Explaining a constitutional delay of puberty diagnosis to an adolescent and his family — OSCE

A 14-year-old boy sits in the clinic with both parents. He has been referred because he is the shortest in his class and has no signs of puberty, and he has been bullied about his size. His father was 'always the smallest until age sixteen' and his mother reached menarche at 16. Investigations show a bone age lagging by two and a half years, normal growth velocity, testes of 3 mL, and low-normal gonadotrophins consistent with constitutional delay of growth and puberty. The boy is withdrawn and embarrassed; the parents are worried he will 'never develop' and ask whether he needs treatment. Counsel them.