The cases weren't unique, but their frequency was. Since early-onset-or "precocious"-puberty first gained widespread clinical attention in the 1990s, it's become steadily more common worldwide. Defined as the appearance of secondary sex characteristics such as breasts, pubic hair, and vocal changes in girls 8 or younger and boys 9 or younger, precocious puberty has been difficult for researchers to attribute to a single cause. But a mysterious, pandemic-generated spike in cases has provided experts with a new opportunity to revisit their dominant theories in hopes of an answer. Case studies have now rolled in from clinics around the world, many of which saw at least a two-or threefold increase in precocious-puberty diagnoses after March 2020. In China's Henan province, for example, doctors at 22 facilities saw five times as many cases in 2020 as they did in 2018.
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