Passionate about Puberty

Does it really matter how we teach girls about puberty? Isn't it just hair, boobs and periods? Is one lecture in school enough?

I've been teaching puberty to elementary and middle school girls in school for years and I've been educating patients about it since I started practicing pediatrics over twenty years ago. I can tell you with 100% certainty that it absolutely matters what, when and how we teach our girls about puberty. I can also tell you that there is much more for girls to know than the standard external changes that everyone associates with puberty. One or two lectures in school is definitely not enough.

The first changes of puberty start well before any of the external physical changes one may observe on an exam. The first changes of puberty start in the brain where infrequently used connections are pruned and new connections are made. Different parts of the brain are developing at different rates, with the limbic system, or "emotional" part of the brain, emerging as the more active part of the brain earlier in puberty and the frontal cortex, or "thinking" part of the brain emerging more towards late adolescence and early adulthood. These early changes in the brain cause girls to become, among other things, much more concerned about how others see them, how they compare to others and whether they are "normal". Given this, it is absolutely imperative that girls feel completely comfortable and educated about all of the possible changes they may experience during puberty well before they start to occur.

Puberty is starting earlier in both boys and girls. There are several theories as to why we are seeing this, but there is no consensus as to the exact cause. With this in mind, you need to consider that your daughter could start with pubertal changes or even menstruation as early as 8 or 9 years old, and if not your daughter, it is likely that one of her friends or classmates will experience at least some aspects of puberty by third or fourth grade. This makes it crucial that our daughters understand and feel some level of comfort with puberty by this age.

Education about puberty starts and continues primarily in the home. Parents should teach their children the correct anatomical names for their genitalia when they are teaching them about the rest of their body parts. When they ask questions about your body parts, give them accurate age-appropriate answers. Parents should not make topics such as body parts or menstruation taboo in the home. Discuss consent in age-appropriate manners when the situation seems applicable, such as toileting or bathing.

When I am in my puberty educator role, my primary objective is to give accurate and thorough information in a lighthearted, but matter-of-fact manner. I try to be absolutely transparent and confront any and all questions that arise. I humanize and normalize this traditionally awkward topic for them. If the educator is flat or the talk is highly medical or overly scripted, the students are going to disengage and the educator will lose that precious opportunity to empower these girls with knowledge and confidence about their changing brains and bodies. Girls do not have a choice about whether or when puberty will happen, so I want to make sure they feel capable of handling anything it has to offer when it does make its appearance and comfortable enough to ask questions when necessary. I try to cover it all from pimples to oily hair to being caught unprepared with your period at school. Have a teacher who won't let you go to the bathroom? Let's talk about 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? Well, let's open up a new tampon and a pad and look at it and go over the parts. Girls at this age are already worried because the shape and size of their bodies are changing at the exact time their brain development is telling them they need to be the same as everybody else, so I also devote a large portion of my lesson to developing a positive body image and how to identify unhealthy emotions or behaviors. We talk about how to handle someone commenting on your body, what to do if you're worried about a friend, or who to talk to if you're feeling sad or worried.

It has been interesting that over the years I have noticed that by the time I arrive in the classroom in 5th and 6th grade, the girls know about the stereotypical topics like bras and periods. What they really have questions about are the practical aspects of how to manage a lot of what I previously mentioned. They want confirmation that what they are experiencing is normal and that all those awkward things happen to others, as well. And we all know, there is power in shared experiences, and as women, we need to have a sense of collective strength and belonging. Girl Power! Puberty Rocks!