Nora Gelperin has been fielding an increasingly familiar question recently when she works with teachers and school nurses. “They say, ‘Oh my gosh, we have a fourth grader who got her period, and she thought she was bleeding to death. Our school doesn’t cover puberty until sixth grade. How do I tell her what’s going on and that it’s normal?’” says Gelperin, director of the sex education and training team at the nonprofit Advocates for Youth.
Today, over half of the world’s girls begin puberty before they turn 10—and starting at ages 7, 8, or 9 is increasingly common. Boys follow soon after, with nearly half of American boys hitting puberty by their 10th birthday. Worldwide, the average age of puberty onset in girls has decreased by about three months every decade since the 1970s, according to a 2020 study.
For many kids, puberty is a difficult time regardless of when it starts—but it’s even more difficult when you’re among the first in your class to experience it. “Kids going through puberty, they’re waking up in a different body every day,” says health educator Shafia Zaloom. Yet in many schools, health education curricula and staff training haven’t adapted to this important developmental shift, and elementary school educators and administrators often feel unequipped to support students through it. “Grade school teachers, they’re not prepared to do this,” says pediatrician and author Cara Natterson. “They never had to do this before. And they certainly didn’t get this when they were in grade school.”
Tracking an Earlier Onset
For a long time, physicians and medical textbook authors generally believed that young girls first showed signs of puberty around the ages of 11 and 12. But in 1997, a team of pediatricians published a landmark report analyzing health data from over 17,000 girls in the United States and found that puberty was arriving significantly earlier. The study found that by the age of 8, when girls are typically in third grade, “15 percent of the white girls and 48 percent of the African-American girls had some breast development, pubic hair or both. In contrast, medical textbooks say that just 1 percent of girls younger than 8 show these signs of puberty,” notes a New York Times article summarizing the research. “The findings suggest that the textbook timetable of puberty onset, which is based on decades-old research on British white girls, is either outmoded or irrelevant in this country.”
Meanwhile, “precocious puberty”—the medical term for puberty that occurs well before the normal age range of 8 to 13 in girls—was found to be increasingly common, but with clear differences between ethnicities. The 1997 report found that 3.7 percent of White girls reach puberty before age 6 in the United States, compared to a sizable 14.3 percent of Black girls.
American boys, meanwhile, are starting puberty around age 10, as evidenced by testicular development, per a large 2012 study by the same lead researcher, Marcia Herman-Giddens, as led the landmark 1997 study involving girls.
What’s driving the earlier onset of puberty is unclear, says Ai Kubo, an epidemiologist and researcher at Kaiser Permanente, but a number of factors may be involved, including stress, trauma, and obesity. While the data is still under review, several recent studies—including one from Germany and another from Korea—are examining the link between the Covid-19 pandemic and an even steeper increase in precocious puberty, a connection that Kubo says makes sense if stress is indeed a driving factor of early puberty.
Early puberty is associated with negative mental health outcomes in both boys and girls—but not exactly in the same way, Kubo explains. In girls, early puberty has been linked to internalized outcomes—“like depression, anxiety, and body image dissatisfaction,” says Kubo—as well as externalized ones, like drug and alcohol addiction. But in boys, studies have only found a clear link between early puberty and externalized outcomes like addiction and delinquent behaviors, Kubo says.
Laying the Groundwork
Requirements for sexual health education vary widely from state to state. Some states, like Virginia and Massachusetts, don’t require it at all; others, such as New Mexico and California, do—but not until middle or high school. By that age, teaching students about puberty is often too little, too late, says Kubo, because the data makes it clear that most kids are already well into puberty by then.
To better meet the developmental needs of children, advocates like Zaloom want health and wellness education to begin a little earlier. That doesn’t mean talking about physical changes or how babies are made, Zaloom clarifies. In early elementary, for example, “we’re talking about bodily autonomy,” says Zaloom—topics like personal boundaries and how to say no. “And we’re talking about recognizing emotion on people’s faces—the beginnings of empathy.” Many schools are already teaching these basic social and emotional skills, Zaloom points out, but it’s particularly beneficial if the lessons are structured so that topics build on each other each year, laying the groundwork for lessons about puberty once kids are at that developmental stage, Zaloom says—now around age 9 or 10.
Some districts are doing just that. Chicago Public Schools’ new Health & Safety Education policy, adopted in May 2023, lays out a curriculum that includes topics like communication skills, personal boundaries, and identifying trusted adults. By third grade, students are taking lessons on “navigating online safety” and “puberty changes and personal hygiene”—consistent with the new data about puberty onset—while “anatomy, human reproductive systems, and pregnancy” are discussed in middle school.
In other districts, teachers and counselors are adjusting their health and wellness units to the new reality of puberty. “I used to teach health and wellness to students starting in grades five through eight, with grade five only getting a cursory overview,” says school counselor and author Phyllis Fagell. “But that was inadequate and too late,” so she now starts the program earlier. As early as third grade, students may experience the mood swings and hormonal changes associated with early puberty, Fagell says—often well before bodily changes become apparent. “They tell me they don’t understand why they have started having such big reactions to things, particularly friendship challenges,” she says. “Counselors can help by teaching kids social skills and emotional self-regulation”— focusing on skills like conflict resolution, dealing with disappointment, and how to think before you speak.
Similarly, human development educator Sarah Huss is adapting her California school’s health program to focus on critical SEL skills in the early grades, then building up the basic health knowledge needed for discussions about puberty in fourth and fifth grades. Huss says she actively engaged parents in the conversation as she developed the new program; those open discussions reduced potential backlash from families who might be confused about why human development education would begin in kindergarten.
Opening Up To Questions
Students are likely to have lots of questions, says sexual health educator Mariotta Gary-Smith. Because it can be a sensitive topic, Advocates for Youth’s Gelperin suggests offering a physical or digital “question box” where students can ask questions anonymously. “They may want reassurance that when they get their periods for the first time, someone at school will help them get a tampon or pad,” says Fagell. “They may worry that getting their period will be painful or that they’ll bleed so much that they’ll need to change their clothes.” To loop parents into the conversation, consider sharing students’ questions (still anonymously) during parent-teacher conferences to show parents what their kids want to know more about so they can carry on the conversation at home.
Making space for questions also creates opportunities for delivering helpful guidance. For example, fourth grade can be a good time for discussions about personal hygiene—“explaining to kids why they smell bad all of a sudden and need to use soap and deodorant,” says Fagell. During teacher training sessions, Gelperin says, educators’ top question is how to get their students to attend more to personal hygiene.
Meanwhile, experts say it’s never too early to discuss sleep hygiene. While it’s generally known that sleep patterns change during adolescence, driving the movement for later high school start times, preliminary research suggests that elementary-age kids undergoing early-onset puberty see similarly disrupted sleep, notes psychologist and sleep researcher Joseph Buckhalt. As more kids experience earlier puberty, “it would be great if all schools started later,” says Buckhalt, noting that the logistical hurdles would be substantial. In the meantime, he recommends teaching students about healthy sleep habits—things like putting away devices after a certain time, agreeing to limit digital contact with one another after hours, and sticking to a specific bedtime.
Period Products Are School Supplies
Fewer than half of the states require schools to provide menstrual products. Some states, like Georgia and Arizona, offer funds for the supplies in schools but don’t require schools to have them; others—New York, Virginia, and Washington, for example—require schools to provide them but don’t offer funding. Plus, many of these statewide requirements and funds make menstrual products available to middle and high school students only; elementary students are often overlooked.
Experts say this can leave some kids in very unpleasant situations. “I have heard stories where second graders will have their period in the middle of class, and they don’t have anything, which can embarrass and traumatize them,” says Kubo.
In districts that don’t provide menstrual products, resourceful teachers like Sarah Milianta-Laffin, a middle school educator in Hawai’i, are taking matters into their own hands; Milianta-Laffin created a menstruation station after learning that her students used “toilet paper, folder paper, socks, rags, and other items in place of clean period products.” Milianta-Laffin and a group of students raised money through the crowdfunding platform DonorsChoose and created a wheeled cart (typically stationed in the main bathroom) stocked with menstrual products for students who need them.
“Period products are school supplies,” Milianta-Laffin argues, and she has pushed for legislation to recognize them as such. Plus, offering menstrual products may very well have academic benefits: “A pilot program in New York City found that attendance increased by 2.4% among girls at a city high school after making tampons and pads available in its restrooms,” NPR reports.
Yes, They’re Still Kids
Another important way to support students entering puberty: Remember to still treat them like kids, say pediatrician Cara Natterson and journalist Vanessa Kroll Bennett, co-authors of the new book This Is So Awkward: Modern Puberty Explained. “When you are an educator, and you have a room of 25 kids who look potentially six years different in age because of their pubertal development, it’s really hard to recognize that they’re actually developmentally all the same age,” says Bennett.
It’s a natural impulse for adults to treat kids who look older as if they are older—but this is unfair to the child. The bias toward adultification is particularly noted in how adults treat Black girls, who tend to go through puberty earlier than their peers, leading teachers to give them more responsibilities and heavier punishments, according to recent research. “The dominant discourses that frame Black girls as less innocent and feminine than all other girls likely influence disproportionate exclusionary discipline outcomes,” the researchers write.
Instead, regularly remind yourself that all the students in your class are at roughly the same stage of brain development, Natterson and Bennett encourage. Once kids hit puberty, “the body looks older,” says Natterson, “but the brain is not speeding up its development. It is not maturing any faster.” Regardless of how they look, the kids in your class are still just kids.
Talking openly about puberty and developing bodies can be a daunting task for many adults for a variety of reasons, health educators told us. “Most teachers feel like this is outside their area of expertise, and it feels onerous,” says Natterson.
Robust training certainly helps. “I wish teacher education programs included child sexual development,” says Huss—a sentiment echoed by many other experts we spoke with. Even if teachers aren’t going to be actively teaching sexual health to their students, it’s important for them to know what their students are going through developmentally, says Huss, who along with Gelperin and Gary-Smith recommends the National Sex Education Standards as a good starting point for teachers seeking guidance on curriculum.
To help teachers ease into the subject, Zaloom and Gelperin both like the website Amaze—and its spinoff for younger kids, Amaze Jr.—which offers a number of short, free animated explainers on a variety of health-related topics. Zaloom includes book recommendations for teachers such as Sex Positive Talks to Have With Kids, by educator Melissa Carnagey; Talk to Me First, by educator Deborah Roffman; and, for students, the illustrated children’s books by educator Cory Silverberg. Natterson has also written a number of children’s books on topics such as puberty and self-care.
Meanwhile, Gary-Smith likes to remind teachers that they already have firsthand experience with this developmental stage. “I always encourage educators to remember their own experience and nurture the young person that they were,” says Gary-Smith. We all went through puberty, she says; what kind of support and answers do we wish we had received?