Is his penis too small?

The Pediatric Insider

© 2013 Roy Benaroch, MD

A question popped up on a bulletin board over on WebMD where I’m a “featured expert”: Could an 8 year old boy have a penis that’s too small? A parent thought that one son’s looked much smaller than that of her other boys.

Penises start out small, and stay fairly small until hormones at puberty cause growth starting around age 10-14. At birth, an average penis is 1.5 inches long, and anything over ¾ of an inch is considered normal. An average 8 year old (and, really, an average any-year-old prior to puberty) has a penis size of about 2 inches—that’s gently stretched, while pushing back the pubic fat pad that can sometimes “bury” the base of the penis. A more detailed table of normal and abnormal penis sizes by age can be found here.

A penis that appears much smaller than expected is sometimes the result of obesity or a thick body type that makes the penis look “pushed in.” This is called a “hidden penis.” If the penis can’t be pushed back out (by pressing back on the fat pad), it may be a truly “buried penis,” which may require surgery. Sometimes, the scrotal skin is attached up high on a “webbed penis,” which can also be corrected surgically.

Parents who have concerns about penis size should bring this up with their doctor—don’t expect that a pediatrician is going to measure Junior’s penis at his well check, or that we’ll more-than-eyeball that part of the exam. If it’s really small, we’ll probably notice, but if you’re worried, bring it up and discuss it to make sure that that part of the exam is done carefully and recorded. Along with penis size, a careful exam should also include a complete genital look-see, checking to make sure testicles are where they’re expected to be and that there are no other signs of unusual genital development.

A truly too-small penis is called a micropenis. This can be treated initially with testosterone injections, which usually enhance growth. If that fails, the family of a boy with a very small penis may have to consider the difficult and ethically challenging issues of whether gender reassignment is appropriate. Anyone facing that kind of situation should certainly be working with university specialists in endocrinology and urology to learn about and explore every option.

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7 Comments on “Is his penis too small?”

  1. Meredith Says:

    Why in the world would gender reassignment surgery be considered in a child because the penis is too small? Why not wait to see how the child self-identifies with regards to gender before going down that road? Why decide at all that any genitalia needs to be mutilated if it doesn’t fit the mold?

    I’m honestly very disturbed by even the suggestion that this is a reasonable thing to do.

    Liked by 1 person

  2. Dr. Roy Says:

    Meredith, I should have made that clearer. The last paragraph only refers to very, very few boys, some of whom are actually genetic girls, and some of whom have other genetic mutations that have prevented normal development. Decisions in this case are complex, so I’ve recommended that any parents in such a situation work with the best, most experienced specialists available.

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  3. sekar Says:

    Dr,
    My son 8yr old, also has small pennis, he is slightly obessed. more to add his testicles arenot hanging down compared to my 2nd son…
    I am really worried every time i make him bath.

    Like

  4. Laural Says:

    I am glad Meredith asked the question- I, too, am shocked at the suggestion of gender reassignment.

    Like

  5. Dr. Roy Says:

    I should have made it more clear– sex assignment would only be considered if the penis wwere tiny and if there were no hormonal or other therapies that could be used. Some of these babies have XX chromosomes, and may be “virilized” females– so it’s not actually sex reassignment at all. In any case, this would be very rare, and the decision would involve the parents, surgeons, ethicists, endocrinologists, and other experts, and it would not at all be taken lightly. I should not have included that remark off-handedly without better explanation.

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  6. Sarah B Says:

    Hi Dr. Roy. I hope that you can answer my question as to whether my 2 and a half year old son has an abnormally small penis or not. It is about 3-3.5 cms long. He is not in any way fat and it doesn’t seem retracted and also grows/goes back to normal when he is playing with it.

    Thanks, Sarah

    Like

  7. Dr. Roy Says:

    Sarah, please visit your pediatrician or family doctor for an examination to discuss your concerns. This isn’t something that can be done over the internet.

    Best of luck-

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