27 year old male, puberty not complete?

Patient

Q: Hello. I believe this question relates to Endocrinology.

I'd like to have a doctor's opinion on my brother's undiagnosed condition. He is 27 years old and of average height, but otherwise appears like an adolescent boy who hasn't gone through puberty.

Symptoms include:

- Childlike, high-pitched voice
- Very small hands and thin limbs and fingers
- A notable bump (deformity) in his sternum
- Small, somewhat underdeveloped jaw
- Barely any facial hair, apart from very light whiskers
- No sideburns whatsoever, no hairline typical for an adult male
- Keen sense of smell, and sensitivity to strong smells (If not for this, I would believe it's Kallman's syndrome)
- Prone to migranes (possibly unrelated)

There may be many more symptoms which he won't disclose, and I haven't seen how developed his genitals are in adulthood. In early childhood they seemed typical for his age.

In adulthood, my brother has come to the conclusion that he is transgender, and offers this as an
"explanation" to all the physical symptoms. He has never undergone any kind of hormonal therapy.

I however, am convinced that there is an underlying medical condition, such as a glandular disorder behind the symptoms. Any advice would be much appreciated.

Symptoms:  - 27 year old male, average height
- Looks like an adolescent boy who hasn't undergone puberty
- Childlike, high-pitched voice
- Very small hands and thin limbs and fingers
- A notable bump (deformity) in his sternum
- Small, somewhat underdeveloped jaw
- Barely any facial hair, apart from light whiskers
- No sideburns whatsoever, no hairline typical for an adult male
- Keen sense of smell, and sensitivity to strong smells (If not for this, I would believe it's Kallman's syndrome)
- Prone to migraines (possibly unrelated)
Doctor

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