DEEP DIVE: Vanessa Kroll Bennett and Dr. Cara Natterson on Puberty

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0:29Amy Wilson:Hello, everyone, and welcome to Fresh Take from What Fresh Hell? Laughing in the face of motherhood. This is Margaret. And this is Amy. And today we're talking to Cara Natterson and Vanessa Kroll-Bennett. Dr. Cara Natterson is a pediatrician and New York Times bestselling author. Vanessa Kroll-Bennett is a puberty educator and writer. Together, they co-host the Puberty Podcast, run Order of Magnitude, a company dedicated to solving the pain points of puberty by empowering kids and their adults. And they are also the co-authors of the new book, This Is So Awkward, Modern Puberty Explained. Most impressively, however, between Cara and Vanessa, they are parenting six teenagers.

1:12Welcome, Cara and Vanessa. Thoughts and prayers. Amy, I just want your voice like around us all the time. It's like so nice and calm. I just want you to talk in my presence and I'll feel better about everything. Thank you. Well, I'll return the favor and say this book is a very calming presence. You lay it out. It's all intense and it's all going to be okay. But where it starts is that puberty has changed in a lot of ways since it was happening to us. And one of the most profound ways that it's changed is timing. So let's talk about that. What's amazing about the data around puberty is that it's actually not that new.

1:49It's just that people don't talk about it a lot. So we've known since 2010 that the average age that girls enter puberty is between eight and nine. And we've known since 2012 that the average age that boys enter puberty is between nine and 10. That's not new, but it's very new to a lot of people who have never really thought about it. That information can feel really overwhelming. And it is very different than the timing of puberty, certainly when I was growing up. So I was a baby of the 70s and 80s. And the average age for entering puberty at that point was the same as it was post-World War II.

2:29Girls would start around 11 and boys would start around 11 and a half. And it was a very quick sprint. And you would get through it in three, four, five years and you'd be done. Now, not only is it starting earlier, but it is not a sprint. It has stretched like taffy and it occupies almost a decade. So we know that kids starting in third or fourth grade are in puberty and they don't finish till they're almost out of or out of high school.

2:54Amy Wilson:So let's double click on that, because it's I think that people think of puberty kind of like a door or a short hallway. And definitely when you say entering puberty, like when I hear entering puberty, I picture getting your period. That's what I picture kind of as the big marker of puberty, but that's not what you're talking about. And I think this idea of puberty as something that happens over time is confusing to me and other people. Yeah. I mean, what's interesting is people think of period, that's super common. They're like, oh, that's the beginning of puberty. But really, that's actually the midpoint for female puberty.

3:32And breast budding is usually the first sign of female puberty. And that's what Cara is referring to as the onset between eight and nine is breast budding. So there are now four years on average, because the first period hasn't moved much earlier, maybe by a few months. So it's like 12 and a quarter, as opposed to 12 and a half when we were going through puberty. So there are four years, maybe more between when a kid is breast budding, and a kid hits the midpoint of puberty approximately with a first period. And then there's a bunch of years on the back end of growth and change and development after that.

4:11So that's what's kind of striking for people is that entry, that on-ramp is longer and the off-ramp is also long on the other end. And so it really is like, I don't want to frighten anyone, but it's like that hallway. What's the movie? The frightening movie with Jack Nelson. Oh, you're going to say The Shining?

4:31Amy Wilson:Yes. I think we need a better metaphor, people. The Shining Hallway is not, I don't know. Yeah, we're one minute in. And your kid is riding their big wheel and then come around the corner. So yeah, the bloody twins. Amy's like, you guys are so positive. And here I am. It's like the Shining Hallway. Can I jump on and add that one of the things that's confusing about all of this, and you are not alone in your confusion. I would say the vast majority of people sit in some confusion around this. What is adding to the confusion is that the definition of puberty can either be very narrow or very broad.

5:04So the narrow definition of puberty is the path to sexual maturation. So a body going from a child's body to a body that can one day potentially be part of making a baby. And that does begin between eight and nine, that sexual maturation. But the sort of concept of puberty as a whole is also much broader. It is all the things in your life that are impacted by the sex hormones that are making your body physically mature. And those sex hormones, estrogen, progesterone, testosterone are the big ones. Those hormones circulate not just in your body, but also in your brain. So Vanessa is exactly right that the first physical sign of puberty in a girl is breast budding.

5:46And the first physical sign of puberty in a boy is testicular or penile growth. But really, the first sign of puberty is usually a slamming door. Because the moodiness that goes along with surging and falling hormones is very real. And parents of third and fourth graders will often recognize that moodiness and go, wait a second, maybe my kid is in puberty. And so when we talk in our book about all the ways that puberty has changed. We talk a lot about the physical changes, but we talk a lot about the emotional and social changes as well. You talk in the book about how sort of normal is early and early is really early, what we call precocious puberty.

6:31And sometimes you say in the book, sometimes we think it's precocious puberty and no, it's really just part of the new normal. But you talk about early bloomers. And I thought this was very useful that a child can look mature, can act mature, can be perceived as older by everybody around them, but their executive functioning skills are not ripe. They're not ready to live in the body that they are living in. So what advice do you have for parents of early bloomers? I think if there's one takeaway, I don't think I can boil it down to one take. One of the most important takeaways from the book is treat kids the age they are, not the age they appear.

7:12And for early bloomers, when they look 16, but they're actually 12, there are all sorts of impacts on kids being treated older. They get unfair expectations placed on them about academic capabilities, decision making, they get exposed to things that are not appropriate for them at their age, right, that can present all sorts of risks for them. And it's true of the late bloomers too, right? A 12-year-old is a 12-year-old, even if he looks nine, he still has the intellectual capabilities and the curiosity and the social desires and, you know, all sorts of things. But if he gets infantilized because he looks younger, that has its own really hard and upsetting effect.

7:57So, we really encourage people to treat kids the age they are. And that takes some real work on the adults part, because we look at a kid and we make the assumptions based on how kids looked when we were kids. And it's completely different. And we have to dial it back and get a sense of, huh, hey, do you mind telling me what grade you're in? Or how old are you? Like, we really encourage people not to guess a kid's age, not to assume they know, right? That's a really simple thing. Oh, you're in fourth grade, right? But you're staring at a seventh grader. That's a pretty devastating question. Yeah, I've mortified at a kid while his older sister stood there laughing that I was like, so you're my fifth guy.

8:40And I wish I read your book 10 years ago, because now I know better.

8:45Amy Wilson:Yeah, you need to give this book to the TSA, because this always happens to my son, who is always like, are you nine? And he's like, I'm 13 and then it ruins this whole day and it's a total bummer. But I also think it's a little bit of a sphere of control problem, right? Like we can try to do this for ourselves and useful information for school, but a nine-year-old girl who looks 16, you don't have a ton of control because that's a problem about how mostly males are reacting to her in this space. So what do we do about this good advice when we actually are outside of a sphere of control? Yeah, and it goes beyond that, because there's very good data to show that those girls in particular are at much higher risk for sexual predation.

9:38So this is actually a really, really important point. You know, the incongruity between how old you are and how old you look is hard everywhere that it's incongruous. And frankly, it's hard when it's not too. It's like puberty is tricky, right? But when When you are a emotionally young female who looks physically old, you are much more ripe for the picking in terms of sexual assault and grooming and other. And so everything that we talk about in this book boils down to conversation, how to have conversations, not just with the kids in your lives. And this is not a book actually in the parenting sphere.

10:18It is not about parenting. It is about being an adult in the lives of kids. So it might be that you have kids living in your house with whom you have these conversations. It might be that you have kids in your classroom, on your team, in your clinic. So there are lots and lots of adults who I think can approach this particular issue in a very empowering way. And some of it is acknowledging to a kid, you look older than you are. Your brain is exactly where it's supposed to be for how old you are. but this is confusing because people might do or say things to you that make you feel good, but they're not okay.

10:58So I am always here. I am never going to judge you or be upset with you when you tell me what someone said to you. Don't ever be afraid to share with me. I'm going to help you. And that's what being a trusted adult is and building a network of trusted adults among adult groups. So when you're worried about a kid who's in your life, having another adult to go to to bounce things off of becomes really, really important. We're talking to Cara Natterson and Vanessa Kroll-Bennett, and their new book is This Is So Awkward, Modern Puberty Explained. We'll be right back.

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14:35Amy Wilson:Plus the Northern Lights Arcade spent some quality time there. So your kid who loves the lazy river and your kid who loves fantasy games will both have a great time great wolf lodge also offers great dining options and complimentary daily events like nightly dance parties all under one roof unpack the car once and you're settled in to have fun and with 22 lodges across the country you're always a short drive away from adventure we've both had such great times at great wolf lodge so bring your pack together at a lodge near you learn more at greatwolf.com and strengthen the pack. So before the break, we were talking about early bloomers.

15:12Amy Wilson:And let's talk about late bloomers. I am in the middle of this experience myself right now. I recently went to a field trip and kids were coming off the bus. And I kept saying, what grades went on this trip? Like some of these kids look 35 years old to me. And it's just that they're much more developed than the kids in my house. And it's a different kind of problem. And so talk a little bit about the problems that are presented for late bloomers. I think there's an array of problems. And typically, when we talk about late bloomers, we say it's more often boys than girls, although there are female late bloomers, but the earliest early bloomers are typically girls and the latest late bloomers are typically boys because they start a little bit later.

16:05The average age is a little bit later. We like to look at it as a whole universe, right? So it's not just that they're smaller or that they haven't grown hair or that they are not getting muscle mass or, you know, all of the physical manifestations, but there are all sorts of social, athletic knock-on effects of being a late bloomer. So I am in a family where all the men in my family were late bloomers, my husband, my brothers, and it was a really big deal for them growing up. It affected, they quit sports teams, they had moments of social challenge because other people were more developed or sort of in on the romantic crush scene and things like that.

16:50They had a real sense of feeling inadequate. And it really affected their self-esteem. We really encourage parents, A, not to say to a kid, oh, it's all going to be fine. Like you'll grow eventually. That doesn't help them because in the moment, everything we say not to say is also all things we've said to our own children. So, okay, strike one for me on this podcast. See also things we have said.

17:18But their sense of time is their kids. So their sense of time, like down the road, what the hell does down the road mean? So one thing we really encourage is like, hey, how does it feel? What's going on for you? Where is this affecting? So you hear a lot from boys about athletics. It's harder for them to compete. They get knocked off the ball. They maybe aren't making the teams they want to make because of their size. So we encourage parents to really ask, like, what does this feel like for you instead of assuming? The other thing is that if you're wondering, go see your pediatrician. Like, even if you have a sense that everything's going to be okay, and this is just how your family is, and all the people in your family were late bloomers, there's no harm in going to see your pediatrician, if only to get some reassurance.

18:06And they may say, and the hard part, particularly about male late bloomers, is that, as Cara mentioned earlier, the first sign of male puberty is penile and testicular growth. But like, we're not hanging out with our middle school kids naked. Like, we don't know if there's growth. Right, right. They're not coming down. They're not even noticing, mom. Right. I mean, they should notice because their hands are down there 99 % of the time. But they're not. And really, a medical professional is trained to determine if there is growth and if there is change that, you know, we wouldn't know or see and nor is it our job to do that kind of exam, but a doctor, it is their job.

18:47And it's really important because there's a lot of worry that goes along with late blooming. The kids will worry that nothing's happening. The parents might worry that nothing's happening. And so the time lag between the very beginning of puberty in boys, testicular and penile growth, and seeing anything else, that can be a couple of years. And so it is actually really important for you to stop in and get a physical exam. That's why that annual checkup is so important, because a pediatrician can be reassuring and say, oh, look, actually, there is testicular growth. I mean, they won't say, oh, look, they should actually be kicking you out of the room at that point.

19:25But just to acknowledge that there's something or to go down a path of what if nothing is happening? And what do we need to do? So I'll double that. I mean, I'm biased, because I used to be in the office all the time taking care of these kids, but it really makes a big difference. I mean, the other thing, Margaret, I would say is that it's an opportunity. You know, if you say to a kid, oh, it'll all work out in the end, fine. But it is an opportunity for them to develop other parts of themselves while they wait, right? So like, if they're doing physical activity and size as an issue, maybe it's time to introduce another sport or another physical activity that doesn't rely on size.

20:06Or maybe it's time to explore some extracurriculars that have are not physical, right? Like a cooking class or something like that, where it's like, as they wait it out, they're developing their interests. And we did episodes on the puberty podcast, both with my brother who made an entire show about being a late bloomer called Big Mouth. And it's an animated show. It is not PG. So I just want your audience to know it is decidedly un-PG. But extremely funny. But extremely funny. And his whole life is based in having been a late bloomer and everything he had to cultivate in himself in response to that.

20:44And there are lots of really successful, brilliant, funny people who use that sort of discomfort of being a late bloomer into building really successful careers. So that's sometimes a nice way to point a kid towards the positive side when it's like less personal and you can point them out and look at the world and see folks like that.

21:05Amy Wilson:And I also think and I agree and I've had a lot of conversations with my kids of the actual reason you cannot keep up in these spheres is testosterone. You don't have enough of it yet. And I think it takes it out of like they're good, I'm bad. And it takes it into like these are physical developments that, first of all, my kid is a calendar year younger than a lot of the other kids in the class because of the way that people, you know, decide to send their kids to school. which is a whole different episode. But there is like you physically can't keep up because of things that are beyond your control.

21:42Amy Wilson:Not you're not trying hard enough. You're not good enough. You're bad. Yes. Although big asterisk there, which is the follow up conversation is and when someone tries to sell you testosterone, don't buy. I'll be right back. I got to make a phone call and make sure that my kid is not right now behind the school in a black market testosterone market. What is fascinating is with information comes sort of rabbit holes. And our kids are all online all the time. And so when we've educated them about the cause of something and that you are perfect, that is exactly what you needed to do is you needed to identify the why of it all.

22:22But then the follow-up is suddenly they start looking for solutions, and the solutions are not necessarily safe. And when it comes to testosterone, it is not safe for kids to be buying testosterone, taking testosterone. If they need testosterone, that's because a doctor has decided they need testosterone and they're being prescribed testosterone. So going down some of those rabbit holes with your kid is really important. And the only way to get there is to do exactly what you just described, which is be in conversation and be open to all the questions and be completely nonjudgmental and really empathic.

22:59And those questions come over time. So let's talk about the questions, right? Because we all think or grew up thinking there's going to be the talk. You have the talk, which I was extremely reluctant to have. And you argue correctly, obviously, that this is, in fact, there's 100 small conversations, which takes the pressure off it in a way, right? Each one doesn't have to be so all-inclusive, but how do we, if we're supposed to have a hundred small conversations about this in a totally relaxed and askable parent way, where do we start? Okay. I'm just going to tell a story and then Vanessa is going to give you all of the secret answers.

23:34That's what she does for me every day. So when I used to see kids in the office, I played this game where I would kick the parents out of the room, I would say to the kids, have you had the talk with your parents? And they would almost to a one say, no, never had it. And then when I was done examining them, I would pull the parents into my office and the kid was getting dressed or whatever. And I would say to the parents, have you had the talk with your kid? And the parents would say, yes. And not only did I, this is exactly how it went. This is where I was standing. This was what I was saying.