (her words). She remained stick thin with very small breasts during the next 2 years I had contact with her.
I think your daughter is still young and not all puberty changes are visible from the outside.
I’d present the appointment as an option for her to consider and just say if all is well then it’s reassuring but if there were to be a problem it’s better to know.
Your dd might come around to the idea of attending if it’s an option and her decision.
Hopefully your dd is just a later developer.

A close friends DD was similar to yours, and it turns out she has PCOS and other conditions.

If she won’t go with you, will she go with best friend or grandma?

I wonder if she thinks they are going to want to look at her naked body? Very unlikely. It might help if she has a clearer idea of what will happen at the appointment.

I was another with very late periods - 15.5.
More importantly, I think at 14 this young woman could be described as "Gillick competent", so it's up to her whether she takes up this appointment. All that the OP can do is give her the facts, calmly and without bias, and let her daughter decide.

Your DD is 14 and would be classed as being Fraser competent. You cannot force her. Maybe see if you can postpone the appointment with the paediatrician incase she changes her mind?

FTR, I didn’t start my periods until I was nearly 17. My breasts also showed up around the same time.

I’m 42 and started at 9
everyone is different

Another late-starter here, I didn't have any signs of puberty until 15, I was very sporty and thin and did a lot of distance running which may have been contributors. I'd say it's a little early to start worrying, my sister and I didn't start our periods until we were 16 and grew into adult women with no issues.

Oh this sounds so hard for you both. What are your conversations about it like? Is she expressing clearly why she is not willing to go - or are you unsure? Do you believe that she understands the potential issues?

It could be worth thinking about how to draw close relationship wise - spending time together, doing things that boost her self esteem, showing you respect her boundaries, etc - and leaving the issue alone for a while, coming back to it in the context of feeling more connected? I know it’s hard as you can do all this and she’s just at a stage where she appears hard to reach perhaps. But keep trying, gently.

Not really a label just a comment that I would consider a healthy, slightly overweight girl to be showing some signs of puberty by that age. I would consider it worth having it checked out.