| Abstract: | ![]()
Community paediatricians are increasingly asked to provide expert opinion on internet child pornography related to ‘sex tourism’, mostly in south‐east Asian countries. The girls involved are often prepubertal, and the main legal question is to establish whether they are under 13 years of age. This paper provides a review of the literature related to this question. Although there are limited data of age of menarche from the countries at risk of ‘sex tourism’, one recent study from the Philippines showed that the mean age of menarche was similar to the mean age of British girls born between 1982 and 1986. There are no data in the above countries on the early pubertal changes in breast development, but studies from India and China suggested that these might be more prolonged than for British girls. In particular, the interval between B2 stage (early pubertal breast development) and menarche was nearly 3 years in these developing countries, compared with 2 years for the British girls. Maternal malnutrition and girls small for gestational age at birth resulted in an earlier menarche, while chronic malnutrition, severe enough to cause stunting in preschool years, caused a delay in menarche. Taking into account information from the existing studies, we estimated that 97.5% of south‐east Asian girls will show pubertal changes of B2 stage by the age of 13.7 years. Copyright © 2003 John Wiley & Sons, Ltd. |
