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 can't imagine taking a distressed 14-year-old to a GP and making her undergo an examination and weight assessment for an issue that sounds like it is more an issue for you than her. Or is she concerned too with lack of hair and periods?

Sorry I can’t get over you referring to your teenage daughter’s body as “having MOOBS” - you know that means MAN boobs, right? Disgusting.

God I'm mortified on her behalf. I can't actually believe they tried to do a physical examination. I'm glad she stood up for herself and refused. Seems very OTT at her age, I think 14 is still young (older than average yes, but well within the normal range) More than likely things will happen in their own time. I think this needs to be led by her and it very much depends if SHE is bothered and wants to speak to a doctor about it.

DD had similar - everything seemed delayed. We sought GP help and he took bloods - she had (has) a pituitary tumour which was benign but affecting periods and causing other symptoms. She was referred to an endocrinologist and has been on dopamine treatment since - her periods started once she began hormone treatment. May be worth considering as a possible diagnosis OP. If it is that treatment is thorough and regular MRIs and heart/ eye tests in early days. Good luck

Ask her why she doesn't want to go. Perhaps she feels this is over intrusive. Tell her why you are worried about her.

You are advised to seek medical attention for a girl who doesn’t display signs of puberty by age 13.

it doesn’t matter what the child thinks , if the child is worried or not

So you are doing the right thing OP and ignore the people who feel that’s intrusive or unnecessary

your daughter can request that the pediatrician is a female if that might help

I hit puberty a lot later than average and started my periods at 16, my Mum was the same though, and my sibling also started puberty late. I was very small and thin though which makes a difference. You could leave it another year, but as there are various conditions which can also cause a delayed puberty it is worth getting checked out sooner rather than later. In my case I did have breast tissue just beginning to appear by 14 but nothing else until later.
I think talking it through with her and finding out what her worries are is key, then chatting to the GP in advance. The GP will probably want to run bloods but she may also need a scan and x rays to look at bone changes. One of my dc had to be checked for possible early puberty, so the opposite situation, but the same checks. (It wasn’t precocious puberty in her case, but needed to be looked at).

I don’t think the OPs dd would be Fraser competent in these circumstances as actually no one knows what, if anything is the problem/potential investigations/treatment to consent to. So she isn’t making an informed decision. She’s just saying no to finding out. Now I’m not saying the OP should ignore her daughter’s feelings and “making” her go would be physically impossible, so exploring her concerns calmly and reassuring her whilst also explaining the possible risks of not attending is the only way forwards.

Same. Poor thing as women we have so many necessary things to have checked later on in life why on earth would you put a child through that? Also what on earth is a doctor hoping to actually find through a physical examination?

They hope to find out if the child has an actual problem?

if instead of going oh poor child you read up on the NHS explaining what has to happen then perhaps you would be more informed

suppose it was cancer ( NOT LIKELY OP) and you said “oh no we can’t alllow you to examine the child it’s too distressing “ how stupid would that be?

I was 16, at 14 no obvious signs of puberty, sporty, fit, although was shorter than many of my classmates, never a second thought re. age. At 16 though, growth spurt and periods and now taller than most of my contemporaries.

She’s not taking blockers on the sly is she? The sort trans kids use?

Well, a pituitary tumour, or a thyroid issue, or Turner's syndrome, or any number of other genetic issues?

A child who is not slim should show some signs of puberty by 14. No pubic hair or breast budding is potentially an issue.

It could be nothing, but it also could be something.

I was 16 before my periods started and I really developed boobs. I was very petite though, I guess more unlikely for a bigger girl.

Poor girl

I think she should go, easier said than done

I’d try and find out what will happen, I’m sure it won’t be necessary to strip off which is what she’s probably worried about. Will it be a female doc?

but if two months away don’t mention (to her) for now

however to offer reassurance nothing happened with me at all until I was 15.

This is why you should never ask Mum’s net for medical advice!
Your daughter has delayed puberty OP if she has no signs of breast development at 14. Periods may start slightly later but no signs of puberty at 14, particularly if well nourished, merits further investigation. Causes are wide ranging, with constitutional delay in puberty common so if your periods started later than it may just be the case for your family, but other causes such as genetic conditions like Turners syndrome which someone mentioned above, should be considered.
Appointment will involve discussion and examination but the doctor will aim to make that as quick and stress free as possible. Doctor will be looking to establish what Tanner stage she is in terms of breast and hair development so you can always discuss that with her in advance so that she/ you can tell the doctor- I would happily take patient reported features of hair development if the patient was reluctant to be examined although would normally need to look and potentially feel re breast development to distinguish breast buds from fatty tissue. Everything will be done to try and maintain her dignity as much as possible. Usually a gown not needed as long as she’s wearing a top that can be moved up. Likely blood tests will also be suggested.
I would suggest that you encourage her to go as knowing about any potential causes means that associated things can be looked for and managed.

That is reassuring yes, that you had no signs until much later.

I just don't know what to do for the best, let nature takes its course and wait it out (definitely her wishes) or investigate further incase something isn't right. I also didn't want to wait too long because I know how long NHS wait lists are and I worry about things impacting her exam year.

Thanks to you and everyone for offering advice.

Thanks for this informative response, it is appreciated.
Although I wasn't asking the forum for medical advice. I've already put that in place. It was guidance on helping my daughter understand going to the appointment is the best thing :)

That is not what it says on NHS website.

Rather than an in person appointment, could there initially be a telephone consultation. She may feel better having spoken to the consultant first?

I would say she has to go. But I’d try bribery before ‘you’re going and that’s the end of it.’
The hospital is quite close to A, I thought after we can pop in for lunch and perhaps a little shop in B unless there’s somewhere else you’d rather go?

I wouldn't wait it out as there could be a serious underlying condition as mentioned above. I'm surprised the GP wanted a physical exam rather than just asking questions. I'm also surprised they didn't suggest blood tests or ultrasound. She may still be reluctant in a year or more and the GP and clinic both think it's worth investigating.

If you can't encourage her to go willingly then definitely speak to the clinic. She may well be worried that something is wrong with her and prefers not to know rather than being embarrassed. They will almost certainly measure her height and weight and may ask parents height and weight too but they aren't going to judge her if she's overweight just use it as part of the overall picture.