From the Editor
Pediatric and Adolescent Gynecology as a TapestryI recently inherited my grandmother's cherrywood floor loom, a beautiful machine that I am learning to use to create fabric, enjoying the process of learning a new craft and becoming a weaver. I've concluded that woven fabric is a good metaphor for my life's work. The field of pediatric and adolescent gynecology (PAG) also represents a tapestry to which many of us from different backgrounds contribute to care for those children and adolescents who were assigned female at birth.
Pediatric and Adolescent Gynecology: The Science is Coming of AgeThe Journal of Pediatric and Adolescent Gynecology (JPAG) is coming of age. I think we're beyond our childhood, continuing our journey through a journal's lifespan. In previous editorials, I've written about PAG and science, discussed the value of case reports, and addressed the maturation of the field of pediatric and adolescent gynecology.1,2 Each year, at the end of the calendar year, I review a report that is termed our “Accountability” report for the year. Throughout the year, David Newcombe, JPAG's wonderfully knowledgeable, consistent, and unfailingly dependable Managing Editor, sends me accountability reports on a weekly basis, allowing me to compare data with last year and previous years.
Reproductive Justice and Adolescents in a Post-Roe United StatesThe US Supreme Court's ruling in Dobbs v. Jackson reversed nearly 50 years of legal precedent following the Roe v. Wade decision in 1973. This decision was an assault on reproductive justice that disproportionately impacts adolescents and young adults. The decision allowed states to enact laws curtailing induced abortions; in some states trigger laws had been enacted prior to the overturn of Roe v. Wade leading to an almost immediate ban on abortions. Some of these laws have been enjoined from enforcement, but others have gone into effect.
The Association between Surgeon Dissatisfaction with Infant Genital Appearance and Surgical Decision-Making Surrounding ClitoroplastyThe study “Exploring factors associated with decisions about feminizing genitoplasty in differences of sex development” by Kremen et al aimed to address if Prader stage, clitoral size, parental uncertainty, anxiety, depression, or dissatisfaction with genital appearance correlated with surgical decision-making in children under age 2 with a difference of sex development (dsd). Most of the 58 children were diagnosed with 46 XX congenital adrenal hyperplasia (CAH), and all but 5 underwent surgery before age 2.
Early Puberty in Girls—What Do We Know in 2022?I remember 1997. Early puberty was THE topic of discussion among pediatric and adolescent gynecologists, adolescent medicine physicians, and pediatric endocrinologists. That year, Marcia Herman-Giddens published the landmark study entitled “Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network.” The study included the findings that at age 8, 48.3% of African American girls and 14.7% of white girls had at least 1 sign of pubertal development, earlier than was suggested in standard pediatric textbooks.
Using the Menstrual Cycle as a Vital Sign: What We Still Want to Know about Adolescent Menstrual CyclesI remember the place and the conversation. Dr. Larry Nelson and I were attending an interdisciplinary women's health education retreat in Chantilly, Virginia, in 2000 and chatted over lunch.1 Dr. Nelson was with the U.S. Public Health Service, working at the National Institute for Child Health and Disease, division of intramural research, and is known for his important work on defining and addressing primary ovarian insufficiency (POI).2 Our lunch conversation was wide ranging, but the conversation struck a chord when we started talking about the menstrual cycle.
Pediatric and Adolescent Gynecology: Where's the Science?In 2010, I was asked by colleagues at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) to moderate a Pediatric and Adolescent Gynecology Research Think Tank Panel. I prepared a presentation on the science of pediatric and adolescent gynecology (PAG) in which I addressed the history of PAG, highlighting that PAG is a “young” and developing subspeciality, with an evolution of scholarship. At that meeting, I showed a chart (Fig. 1), which indicated that the type of article most commonly published in the Journal of Pediatric and Adolescent Gynecology (JPAG) was a case report.