Episode Transcript
Dr. Amy Kelley:
If you are willing to talk about those things and not judge their questions and you know, not get upset that they’re talking about those things, you are going to be their safe person and that’s what you want to be.
Courtney Collen (host):
Hello and welcome to “Her Kind of Healthy,” a podcast series brought to you by Sanford Health. I’m your host, Courtney Collen with Sanford Health News. I’m so glad you’re here.
In this episode, we are having the girl talk. This conversation is all about puberty. We’re diving into what it is, but also how to approach, navigate and get through what can sometimes feel like an awkward or uncomfortable conversation with the daughter or preteen in your life.
I am so excited to bring in Dr. Amy Kelley, an OB/GYN at Sanford Health, who specializes in pediatric and adolescent gynecology. Dr. Kelley, good to see you.
We know this is a time of understanding yourself, your body growing and transitioning into the next phase of your life, but the conversation with a parent or caregiver can be awkward. So I want to start with this. What is physically or physiologically happening in our bodies during puberty, and what are some of the earliest signs in girls?
Dr. Amy Kelley (guest):
It’s interesting because I don’t think it’s awkward, but I suppose I do this every day and talk to people about it a lot. And I think that it’s definitely worth looking in the mirror if you’re going to talk to your kids and kind of say words that maybe you might have a hard time saying. Because if you look and feel awkward, then your kids will kind of look and feel awkward too.
And so the more comfortable you can get yourself versed in kind of the language that you need to use, which honestly is just like our body parts, but there are certain body parts and certain things that we’ve been taught are like really private. And it’s OK that they’re private.
But when you have a kiddo, it’s really important that they know the real words for things like their body parts. So I think that if those things like breasts or vagina or any of those things are hard for you to say without blushing, then looking in the mirror and saying them like a million times and making funny faces at yourself so that you really can say that without blushing will help make the conversation go better.
And if you really can’t do that, then I would maybe consider talking to your kids when you’re getting ready for bed and you’re like talking to them about a bedtime story or something because then it’s dark and so it doesn’t matter as much. Or if you’re in the car, then you don’t have to look at them if you feel really awkward. There you go. Those are a couple of like tips I have for parents.
Courtney Collen:
Good pro tips.
Dr. Amy Kelley:
But I think that you know, puberty is a time when basically your child is going from being a child to being an adult. And so their entire body, including their brain, changes a lot. And so it’s about maturing certain organ systems, the reproductive system in particular, but also other things.
Your kids grow taller, they start making pubic hair, they start smelling more like adults. And their brain changes quite a bit and matures. So, it really is kind of an all-encompassing thing. It’s not just about your reproductive organs.
Courtney Collen:
So when would we typically start to see some of these signs in young women?
Dr. Amy Kelley:
Yeah, so really anytime between about 7 and 13 would be pretty normal. African American girls and Hispanic girls often do go through puberty a little earlier. So sometimes they even will exhibit signs at like 6.
But typically I tell people if it’s before 7 they should probably talk to their pediatrician. If they haven’t started any puberty signs by 13, they should also talk to their pediatrician. But there’s a wide range of what’s normal.
Typically girls will, you’ll see breast development first. Although some girls will get underarm hair and pubic hair first. One of those two things is usually what comes first.
Courtney Collen:
How can parents distinguish between normal development during that kind of normal age range and something that might need medical attention that might be a concern?
Photo by Sanford Health
Dr. Amy Kelley:
Yeah, so honestly, sometimes it’s hard to know. And so I think just being able to talk to your pediatrician about it is really important and making sure you’re going to your well child visits during those years to make sure things are developing normally is really important.
But really because of the wide age range that puberty happens, there’s a huge breadth of what is totally normal. And so it’s really hard to generalize that, but I would say if you’re concerned about it, you should just talk to your pediatrician. But average is between 8 and 13 for starting to get breast development or pubic hair.
Courtney Collen:
Talk through some of the biggest, most common misconceptions about puberty.
Dr. Amy Kelley:
I think that a lot of people are like, my kid is crazy or super emotional. And some kids are so, I mean, that’s not a complete misperception. I think that there are some kids who really do fine and don’t have mood issues going through puberty. And so, I wouldn’t assume it’s going to be this huge tumultuous thing for your kid because sometimes it is not. So I think everybody kind of goes through it a little differently.
I think the kiddos who have the hardest time are the kids who are really early or the kids who are really late. Because middle school is all about “am I normal? Am I lovable?” Those are like the things your brain is trying to figure out in middle school. And so, to have puberty happening at that time too is difficult. It’s a lot. It’s a lot.
Courtney Collen:
I know we’ll get to kind of the emotional and social development that someone might be going through during that time, so we’ll get to that in a little bit. But talk through maybe how do hormonal changes affect puberty?
Dr. Amy Kelley:
When you go through puberty, your ovaries turn on and you start making estrogen. And for some people estrogen is a huge mood changer. You know, like it will make them, it makes them a little bit more emotional.
But the other thing that’s going on is your brain is changing. And so the part of your brain that kind of functions to control emotions gets a lot bigger during puberty. And so, you know, something that was not a big deal, like I stubbed my toe, it hurts a little is not a big deal before puberty. But suddenly when your part of your brain that controls emotions is getting bigger and you throw some estrogen in there, then suddenly, I stubbed my toe, ouch and tears, or this person said something mean to me and tears, when normally maybe it wouldn’t have caused that.
But it’s that filtering of everything through that emotional part of the brain that sometimes makes things very dramatic.
Courtney Collen:
Like exacerbates everything.
Dr. Amy Kelley:
Yeah. It’s like it puts an exclamation point on everything. And the hard thing is that your frontal lobe, which is the part that kind of controls like your actions, is not completely developed. So if you think about you have this emotional like machine in your brain that throws extra emotion into everything, but you don’t have the frontal cortex to control that emotion, that’s really why some teenagers get very, seem very “hormonal.”
It’s not necessarily even about the hormones. It’s also about the changing brain. And I always tell parents that that means that you are their frontal cortex. So, they are not going to think about the consequences. They are just thinking about the emotion of it right in the moment.
And so part of being a parent of teens is helping them slow down that emotional part and think through the logical. Like, that person is mad at me, but that doesn’t mean they’re not my friend. Or I’m really mad at the math teacher, but I still have to do my homework because I still want a good grade. You know what I mean? Like, so that is kind of the hard part of being a parent of teens is that you are their frontal cortex until they have developed it, but you can help them develop it by making them walk through the consequences of what they’re doing.
Courtney Collen:
That makes so much sense. And it’s such good insight. And you are in the thick of it with what, 18-year-old twins? Right now? And a 13-year-old.
Dr. Amy Kelley:
Well, he’s not quite 13. He’ll be 13 in a month.
Courtney Collen:
You are a seasoned pro at parenting, I’m sure, for this stage of life.
Dr. Amy Kelley:
Well, giving advice is different than taking it, you know. We’re very good I think at giving other people advice and sometimes it’s a little harder when it’s you. But yeah, I mean I understand the what’s behind some of those things. Yeah. It doesn’t always make it easier to deal with as a parent, just knowing that though.
Courtney Collen:
And of course we’re talking about, you know, you have boys and we’re speaking about girls and it’s a little bit different. But that kind of, that frontal cortex, that idea is it could be for both.
Dr. Amy Kelley:
The planning part of your brain isn’t fully developed until 25. And so, when we think about older teens and how sometimes they don’t make the best decisions too, that’s really kind of why – that frontal planning cortex isn’t completely developed.
But again, it’s our jobs to help develop that by making our teens and young adults walk through the consequences of their actions so they can make better choices. If they’ve thought about it, then usually they can make pretty good choices.
So I think the other thing I think’s really important with teens is talking about the things that you’re worried about. Like if you’re worried about there are drugs out there, there’s smoking, sex, whatever it is that you’re worried about – as your kids become teenagers, not talking about it doesn’t really help because it’s still out there.
But talking about it and saying, this is what we expect, you know, as a family, these are our values and this is the behavior that we’re expecting of you or the choices that we’re hoping that you will make. And talking about what are you going to do in the moment? Like, you know, what would you say to a friend? How would, if you want to say no, how would you say no? If you needed to call me, how would you call me? Because a lot of times if you’ve thought through a lot of those things beforehand or they’ve thought about it, they’ve made a pathway in their brain. If I need help, I can call my mom about this or I can say no to this friend. Or I can say no to my boyfriend if I don’t want to have sex.
If you’ve never talked about those things, they have no pathway in their brain to make a good decision.
Courtney Collen:
I feel like that’s just such a great approach to parenting this day and age because there’s so much going on. Yeah. And with social media at play, you know, having that conversation just authentically approaching conversations and talking through things and how we feel and what we’re concerned about. I feel like that’s just a great way to connect with your child and build that foundation. I mean, is that true?
Dr. Amy Kelley:
Yeah. And you don’t want it to just be like one talk. Like a lot of people talk about the sex talk, but really if you’re doing a good job with that, it’s not one talk; it’s over time. You may have a talk when they’re 8 or 9 about puberty, yes. And what to expect and maybe what sex is very basically.
And then as you get older you add more to it and you use things like, the neighbor is pregnant, how do people get pregnant? You know, and then talking about, or you watching a TV show and there’s a teen pregnancy on the show. Well that’s a great little in to be like, Hey, do you know how to prevent pregnancy? Yeah. And have we talked enough about that? Do you have questions about that?
Courtney Collen:
And it’s age appropriate.
Dr. Amy Kelley:
Yes. As you go through. But I think that sometimes people have a misperception about what age kids should know this stuff because unfortunately with social media, the average age that somebody runs across porn on the internet is 11 and usually it’s something silly like when will I have breasts? Or, you know, like it’s questions about things they want to know. Yeah.
But we all know if you Google, when am I going to get boobs? What are you going to get on the internet? We all know what you’re going to get. But when you’re 11, you don’t know what you’re going to get. And so I usually talk about 8 is great, 9 is fine, 10 is too late. Now it’s never too late. But usually by 10, kids know more than you think they know and then you have to reteach them some stuff.
So it’s so much easier when they’re 8 or 9 because they’re not embarrassed because they don’t really know that much. And it’s actually easier because you just approach it from a science standpoint and isn’t this cool how babies are made? And they might be like, “ew, gross.” But they might be like, “that’s cool.”
Courtney Collen:
Absolutely.
Dr. Amy Kelley:
And they’re not going to be as embarrassed about it. The longer you wait, the more embarrassed they’re going to be to talk to about it.
Courtney Collen:
And they might think they know and then you’re there to basically clarify what they think they know is right from their friends who have older siblings who may not know the full, you know, the full scope of things. So you have to juggle that too on top of catching them up.
Dr. Amy Kelley:
Yeah. And you want to be their safe person. You want to be the person that they come to with questions, not their like – yes, they’re going to go to their friends with things too. But if you are willing to talk about those things and not judge their questions and you know, not get upset that they’re talking about those things, you are going to be their safe person and that’s what you want to be.
Courtney Collen:
Let’s shift to having the talk now, Dr. Kelley. When is the best time for parents or caregivers to start talking to their daughters about puberty?
Dr. Amy Kelley:
So I would really say like around 7 or 8. And honestly, if you’re an African American and you’re seeing some signs of puberty in your daughter or your daughter is African American, whether you are or not, if you’re seeing some signs around 6 or 7, then you probably need to talk to them at that point.
And really the first signs are going to be pubic hair or underarm hair or some breast development. And because once that happens, you’re kind of on a time clock. So, most of the time after breast development, you’re going to get your period between two and three years after breast development starts. OK.
Now, sometimes for certain reasons it’s a little bit accelerated and it’s a little less than that. Sometimes it’s a little more than that. But the average is about two to two and a half years. And so you kind of know when you start seeing that, you’re like, “oh, I’m on my timeline now. So, we got to talk about that in time for the period.”
So I don’t think you have to tell them everything at once, but I do think like telling them, “Hey, have you noticed this? I’ve noticed that you have some dark hair in your underarms. Did you notice this? What do you think of that?” And kind of just asking them how they’re feeling and going from there. Like, do you know what that means? And talking about how they’re going to start going through what we call puberty, which is how you become a teenager and then an adult.
And girls, because they usually go through puberty first before boys, I think that it’s even a little bit more important to have that conversation on the early side. Schools, you can’t rely on the school to tell your daughter she’s going to get her period. And the reason why is because some schools will do it in fourth grade, some do it in fifth or even sixth grade. And if you’re 11 or 12 in fifth and sixth grade that your kid might already have their period by the time the school has talked to them. Particularly if you’re African American or Hispanic.
And so I think it’s really important if you see any signs to kind of start having that conversation.
Courtney Collen:
You had some great tips about ways to approach like body hair, underarm hair, specifically or growing breasts and then approaching that kind of age appropriately. Are there any other like good tips, age-appropriate tips, ways to explain that first period or body changes?
Maybe when we get a little bit older to 7 or 8, say, or 9, would you still approach it the same way, kind of like, “hey, have you noticed this? How do you feel about that?” Any other tips along those lines for parents or caregivers?
Dr. Amy Kelley:
Yeah, I think that I would just kind of start with the same kind of thing. Sure. And then, you know, talk about when, like if you’re a mom, you can say, “I experienced that too when I was going through puberty and these are kind of the things that are going to come next,” and talking about how breasts may grow enough that maybe we’re going to have to talk about getting a bra for you. And hey, once you have underarm hair, you might smell weird. Like you are going to sweat more and maybe we should think about deodorant and like doing something along those lines.
There’s great books out there to kind of help with that. So if you have kind of a more introverted kid who maybe wants to read about it, there’s lots of different age, good age-appropriate books. The American Girl Doll series is kind of a classic. But there’s, it’s called “There’s Something New About You” and it’s really made for like that 8-ish age range, 8, 9. And then there’s actually follow-up books to the American Girl Doll books. Like there’s two more for older kids, but of course sometimes kids outgrow dolls.
So, another great book series is called “Girlology.” It’s like biology but “girl” instead. And it’s written by an OB/GYN and a pediatrician together. And there’s three in that series and one of them is about puberty for like ages 8 to 11. There’s one that’s kind of a middle school book that’s a lot about like sex and consent. And there’s one that’s for older middle schoolers, early high schoolers that’s a lot about contraception and protecting yourself and making good choices.
So I really like that book series too because it definitely kind of grows up with your kids since there’s three different ones.
Courtney Collen:
Great resources. Thank you for that.
We kind of touched on this at the beginning of the conversation, Dr. Kelley, but what advice would you have for parents or caregivers who feel uncomfortable or unsure about how to start the conversation? And you kind of gave some great options, like if you feel this way or that way, maybe in the car, it’s casual or maybe before bed it’s dark, you know, less eye contact.
Dr. Amy Kelley:
Those are two ways to kind of, if you feel uncomfortable to kind of allow you to not look at your child or if it’s in the dark. Like you may, they may not see if you’re a little bit uncomfortable.
But I think just starting with the basics and let them lead the conversation a little bit. You know, a conversation at 8 about puberty and sex is very different than a conversation at 14 or 15. And when I talked to my kids about this, like we were laying down in bed and one of them had asked me a question about the neighbor being pregnant. And I’m like, OK, this is it. This is it. I’m going to do it.
Courtney Collen:
Your day has come.
Dr. Amy Kelley:
My day has come and they were like 8-ish, 8 and a half. And I was like, “Hey, you asked me how people get pregnant because you know, our neighbor’s pregnant or I think it was maybe even the dog, like their dogs were having puppies or something and somebody was with child or somebody was with child or puppy. And I said, so like, let’s talk about how that happens.” And I was just very scientific about it, you know, like, this is how babies are made. It’s like super cool. It’s, and you know, sex is something that happens only between adults. And I told them like the name, like use the names of their parts. You know, I use the word penis, I use the word vagina. Because actually unfortunately the age of sex, average age of sex abuse is 9. And so that’s kind of the other reason that I recommend your kids know the basics about sex at 8 or 9 is because it can help protect them.
Courtney Collen:
And it includes like the names of the actual body parts.
Dr. Amy Kelley:
It’s important because your kids have to know the names of their body parts because if something happens to them, they must be able to tell you what happened. And to tell someone else what happened. And if they don’t know the right names, that can lead to confusion and misunderstanding. If they tell like a teacher or something.
I actually had somebody who called their vagina pocketbook and told their grandma that someone was hurting their pocketbook and their grandma didn’t know that was the name and so it kind of delayed that being found out. And so I always tell people kind of that story, like you have to tell your kids the real names of things.
But also like if you tell them if they know what sex is and they know what makes babies and they know it’s only for adults, like literally that’s totally all they need until they’re like 11, 12. Then I think that it also helps protect them. Like if someone tries to trick them. They can be like, no, my mom said that’s only for adults. Like, why would I do that? They can kind of help protect themselves.
But puberty wise, that’s kind of how I cleared the fence over to puberty and I was like, remember you guys are talking in school of like, the girls are going to talk to the health teacher about periods. And I’m like, remember how we talked about what happens when you make babies and how the sperm and the egg have to meet? I said, you have to go through puberty before you can have sperm and eggs. And the way that girls get those is this, and I kind of talked about the menstrual cycle with them.
And some, some people are like, well, why would you tell boys that? But because they should know. Because they should know what happens.
Courtney Collen:
Because then they get into their 20s and they start having a girlfriend and they’re like, what’s going on with your body?
Dr. Amy Kelley:
Yeah. Honestly, I really think when they’re young too, you don’t have to tell them all the details. And you can kind of let them ask you questions and let them lead you down what they think is important too.
And it’s interesting. Kids will react in very different ways. I had one twin who was like, “la, la la la, la I don’t want to even talk about it.” And then I had one who was very, very scientific. Like, he had a microscope and he was like, can I look at sperm and eggs under my microscope? And I was like not easily. Like, well, let’s put that on ice for now. It was just interesting. Kids do react different, and they might, they’re going to react a total, maybe completely unexpected from what you thought too. That was not what I thought my kid would say.
Courtney Collen:
Could your twins be any different?
Dr. Amy Kelley:
Right. They’re totally different.
Courtney Collen:
But at least they’re getting, and you know, it helps to have a mom who’s an OB/GYN. But I mean, any parent can really kind of fill their son or daughter in when they feel it’s appropriate.
And especially for young men, even though, you know, we’re talking specifically about girls. Informing them about what’s going on. I just went to a period pad donation drive where organizers were collecting tampons and pads and a dad brought his boys in. They were at that age where they were starting to learn about what happens as women go through puberty and they were proud to pass along their donations, a big case of tampons and pads.
And that’s awesome. Other people in the community. And I was like, yeah. Like, go dad. And or you know, whoever might be in their family having the conversation with them. But it’s a good thing. It’s OK to spread awareness about.
Dr. Amy Kelley:
Well, and I remember when I was in middle school and unfortunately your period isn’t regular a lot of times when it starts and it surprises you and like, yeah. We had girls who, you know, would have like red on their pants or obviously got their period when they weren’t expecting it and it’s like, can be really embarrassing. Then you’re known as the girl who bled on your seat.
And like, and I don’t want my kids to make fun of people for that. I just want them to help them. So I think that that was like one of the big reasons why I thought it was really important for everybody to know about periods. Totally. So they can have that empathy for other people. And, you know, hopefully not make fun of girls.
Courtney Collen:
Just be more aware and understanding. Yeah, absolutely. At the end of the day, kind at least. Yeah. Right.
Dr. Amy Kelley:
Absolutely.
Courtney Collen:
OK, you just brought up a good point. You don’t really know when your period’s going to come, right? Yeah. Between that age range, so it could just come in at school, you don’t know, you absolutely could find some blood in your underwear.
Do you have any advice for moms or caregivers sending their kids to school? Should they have a little Ziploc bag with an extra pair of underwear to stay in their locker? Or a, you know, maybe a pair of period underwear, which are fantastic. Anything that they can take and when should they start maybe thinking about that?
Dr. Amy Kelley:
Yeah, I think probably somewhere between 12 and 24 months after your kiddo maybe starts getting breast development. So typically, they’re going to get their period, like I said, about maybe two to three years after they start breast development. And so kind of when you start to get close to that two-year mark, it’s probably not a bad idea to have like a go bag. And if you’re not sure what to put in a go bag, like you can go to the internet. It will help you.
Courtney Collen:
As it does.
Dr. Amy Kelley:
There are plenty of companies that sell little first period like kits. But you can make your own too. I mean you don’t have to buy one. But having just, like you said, an extra pair of underwear or, like a pad, making sure they know how to use them. Like you know, where the pad goes in their underwear. And just kind of going through that with them really might help alleviate some anxiety.
Because hopefully you’ve talked to them and they know, hey, my period is going to come soon. Like probably in the next six months to a year. And so I’m just going to have this in my backpack just in case.
Courtney Collen:
And hey, if you’re like a crafty or Pinterest-y type of mom, maybe you get all the things and you decorate it and you put it in a little discreet box and you say, “Hey girlfriend, like let’s talk about this and I’m going to give this to you when you need it.” And it’s like, you know, it’s just like part of the conversation.
Dr. Amy Kelley:
Yeah, the other thing is, I think it’s not a bad idea to just have like a little kid at home that maybe has some period underwear, some different kinds of pads and maybe if you have a swimmer or gymnast or something, maybe a couple of different tampons just so they have like a variety of things that maybe they want to try.
Just a note for parents who have health savings accounts you can get reimbursed for period underwear and periods. So a couple companies, Thinx and Ruby Love, take HSA money. So just FYI parents, you know, I mean that or flex spending money, which is a super nice thing to know.
Courtney Collen:
Either way, insurance related. Yeah. Fantastic. Because I can’t say enough good things about it. And that’s a whole other conversation like the menstrual cups and the period underwear which have come so far in comfort and style and anyway. I’m sure perfect for those adolescent girls.
So we talked about the internet and being able to find resources there. Let’s talk about social media and peer influence. They have a lot to do with shaping our young people today, Dr. Kelley, which can be a good thing or a challenging thing. How is social media in influencing how girls perceive puberty and body image today? What are you noticing in conversations with your patients and their families?
Dr. Amy Kelley:
I would like to say it doesn’t have as much of a role, but I don’t know that that’s always necessarily true. But I’m a big proponent of wait until 8, meaning wait until eighth grade before getting a phone because we definitely know that it’s not good for mental health of teenagers now.
In all honesty, my twins got their phone when they were in seventh grade, so I kind of like jumped the gun a little bit there, but they did not have social media until they were 16. I would really encourage parents to do their best to kind of wait until their kids are older for social media.
Honestly, that’s hard because they can kind of sneak it in, you know, I mean unfortunately it’s – kids are smart. And even with barriers that you put up for them, like they figure out how to get around them. So, you know, that that can be a hard thing.
But I do think it’s totally reasonable to monitor your kids’ social media accounts and until they’re 16-ish if they have them. Because you want to know what’s going on there and that they’re safe. That’s the biggest thing. But I think that unfortunately it is really hard to figure out sometimes what is good information and what is not good information.
There’s influencers, particularly in women’s health who, you know, they’re trying to sell things to you. And they’re not necessarily giving you good information. They’re just trying to sell you things, whether that’s supplements to make your periods better or, you know, to make you feel better or whatever. And so I think that letting your kids develop a healthy dose of skepticism is not a bad thing. Or at least having them, like every time they’re getting information from the internet, thinking about who’s giving me this information? Who’s paying for the website? What are they trying to do?
Because if you have that mindset rather than “Oh, this influencer is telling me the truth and they’re a great person.” Maybe they are a great person, but they’re also an influencer trying to make money. And so I think that, you know, having the sense to go through those kind of things and sometimes adults aren’t very good about that either. We’re working on it. So maybe we all need to think about that a little bit more: if somebody is trying to sell us something they make money from, maybe be a little skeptical of that.
Courtney Collen:
Yes, a hundred percent.
Dr. Amy Kelley:
But I think that I’m hoping that with time and us knowing that social media is not great for mental health of young people. That hopefully we can continue to maybe put that off until middle-late teens.
But yeah, I think that you’ve just got to have your button in there all the time. If you’re letting your kids have some social media, you got to like, be following them in front of things, things you got to know of who their friends are and try to – it’s so, so hard because they’re always one step ahead of you. It’s rough.
Courtney Collen:
Especially when it comes to social media. And that was my next question about filtering out misinformation. How do we do that and help them develop a healthy self-image? But it really sounds like, you know, when it gets down to it, just making sure you’re having that open, honest conversation or at least keeping that line of communication open. To allow them to ask questions.
And then maybe when they do see something, they’re comfortable to approach you about it and then you’re getting in front of it to like clarify or kind of dispel some misinformation. Or at least helping them build that healthy dose of skepticism, like you said. Which is always a good thing.
Dr. Amy Kelley:
Well, and I always try to give my patients and my kids websites that I know are good because there’s, especially with reproductive health, there’s several studies that show at least 50% of reproductive health websites have misinformation on them. So you do have to be really careful.
So I usually am always trying to encourage parents to go to places that I know have good information and the people that pay for that website are people who are trying to help, not sell things.
So I really like Young Women’s Health, which is a website from Boston Children’s Hospital. And you can literally go to Young Women’s Health and you can like search almost anything you can imagine and they have a little blurb about it with other resources. You can type in eating disorder. You can type in periods. Or they have a really good tampon video that goes through anatomy and shows people how to put tampons in. Love it. So I really like that website. A lot.
And there’s some other really good ones out there as well. But I think that giving people good resources can be helpful because I know they’re going to Google stuff. So I might as well give them a good website to look at that I know is accurate.
Courtney Collen:
Absolutely. Which they can get in the same place that they’re getting their social media information too, so. Absolutely. Yeah. Good information.
Safety and awareness are so important in our youth, especially in women. We know that we talked about it a little bit at the beginning. Why is it important to include discussions about consent, boundaries and abuse in puberty type education? I mean, one of the tips you had was to use the actual body part names, which helps lay that foundation. But why is it important to include some of those other things and how would you include that?
Dr. Amy Kelley:
In today’s world, like consent is, is absolutely needs to be taught from the time your kids are little. So that is something you can start teaching them as soon as they can talk. You know, like they don’t have to give hugs to people they don’t want to give hugs to. That’s their choice. You know, like these are there when you’re teaching them to toilet train, you know, mom’s helping you wipe, but nobody else really needs to help you here. And if Mom’s with you and like we’re at the doctor’s office or something looking to see if there’s a problem, that’s OK. But otherwise nobody else needs to be touching or looking here.
And as they get older just talking about how this is their body and they get to decide what happens to their body that I think that that’s just a really important thing. But it’s definitely, you don’t have to wait to link it with sex. You can link it to like, everything in life you need consent for, you know? Yeah. So I think starting when they’re little is good for that.
But safety things. We had a couple of rules in our house, when my kids got access to the internet, if you find something scary, you come talk to Mom about it. Mom’s never going to be mad because sometimes you can end up in weird places on the internet. We couldn’t have internet in our rooms. Like it had to be in spaces that everybody could be in. So you know, they’re not looking at things that they wouldn’t want you to see as you walked by.
But also, like, you don’t friend people you don’t know in real life. You don’t play games with people that you don’t know in real life. Now as my kids have gotten older, that’s shifted because now they’re old enough that they can make some of those choices on their own and I’m not so strict about it.
But I think that those kind of rules are really important to keep your kiddos safe. And schools are doing a much better job with that than they used to. You know, my kid that’s younger, he knows you don’t give your real name on the internet if you’re talking to somebody. And I’m like, we only talk to people we know in real life, but you know, they have taught him at school, you don’t give your address to anybody. You don’t give your full name to anybody. You don’t give your phone number to people. You don’t tell them all these things. And so I think schools are starting to catch up a little bit with some of that safety stuff.
But I think having some parameters and boundaries around the computer, but also like having boundaries around yourself. Like what is acceptable behavior? Is it OK for people to say mean things to you that you’re going on a date with? No, it’s not OK. Definitely putting boxes around what behavior is OK with dating is I think an OK thing to do as they get to be teenagers too. Whether you have some rules about dating or whether you just have, you know, rules about this, like, I want to meet this person first. That’s OK. Or, this is what I want from a relationship.
It’s not ever OK for somebody to hit you. It’s not ever OK for somebody to call you names. And just kind of knowing that. But then we have to also, as parents, we also have to model that for our kids. And so our kids learn relationships from us. And so that sometimes means that you get a little microscope on your own relationships, which can sometimes be hard because then you’re teaching them, but maybe you’re not showing them some of that – how you should be treated or how you want to be treated.
So I think that like, it’s also really important to model those behaviors. And that can be a little bit harder. It’s much easier to be like, do what I say, not what I do, you know, but your kids will pick up what’s going on with your relationship. So I think that it’s also important if your relationship needs some work, as your teens get older, I also think it’s OK to be like, yes, you know what, you’re right. Dad spoke to me really meanly and we should probably talk about that and we will take care of that. But that’s an adult thing. It’s OK to be like, yeah, we’re not perfect and we’re working on it.
Courtney Collen:
Absolutely. Kind of like you can’t always control what happens in the situation, but how you react and respond to it and then look back on it is a great teaching moment.
Dr. Amy Kelley:
Yeah. In a lot of cases. So yeah. But it’s hard. I think if you look at relationships in general, like teen, there is some evidence that there is more violence both emotionally and physically in relationships under 20, when you’re under 20.
And so I do think that you have to be like on the lookout for that and make sure that your kids are safe in their relationships. But I also think that one of the other things I often just caution parents about is dating someone much older, especially for young women. So since women do go through puberty earlier, sometimes they get treated as older than they are. You know, a 12-year-old that’s gone through puberty could look like a 16-year-old too. And so they often get attention from older men who may or may not realize their age.
I think that it’s also teaching our daughters about boundaries with everyone is important. But also like letting them be kids. And so, you know, maybe your 14-year-old doesn’t need to date the 18-year-old. That’s hard to police, but I think you do have to just be aware that they’re more likely to have sex early if they’re dating someone who’s more than two years older than them. They’re at risk for an unplanned pregnancy.
So I think that us just being aware of what those risk factors are is important too. I mean, it’s so hard to be the parent of a preteen and a teenager, and there’s nothing that prepares you for it either. Like there’s not a class you can take. So I think that we all just need to also just be kind to each other as parents as well.
Courtney Collen:
I have a 2-year-old at home and I feel like I’m going to blink and then have this conversation in a few years with her. I’m going to be calling you to come in and like be my sidekick for this. And I have another little girl on the way, so I’m like, oh my gosh, this is going to be double trouble.
Dr. Amy Kelley:
We all need a village to help raise our kids. And fortunately, it is not us alone that is raising our kids. Right. You know, social media is, all of these other things are, and so I do really think parents get way too much of judgment.
And so, especially if parents are listening to this, they’re like, oh my God, I gave my kid a cell phone at in sixth grade. Oh my God, I’m terrible. No, you’re not terrible. We’re all just doing the best we can. And I think trying to, especially as a physician and primary care doctors, I think we have to also have lots of grace for parents. I think we all love our kids. We all want what’s best for them. And we’re all trying to do the best we can. So I try not to judge other parents. It’s just a hard world out there.
Courtney Collen:
So exclamation point. Yeah. For sure. We are doing the best we can and the world is changing every single day. And we never know what tomorrow’s going to bring. But again, when it comes down to it, having that line of open communication, keeping that open no matter what type of household you’re in, what type of situation you’re in that relationship with, you know, if you’re caring for an adolescent girl, or it’s your daughter, granddaughter maybe, you know, that’s important. What else would you say to parents as they kind of think and we wrap this up?
Dr. Amy Kelley:
I think I would say two things. One is that your kid is going to grow up and be an adult. And I think thinking about what kind of adult you want to help them become. They’re going to become an adult that maybe you don’t anticipate. Like your kids aren’t going to be exactly what you think they’re going to be. But I think helping them become what they want to be is really important.
I always tell parents that connection is what protects your kids. So connection equals protection. So I think we’re all so worried about protecting our kids from all these other things. But they’re going to get exposed to that. They’re going to grow up. They’re going to see all these things. So we need to teach them how to deal with all the things in the world. So connection allows you to help protect your kids because they will come to you. And you are their safety. And so, if you can be that, that’s how you’re going to protect your kids by having that strong connection to them.
Courtney Collen:
I appreciate this conversation. So valuable and such a great resource for our listeners. Dr. Kelly, thank you so much for your time and for all that you do in the OB/GYN space in the adolescent space and of course being a resource for us here. Thank you so much.
Dr. Amy Kelley:
Yeah, of course. Thanks for having me.
Courtney Collen:
This was another conversation in our series, “Her Kind of Healthy” by Sanford Health. A reminder you can find any of our Sanford Health podcast series wherever you listen and anytime at news.sanfordhealth.org. I’m Courtney Collen. Thanks for being here.
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Posted In Children's, Family Medicine, General, Gynecology, Health Information, Healthy Living, Parenting, Sioux Falls, Women's
