Teenagers: Maturing and “THE Talk”
Having “The Talk” about sex is important parenting
Growth, Development, “Mature” Conversations
Important, Inevitable, Necessary Parenting
by Gregory A. Barrett, M.D.
Adolescence, the period in which a child evolves from innocent, trusting pre-pubertal being into a mature, independent adult, is amazingly complex. The two principal dynamics working in parallel during this process are the physical and the psychological, and in order to understand what’s happening it is invaluable for a parent to have a working understanding of each. Let’s start with the simpler one first, their bodies, and then undertake the daunting task of attempting to examine what’s happening inside the adolescent brain.
Sexual maturity is defined by precise physical findings known as Tanner Stages. Now in truth I really don’t know much about this Dr. Tanner, but I suspect he was the first physician who was able to successfully take serial snapshots of the genitalia and breasts of developing teens and thus was immortalized by his photographs.
At any rate the progression of Tanner Stages can be summarized as: big, bigger, biggest, and some, more, most. The initial evidence of puberty in boys is a subtle enlargement of the testes with subsequent increase in size of the penis and growth of pubic hair. In girls the breasts usually enlarge prior to the appearance of pubic hair, although occasionally the order is reversed. But whichever comes first, once things start happening there follows an orderly progression ultimately resulting in the typical adult appearance.
Puberty, Teenagers and the Sex Talk
Both the timing of the onset of puberty and the rate of evolution varies dramatically between the sexes. On average females begin to develop approximately eighteen months earlier than their male counterparts, a fact which leads to a considerable amount of weirdness in fifth and sixth grade. The very onset of puberty in girls triggers an immediate, dramatic increase in height. Typically, they will shoot upwards at a pace of three to five inches per year for the ensuing twenty-four months. At the end of this growth spurt initial menstruation occurs. I believe God designed it that way in order to give mothers two years of forewarning, hopefully an adequate amount of time to prepare and figure out how in the heck to handle the situation when it finally occurred.
My wife asked me in my role as a physician for any advice I might have to offer on dealing with our daughter’s imminent first period and I, of course, being a typical male, replied, “Are you kidding me?!? Huh-uh! No way am I getting involved! I mean, come on, you’re the female here. That’s your job.”
We were actually quite fortunate in the Barrett household that Rachel’s mom was something of an expert on this matter courtesy of having shown the “sex movie” and answering questions from fifth graders for a number of years in her role as an elementary guidance counselor. I mean, one would assume she must have learned something, right? And, sure enough, when the big day finally arrived the two of them appeared to have handled the challenging life event quite well.
There was one rather cute story that came out of this. Checking on Rachel in bed the night of her initial period my wife noticed that her newly grown-up daughter was crying a little.
“Honey, what’s wrong?” she asked, rubbing her shoulder.
“I just feel sad, that’s all,” sighed Rachel.
“And why is that, sweetie?” inquired the counselor mother, wondering if she had failed somewhere along the line or had inadvertently given some faulty advice.
It took a little coaxing but eventually Rachel blurted out what was bothering her was that she was afraid her daddy wouldn’t hug her anymore.
My wife dutifully relayed the message to me, and needless to say I was fully prepared and waiting in the kitchen the following morning. When my daughter glumly clumped downstairs I smiled and said, “Hey, Princess, don’t you look nice today!” and proceeded to give her a long, tight, heartfelt squeeze I’m sure she felt right down to her bones. My eyes got a little wet, and I will never forget the smile of relief on Rachel’s face.
The onset of the first period marks an abrupt end to the adolescent growth spurt. Girls are not entirely done, but they are pretty close. Only about two more inches are added after menarche. I have labeled this pattern the Rule of Two. Two years of rapid growth, the onset of menstruation, two more inches added over the following two years, and the final adult stature has been achieved.
Teen Girls
The definitions of both sexual precocity and delay are continually moving targets. It is a fact — females are developing earlier than ever these days. (I think there just must be something in the milk.) Anyway, in these modern, industrial times breast development before age eight or first menses prior to ten are the newly established lower limits for early puberty in females, and any changes in a boy prior to his ninth birthday would be worth noting. Delay in girls is defined as no breast changes before thirteen or periods before fourteen, although in competitive gymnasts, dancers, and the like this is actually quite common and often not a legitimate cause for concern. Nothing happening before the fourteenth birthday in boys is generally accepted as a cutoff point to begin considering a further medical investigation.
The timing of puberty can have long-term effects on a child, and the gender differences are diametrically opposite. For males, early maturers in general enjoy increased popularity, greater athletic and academic success, and better affect, whereas later blooming boys tend overall to have poorer self-image, decreased school performance, and lower goals and expectations. Girls who mature much earlier than their female peers, however, have a significantly lesser opinion of themselves, greater parental restrictions, decreased paternal attachment, and poorer grades. By comparison, and differing completely from the male experience, females who develop much later have a stronger self-image, are more focused on academics and perform better in school and have higher life aspirations. Thus, it is invaluable for a parent with an early developing daughter or a late blooming son to realize the traps and avoid them. Even if your ten-year-old daughter looks seventeen she’s still your little girl and you must treat her as such, particularly you dads out there. And be very attuned to maintaining your sexually immature son’s self-image and spirits while awaiting the inevitable spurt. Also, it certainly doesn’t hurt to remind him that one of these days he’s going to be looking down on a lot of those other guys. His time will come.
Males, in keeping with our tendency to be slower at everything, tend to mosey along at a different pace through puberty. As mentioned previously they begin changing on average roughly eighteen months later than their female counterparts. For the first two to three years the rate of growth in boys is actually only slightly higher than it was back in the pre-pubertal days, and the alterations occurring in their bodies are quite subtle and relatively hidden. It is not until the later Tanner Stages that they really blast off and at last have their height, weight, and strength spurt. Body changes in both sexes follow the “feet first” phenomenon. Initially the hands and feet lengthen, then the arms and legs, and at last the trunk catches up with the rest of the body. The entire journey through the Tanner Stages takes approximately five to six years in males in contrast to the four-year start-to-finish for females.
Father and Son Talk
As our son Keith’s pubertal changes inexorably advanced, my wife decided to extract some revenge for my bailing out so shamelessly on helping her with Rachel and began demanding I have a sex talk with my son. I put her off for as long as possible by feigning agreement (“Yeah, yeah, I’ll have to do that, honey. Thanks for reminding me…again….”), but she was not to be deterred. In all honesty I was fairly assured from several indirect conversations I had had with Keith that he already possessed a pretty fair handle on the basics.
Thus, I saw no legitimate reason in the world why the two of us needed to address this unsavory topic head-on. My wife, however, remained unconvinced, and continued to insist upon extracting her pound of flesh. So it was that on a snowy January evening, the night before Keith and I departed on our annual National Hockey League road trip, she declared that the time had come for me to man up and have the dreaded sex talk. The time for procrastination had apparently expired.
“Well, what exactly is it that I’m supposed to talk to him about, anyway?” I groused.
“You know, sex!” she replied.
“Yeah, I know, sex, but which part? I mean, come on, give me a break. You’ve got to admit that is a pretty large topic.”
“Just tell him what he needs to know.”
“But how do I know what he doesn’t know?”
“You ask!” she cried. “For heaven’s sake, that is what a sex talk is — you find out what he doesn’t know and then you explain it.”
“Why does it have to be me, anyway?” I whined, stepping into the carefully baited trap.
“Because I handled menstruation with Rachel,” she responded smugly. “Now it’s your turn. You are his father, and this is your responsibility.”
“Hey, I offered to talk to Rachel about periods,” I lied.
“You most certainly did not!”
Darn. She remembered….
“Well, what’s the minimum I have to discuss with Keith?”
“The minimum?!?” she exclaimed, her frustration with me mounting by the second.
“Yeah, the minimum. You know, what’s the very least we have to talk about?”
“Wet dreams!” she said in exasperation. “You must at the very least tell him about wet dreams! You cannot put this off any longer, Greg, and I’m being serious. This is your responsibility, and I absolutely insist you talk to him this weekend.”
“Good lord,” I muttered underneath my breath. “Wet dreams…”
The gauntlet had been thrown. Escape was no longer possible. Keith and I were going to have to have “the talk,” and I was dead certain it was going to be a horrific experience for both of us.
I had no opportunity the first day as Keith, being thirteen and in a car, slept all the way from Columbus to Buffalo. We watched the Sabres win their hockey game and on Saturday morning after breakfast we checked out of our motel, tossed our suitcases in the trunk, and pointed the car towards Pittsburgh and that night’s contest.
Just before Keith slipped back into his standard comatose state, I cleared my throat and nervously began, “Hey, Keith?”
“What?” he mumbled, settling into his morning nap.
“How would you like to talk to me about sex?”
Perhaps not the smoothest opening line a father had ever used to open the door on this topic, but at least the subject had been broached.
“Heck, no,” he replied, opening one eye and arching his eyebrow suspiciously.
“Well, Mom thinks I ought to talk to you,” I apologized.
“Why?”
“I believe it has something to do with the fact that she told your sister about periods.”
“So?”
(Keith was at that stage of adolescence where almost all of his verbal interactions with his mother or father were monosyllabic.)
“Well, she was pretty insistent that we talk.”
Groan.
“So,” I said, taking a deep breath, “now that we ARE talking about it…”
“We are?”
“Come on, buddy,” I pleaded. “Don’t make this any harder for me than it already is.”
“Hard for you?” he replied in a sudden, prolific outburst of words. “Gosh, Dad, what about me?”
“Well, let’s just get through this.”
Keith sighed heavily.
“Do you have any questions?”
“About sex?”
“Yeah, sex.”
“No.”
“Really?”
“Huh-uh.”
“Are you sure?”
“Yes, I’m sure.”
“That’s great!” I cheered. “Awesome. So, where did you find out about all of this stuff?”
“You know,” he said, waving his hand casually. “School, friends, the usual places…”
“Oh,” I nodded.
Well, I guess some things hadn’t changed after all. Come to think of it, my father had never talked to me about any of this either, and thank goodness for that. Dad was an absolutely brilliant mechanical engineer, but he couldn’t have taught a seamstress how to tie her shoelaces. In fact, if he had even attempted to explain anything to me about sex, I’m sure I would still be harboring several bizarre misconceptions yet today.
“Say,” I said in a considerably lighter mood, the weight of the world having been lifted from my shoulders, “that wasn’t so bad, was it?”
“I suppose. Are we done?”
“Yes, indeed, I believe we are,” I nodded with satisfaction.
Keith grunted and closed his eyes to resume his adolescent slumbers. I had done a pretty good job, if I do say so myself, dispensing with grace and élan my paternal duties. It did help to be a physician, I suppose. I whistled along to a tune on the radio for a while thoroughly enjoying the upper New York state scenery before recalling his mother’s final specific marching orders. Uh-oh….
“Oh, yeah, Keith, one more thing.”
“What now?” he muttered.
“Do you, uhm, like, have you ever, uhm, has it ever happened to you that, uhm, I’m not sure how to put this, uhm, but, uhm, at night, do you, you know, uhm, well…”
“For gosh sake, Dad, spit it out!”
“Do you know about wet dreams?” I finished clumsily, hot blood rushing into my cheeks.
“Yeah.”
“You do?”
“Sure. Now, can I go back to sleep?”
“Yes,” I exhaled. Ahh, he knew all about wet dreams, too! How lucky could a dad get? My wife was going to be very pleased with me. That is, if…
“Hey, Keith?”
“What now?” he groaned.
“Well, when we get home, I’m pretty sure our mother’s going to ask you about this talk, and I was wondering if maybe you could…you know…”
“Don’t worry, Dad”, Keith said sleepily, rearranging himself on his pillow. “I’ve got your back.”
“You’re a good boy,” I smiled. “So, tell me, do you like the Penguins in the game tonight?”
He was already asleep.
Sure enough, no sooner had we returned back home on Sunday afternoon and unpacked than my wife pounced.
“Well,” she sneered, “did you have your talk with Keith?”
“Yes,” I declared proudly.
“Really?”
“Uh-huh.”
“You honestly talked to Keith about sex?”
“Of course,” I replied self-righteously, affecting great offense at this line of questioning. “I accept that it is a father’s duty to explain the facts of life to his son, and that is precisely what I did.”
“Hmm,” she said, regarding me skeptically.
I smiled back at her with a look of pure, guileless innocence.
“Keith!” she called, not taking her eyes from mine. “Get in here!”
“What is it, dear?” I asked.
“Something funny is going on and I intend to find out,” she declared.
Keith reluctantly dropped the TV remote onto the floor and rolled off the living room couch to join us at the kitchen table. Plopping onto a chair he greeted his parents with a sullen, “What?”
“Keith, did your father talk to you about sex on this trip?” she demanded, not wasting a second beating around the bush.
The moment of truth had arrived. Or rather, hopefully, the moment of the little white lie.
“Yeah.”
Whoosh!
“He actually did?” she asked, a shocked expression on her face.
“Uh-huh.”
“Even the part about wet dreams?”
“Yep.”
“Hmm,” she said, shaking her head in astonishment. “Well, was it helpful?”
“Oh, yeah,” he nodded enthusiastically. “Dad was great! He really cleared a lot of things up for me.”
My heart nearly burst with pride for Keith at that moment. What a fine, fine son I had!
His mother stood there staring at both of us in open-mouthed amazement.
“Is that it, Mom?” he yawned. “I’m still kind of tired from the trip” (remarkable in that he had slept forty-eight of the previous sixty hours) “and I wanted to take a nap before dinner.”
“Yes, Keith, you can go,” she muttered, shaking her head.
“Fine,” he mumbled drowsily, lumbering up the stairs to his room.
“Greg, I am so proud of you,” my wife said, stars in her eyes.
“Aww, it was nothing, really,” I replied modestly, more truth in that statement than she would ever suspect. “A dad’s gotta do what a dad’s gotta do.”
Later that evening I slipped into Keith’s room and sat on the edge of his bed, giving him a pat on the leg.
“Keith,” I whispered, “I want to thank you for standing up for me today with your mom. And seriously, all teasing aside, if you ever have any questions about this or any other subject just let me know. I will always be there for you, son. And that’s a promise.”
It was right about then that I detected the steady rhythm of his breathing. My fine speech had been wasted; he hadn’t heard a single word. Keith was sound asleep. Again…
Mother Daughter Talk
I often get asked by parents to recommend a “facts of life” book for their child, but unfortunately, I am generally unable to assist with this simple request. It’s not as if I haven’t researched the subject. Far from it, I scour the local bookstores periodically and have purchased for review any number of these texts, but all of them seem somehow flawed. Stylistically they range from “the birds and the bees” simplistic to coldly clinical to borderline pornographic, and as far as I’m concerned in the final analysis, they are all rather disappointing. It’s not that these books aren’t well-written and well-pictured, and they may actually be quite helpful in their way, but it is unlikely you will find yourself completely thrilled with any of them. The problem is that once one gets beyond “boys have penises and girls have vaginas and this is where things go to make babies” it becomes extremely personal, and each of us will wish to put our own particular slant on the subject based upon personal religious, moral, and philosophical beliefs.
Now, of course, I could write the book myself, but then it would be my book, it wouldn’t be your book, and you probably wouldn’t like mine, either. Here’s how I see it… in today’s world the schools have stepped up to the plate and can be relied upon to do a commendable job presenting the basic anatomic facts, and then the rest is still going to be up to us. Granted, some parents will do a better job (my wife) than others (me) in filling in the gaps, but so be it.
Coincidental with the physical changes occurring during this time are the psychological. For convenience of understanding these steps can be broken down into three distinct stages:
The first stage occurs during Tanner’s One and Two, a time of intense physiological changes in girls and the much less impressive alterations in boys. This is a period of awakening sexual interest but seldom actual activity. Natural curiosity about the opposite sex commonly leads to a need for exploration. The transition can be quite shocking to some parents, and may lead to imaginary exchanges such as the following:
“So, what happened today?” the hypothetical husband asks his hypothetical wife as he tosses his briefcase on the hypothetical couch.
“What happened today, you ask? Well, let’s see. The Smiths are moving, a new Walmart is going into the shopping center west of town and, oh, yes, your son Richard has become a pervert.”
“Huh?”
“Look at this disgusting magazine I found underneath his bed!”
“Hey, that’s my Playboy! How did he find it?”
(Like I said, some parents out there handle this stuff a whole lot better than others.)
Awkward Teens
Besides being pre-occupied with the bodies of the opposite gender there is also an increased awareness of their own, and not uncommonly the Tweens are grimly dissatisfied with what they discover. Intense self-consciousness and awkwardness rule the day, particularly with girls as the fat deposition which occurs during the early Tanner Stages is cruelly unsettling. Kids at this age form same sex cliques and are obsessed with conformity. It is almost comical how they cling to a group uniform while marching around in public imagining they are being so daring and different.
Belonging is all important. Female friendships are dependent upon shared confidences, males upon competition and shared activities, although these classic lines are becoming increasingly blurred. Oftentimes they will select an outside adult such as a coach, a teacher, or a friend’s parent as an important role model.
This can be a time of ambivalent separation. The child will often test things out and then come home and confide confidentially sharing everything in their lives with one of their parents. The mom or dad may find themselves deluded during this calm before the storm, thinking, “Hey, maybe adolescence isn’t going to be so bad after all. Apparently, I have a unique, close, special relationship with my child which is quite different than other parents enjoy with theirs. We’re going to be fine, just fine.”
And they would be horribly mistaken….
Flirting
The second stage coincides with Tanner’s Three and Four and basically can be hell on earth. This marks the arrival of the long-awaited strength and growth spurt for males, menstruation for females, and acne, body odor, and shaving. The teen establishes his or her sexual orientation and commonly begins actual experimentation. Bluntly put, there is a surge in sexual activity.
Thinking becomes more abstract, and conventions are questioned. Kids in the second stage are almost unbelievably (and at times unbearably) egocentric and narcissistic. They experiment not only with dress but often with their actual persona, sometimes switching from one to another with nearly breathtaking speed. Physical attractiveness is all-important. They tend to be brutal to children with visible differences. Family life involves an intense daily struggle for autonomy of which the parents are often only dimly aware. Peers become all-knowing and all-important, and relationships with adults in general deteriorate.
Just when you think the roller coaster ride of adolescence is never going to end, it does. Honestly. The long journey known as puberty does have a conclusion, the third psychological stage and Tanner Five. Growth slows. The erratic, painless, anovulatory (no egg) early periods are replaced by the predictable monthly cycle with its accompanying peri-menstrual symptoms. The formally confused younger teenager has settled on an identity and is at last able to define themselves. But remember, even now this is still a phase of adolescence. It is the time of greatest idealism. Although less self-centered they are typically quite intolerant of the opinions of others. Everything tends to be seen as black or white, no shades of gray existing in their universe. Teenagers (or beyond) in this stage are actively searching for the answers to life’s great questions. Their self-concept becomes more stable; they are at last able to look in the mirror and recognize themselves. An undercurrent of dependency upon the family does continue to exist. Children of this age will return to the family unit for succor in times of stress and self-doubt. Their greatest need is for intimacy as they begin the search for love and commitment. By this time your child is well on their way to adulthood. Congratulations. The worst has passed.
Teen Discipline
The real key to parenting during the teenage years evolves around finding some way to survive the psychological Stage Two. And to do this it is essential to understand what is happening.
The single most critical task for a child to accomplish in adolescence is to break free from their mother and father and become a unique individual. Parents MUST accept this and allow it to happen. This process needs to be done under their guidance in measured steps. The reins should be gradually loosened leading in the direction of steadily increasing independence in reward for demonstrating responsible behavior. However, parents must never go overboard in the other direction, sticking their head in the sand and adopting a “see no evil, hear no evil” approach. They are still your children and are very much your responsibility, and as long as they reside under your roof you are entitled and morally obligated to hold them to a certain standard of behavior. But caution — do not make the mistake of treating your sixteen-year-old like a four-year-old or you will be in danger of losing them altogether. Know how to let go.
Accept it as natural if your adolescents express different values or political beliefs than your own. It is a part of the process, and it’s very likely after everything finally settles years later that their positions will be relatively similar to their parents. Be patient. The differences in opinions, if accepted with mutual respect, can lead to some fun and invigorating discussions around the dinner table.
Tween
When those conflicts inevitably arise resist laying down the law dogmatically but rather consider utilizing the technique known as brainstorming. How this works is one identifies an area of contention and then everyone gathers together, each takes turn explaining their feelings non-judgmentally to the others, and the actors are invited to offer suggestions for possible resolutions which are met without criticism. It may sound hokey but brainstorming can be a highly effective method to use with teens, discovering a compromise solution to the problem while at the same time demonstrating the respect for their feelings and opinions the adolescent so desperately needs. Give this method a shot during the next nuclear storm.
The Second Stage does pass, it really does. Your number one concern during this time should simply be that your child gets through this phase physically and emotionally intact. The greatest danger, by far, occurs when parents lose touch with their child. That is when serious trouble lies right around the corner. And it is incredibly easy to allow disassociation to occur when the door to their bedroom is eternally shut and if not mute they seem to be angrily lashing out at you at every opportunity, belittling all that you hold dear. But believe me, underneath their adolescent disguise this is still your son or daughter, the same child they have always been. So, no matter what else is happening, it is imperative to keep some dialogue going with them at all costs. The topic itself may seem trivial, be it the weather, music, pro football, the family dog, or the crazy lady who lives next door. That is not important. What is important is simply to keep talking. Never allow them to push you outside the range of your voice.
Loosening the reins while simultaneously maintaining a prudent degree of oversight are the keys to survival. Learn to identify problems and try to solve them together. Accept the second stage of adolescence for what it is, an obnoxious but necessary right of passage. And no matter what happens, no matter how bad it gets, don’t ever quit or give up on your teenager.
Always keep the conversation alive.
☤
Gregory A. Barrett, M.D.
Gregory A. Barrett, M.D. to Columbus for college and never left. He graduated from the Ohio State University College of Medicine did a pediatric internship and residency in Columbus and taught at the Children’s Hospital there as well receiving the Distinguished Educator Award by the Ohio State School of Medicine.
He and his wife Darla had two children, Rachel and Keith. His wife of thirty-one years passed away in 2008 from complications of breast cancer and he authored a popular web site, “Real Pediatrics”, dedicated to her memory.