Passionate about Puberty

Does the way we teach girls about puberty really matter? Isn't it just about hair, breasts, and periods? Is a single lecture at school sufficient?

I've been teaching puberty to elementary and middle school girls for years and educating patients about it since I began practicing pediatrics over two decades ago. I can say with absolute certainty that it is crucial what, when, and how we teach our girls about puberty. There's much more for girls to learn than the typical external changes associated with puberty. One or two school lectures are definitely insufficient.

The initial changes of puberty begin well before any visible physical changes are noticeable. These changes start in the brain, where unused connections are pruned and new ones are formed. Different brain parts develop at varying rates, with the limbic system, or the "emotional" part, becoming more active earlier in puberty, and the frontal cortex, or "thinking" part, developing more towards late adolescence and early adulthood. These early brain changes lead girls to become more concerned about how others perceive them, how they compare to others, and whether they are "normal." Therefore, it is essential that girls feel completely comfortable and informed about all the potential changes they may experience during puberty well before they begin.

Puberty is beginning earlier in both boys and girls. There are several theories about why this is happening, but no consensus on the exact cause. With this in mind, your daughter could start experiencing pubertal changes or even menstruation as early as 8 or 9 years old. If not your daughter, it's likely one of her friends or classmates will experience aspects of puberty by third or fourth grade. This makes it crucial for our daughters to understand and feel somewhat comfortable with puberty by this age.

Education about puberty primarily begins and continues at home. Parents should teach their children the correct anatomical names for their genitalia when teaching them about other body parts. When they ask questions about body parts, provide accurate age-appropriate answers. Parents should not make topics like body parts or menstruation taboo at home. Discuss consent in age-appropriate ways when applicable, such as during toileting or bathing.

In my role as a puberty educator, my main goal is to provide accurate and thorough information in a lighthearted yet straightforward manner. I aim to be completely transparent and address any questions that arise. I strive to humanize and normalize this traditionally awkward topic. If the educator is unengaging or the talk is overly medical or scripted, students will disengage, and the opportunity to empower these girls with knowledge and confidence about their changing brains and bodies will be lost. Girls do not have a choice about whether or when puberty will occur, so I want to ensure they feel capable of handling its challenges and comfortable enough to ask questions when needed. I cover everything from pimples to oily hair to being caught unprepared with a period at school. Have a teacher who won't let you go to the bathroom? Let's discuss ways to approach that. Why do pads have "wings"? Can you flush a tampon? What does a tampon look like? How do you insert it? Let's open a new tampon and pad, examine them, and go over the parts. Girls at this age are already worried because their bodies are changing shape and size just as their brain development tells them they need to be like everyone else, so I also focus on developing a positive body image and identifying unhealthy emotions or behaviors. We discuss how to handle comments about their bodies, what to do if they're concerned about a friend, or who to talk to if they're feeling sad or worried.

Over the years, I've noticed that by the time I reach the classroom in 5th and 6th grade, the girls are familiar with stereotypical topics like bras and periods. What they really have questions about are the practical aspects of managing what I've mentioned. They want reassurance that what they're experiencing is normal and that these awkward things happen to others too. We all know there is power in shared experiences, and as women, we need a sense of collective strength and belonging. Girl Power! Puberty Rocks!