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Magazine

PubertyBeforeAge10:ANew
Normal?
ByELIZABETHWEIL

MARCH30,2012

Onedaylastyearwhenherdaughter,Ainsley,was9,TraceeSiouxpulledher
outofherelementaryschoolinFortCollins,Colo.,anddroveheranhour
south,toLongmont,inhopesoffindingasatisfyingreasonthatAinsleybegan
growingpubichairatage6.Ainsleywasthetallestchildinherthirdgrade
class.Shehadathick,enviableblondstreakedponytailandbigfeet,likea
puppys.ThecurvesofherLevismatchedhermothers.
Howwasyourday?TraceeaskedAinsleyassheclimbedinthecar.
Prettygood.
Whatdidyoudoatarecess?
Iplayedontheslidewithmyfriends.
Inthebackseat,Ainsleywiggledoutofherpinkparkaandlookedinher
backpackforherHarryPotterbook.Overthepastthreeyears,Traceepretty
andwellputtogether,wearingaburntorangeblousethatmatchedher
necklaceandherbaghadtakenAinsleytoseeseveraldoctors.Theyordered
bloodtestsandboneageXraysandturnedupnothingunusual.Thedoctors
alwayscomebackwiththeseblanklooksontheirfaces,andthentheystart
redefiningwhatnormalis,TraceesaidaswedrovedownInterstate25,a

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ribbonofasphaltthatrunsclosetowheretheGreatPlainsbumpupagainst
theRockies.AndIalwaysjustsittherethinking,Whatareyoutalkingabout,
normal?Whogetspubichairinfirstgrade?
Fedupwithmainstreamphysicians,Traceebeganpursuingless
conventionaloptions.ShetriedgivingAinsleydiindolylmethane,orDIM,a
supplementthatmayormaynothelpabodybalanceitshormones.Shealso
startedablog,theGirlRevolution,withamissiontorevolutionizethewaywe
thinkabout,treatandraisegirls,andtheaccompanyingT.G.R.Bodylineof
sunscreensandlotionsmarketedtotweensanddescribedbyTraceeas
natural,organic,craptasticfreeproductscontainingnoestrogens,
phytoestrogens,endocrinedisrupters.
NoneofthisstoppedAinsleysbodyfrommaturingaheadofitstime.That
afternoon,TraceeandAinsleyvisitedtheofficeofJaredAllomong,anapplied
kinesiologist.Appliedkinesiologyisahealingartsortoflikechiropractic.
Practitionerstestmusclestrengthinordertodiagnosehealthproblemsitsa
refugeforthoseskepticalandwearyofmainstreammedicine.
So,whatbringsyouheretoday?Allomongaskedmotheranddaughter.
TraceestrokedAinsleysarmandsaid,wistfully,Precociouspuberty.
Allomongnodded.Whatarethesymptoms?
Pubichair,armpithair,afewpimplesaroundthenose.Somebudding.
Traceegesturedwithherhands,implyingbreasts.Theemotionalstuffis
gettingworse,too.Ainsleysbeengettingsuperupsetaboutlittlethings,
crying,andshedoesntknowwhy.Ithinkshescyclingwithme.
Ainsleyclosedhereyes,asiftoshutouttheembarrassment.Theongoing
questtounderstandwhyheryoungbodywasturningintoawomanswasnot
oneofAinsleysfavoritepastimes.Shepreferredtorturingher6yearold
brotherandplayingschoolwiththeneighborhoodkids.(Ainsleywasalways
theteacher,andshewasverystrict.)

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HaveyouseenWesterndoctorsforthis?Allomongasked.
Traceelaughed.Yes,many,shesaid.Nonesuggestedanycourseof
action.Theyleftushanging.SherepeatedforAllomongwhatshetoldmein
thecar:Theyseemtohavechangedthedefinitionofnormal.
Formanyparentsofearlydevelopinggirls,normalisacrazymaking
word,especiallywhenutteredbyadoctoritimpliesthatthepatient,or
patientsmother,shouldquitbeingneuroticandacceptthatnotmuchcanbe
done.Allomonglistenedintently.Henoddedandtooknotes,askingTracee
detailedquestionsaboutherbirthcontrolhistoryandvalidatingherworst
fearsbymentioningtheextremelyhighlevelsofestrogenmimicking
chemicalsinthefoodandwatersupply.Afterabout20minutesheasked
Ainsleytolieonatable.Thereheperformedalengthyphysicalexamthat
involvedtestingthestrengthinAinsleysarmsandlegswhilesheheldsmall
glassvialsfilledwithcompoundslikecortisol,estrogenandsugar.
(Kinesiologistsbelievethatweakmusclesindicateillness,andthatapatients
muscleswilltestasweakerwhenheorsheisholdingasubstancethat
contributestohealthproblems.)
Finally,heaskedAinsleytositup.Itdoesnttestlikeitsherown
estrogens,AllomongreportedtoTracee,meaninghedidntthinkAinsleys
ovarieswereproducingtoomanyhormonesontheirown.Ithinkitsxeno
estrogens,fromtheenvironment,heexplained.AndIthinkitsstressand
insulinandsugar.
Youcantbemorespecific?Traceeasked,pleading.Liketellmewhat
crapinmyhouseIcangetridof?Allomongshookhishead.
OntheridebacktoFortCollins,Traceetriedtocheerherselfupthinking
abouttheteenagesufferingthatAinsleywouldavoid.Youknow,Iwasoneof
thoseflatchestedgirlsatage14,reading,AreYouThereGod?ItsMe,
Margaret,justprayingtogetmyperiod.Ainsleywonthavetogothrough
that!Whenshegetsherperiod,weregoingtohaveabigoldparty.Andthen

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Imgoingtogointhebathroomandcry.
Inthelate1980s,MarciaHermanGiddens,thenaphysiciansassociate
inthepediatricdepartmentoftheDukeUniversityMedicalCenter,started
noticingthatanawfullotof8and9yearoldsinherclinichadsprouted
pubichairandbreasts.Themedicalwisdom,atthattime,basedonalandmark
1960studyofinstitutionalizedBritishchildren,wasthatpubertybegan,on
average,forgirlsatage11.ButthatwasnotwhatHermanGiddenswasseeing.
Soshestartedcollectingdata,eventuallyleadingastudywiththeAmerican
AcademyofPediatricsthatsampled17,000girls,findingthatamongwhite
girls,theaverageageofbreastbuddingwas9.96.Amongblackgirls,itwas
8.87.
WhenHermanGiddenspublishedthesenumbers,in1997inPediatrics,
shesetoffasocialandendocrinologicalfirestorm.Ihadnoideaitwouldbe
sohuge,HermanGiddenstoldmerecently.TheLolitasyndromethe
prurientfascinationwiththesexualityofyounggirlscreatedalotof
emotionalinterest.Asafeminist,Iwishitdidnt.Alongwithmedical
professionals,mothers,worriedabouttheirdaughters,flockedtoHerman
Giddenssslideshows,gaspingassheflashedimagesofpossibleculprits:
obesity,processedfoods,plastics.
Meanwhile,doctorswroteletterstojournalscriticizingthesamplein
HermanGiddenssstudy.(Shecollecteddatafromgirlsatphysiciansoffices,
leavingheropentotheaccusationthatitwasntrandom.)Wastheageof
pubertyreallydropping?Parentssaidyes.Leadingpediatricendocrinologists
saidno.Thestalematelastedadozenyears.TheninAugust2010,theconflict
seemedtoresolve.Wellrespectedresearchersatthreebiginstitutions
CincinnatiChildrensHospital,KaiserPermanenteofNorthernCaliforniaand
MountSinaiSchoolofMedicineinNewYorkpublishedanotherstudyin
Pediatrics,findingthatbyage7,10percentofwhitegirls,23percentofblack
girls,15percentofHispanicgirlsand2percentofAsiangirlshadstarted
developingbreasts.

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Nowmostresearchersseemtoagreeononething:Breastbuddingingirls
isstartingearlier.Thedebatehasshiftedtowhatthismeans.Puberty,ingirls,
involvesthreeevents:thegrowthofbreasts,thegrowthofpubichairanda
firstperiod.Typicallythechangesunfoldinthatorder,andtheproc
esstakes
abouttwoyears.Butthedatashowaconfoundingpattern.Whilestudieshave
shownthattheaverageageofbreastbuddinghasfallensignificantlysincethe
1970s,theaverageageoffirstperiod,ormenarche,hasremainedfairly
constant,droppingtoonly12.5from12.8years.Whywouldpubertybe
startingearlieryetendingmoreorlessatthesametime?
Toendocrinologists,girlswhogothroughpubertyearlyfallintotwo
camps:girlswithdiagnosabledisorderslikecentralprecociouspuberty,and
girlswhosimplydevelopontheearlysideofthenormalcurve.Buttheline
betweenthegroupsisblurring.Thereusedtobeadiscretegapbetween
normalandabnormal,andthereisntanymore,LouiseGreen
span,apediatric
endocrinologistandcoauthoroftheAugust2010Pediatricspaper,toldme
onemorninginherofficeatKaiserPermanenteinSanFrancisco.Amongthe
fewtoolsavailabletohelpdistinguishbetweensocallednormaland
precociouspubertyareboneageXrays.Toillustratehowtheywork,
Greenspanpulledoutabeautifuloldbook,GreulichandPylesRadiographic
AtlasofSkeletalDevelopmentoftheHandandWrist,astandardtextfor
pediatricendocrinologists.EachpageshowedanXrayofahandillustrating
boneage.Thesmallesthandwasfromanewbornbaby,theoldestfroman
adultfemale.Whenababyisborn,theresallthiscartilage,Greenspansaid,
pointingtolargeblackgapssurroundinganarrayofdelicatewhitebones.As
thebodygrows,thepatternofblackandwhitechanges.Thewhitebones
lengthen,andtheblackintersticesbetweenthem,someofwhichiscartilage,
shrink.Thisprocessstopsattheendofpuberty,whenthegrowthplatesfuse.
Onemainriskforgirlswithtrueprecociouspubertyisadvancedboneage.
Pubertyincludesafinalgrowthspurt,afterwhichgirlsmostlystopgrowing.If
thatgrowthspurtstartstooearlyinlife,itendsatanearlyagetoo,meaninga

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childwillhavefewergrowingyearstotal.Agirlwhohasherfirstperiodatage
10willstopgrowingyoungerandendupshorterthanageneticallyidentical
girlwhogetsherfirstperiodatage13.
ThatmorningoneofGreenspanspatientswasa6yearoldgirlwitha
boneageof9.Shewasthetallestgirlinherclassatschool.Shestarted
growingpubichairatage4.Noonethoughthergrowthcurvewasnormal,not
evenherdoctors.(Eightusedtobetheagecutofffornormalpubichairgrowth
ingirlsnowitsasearlyas7.)Forthisgirl,Greenspanprescribedaoncea
monthshotofthehormoneLeuprolide,tohaltpubertysprogress.Thegirl
hatedtheshot.Yetnobodysecondguessedthetreatmentplan.Themismatch
betweenhersexualmaturationandherageandthediscomfortthatcreated,
foreverybodywasjusttoogreat.
Bycontrast,Ainsleywasolder,andherpubertywasprogressingmore
slowly,meaningshewasntatmuchofanincreasedriskforshortstatureor
breastcancer.(Earlyperiodsareassociatedwithbreastcancer,though
researchersdontknowiftheriskstemsfromgreaterlifetimeexposureto
estrogenorahigherlifetimenumberofmenstrualcycles,orperhaps
somethingelse,liketheageatwhichagirlhashergrowthspurt.)Incasesof
girlsAinsleysage,Greenspanhasbeenaskedbyparentstoprescribe
Leuprolide.ButGreenspansaysthisisabadidea,becauseLeuprolides
possiblesideeffectsincludinganincreasedriskofosteoporosisoutweigh
thebenefitsforgirlsthatage.Ifyouhaveanormalgirl,agirlwhos8or9,
theresabigethicalissueofgivingthemmedicine.Givingthemmedicinesays,
Somethingiswrongwithyourbody,asopposedto,Thisisyourbody,and
letsallfindawaytoacceptit.
Iwouldhavealongconversationwithherfamily,showthemallthe
data,Greenspancontinues.Onceshehasgonethroughwhatshecallsthe
proc
essofnormalizingaprocessintendedtoreplaceanxietywithstatistics
shehasrarelyhadafamilycontinuetoinsistonpubertyarrestingdrugs.
Indeed,mostparentslearntocopewiththechangesandhelptheirdaughters

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adjusttoo.Onemotherdescribedformebuyingadrawerfulloffootballshirts,
atherthirdgradedaughtersrequest,tohidehermaturingbody.Another
remindedherdaughterthatitsO.K.toactherage.Itslikewhenyouhavea
reallybigtoddlerandpeopleexpectthekidtotalkinfullsentences.People
lookatmydaughterandsay,Lookatthosecheekbones!Wehavetoremind
her:Youmaylook12,butyoure9.ItsO.K.toloseyourcoolandstompyour
feet.
Westillhavealottolearnabouthowearlypubertyaffectsgirls
psychologically,saysPaulKaplowitz,chiefofendocrinologyatChildrens
NationalMedicalCenter.Wedoknowthatsomegirlswhostartmaturingby
age8progressrapidlyandhavetheirfirstperiodbeforeage10,andmany
parentspreferthatweusemedicationstoslowthingsdown.However,many
girlsdofineiftheyaresimplymonitoredandtheirparentsarereassuredthat
theywillgetthroughitwithoutmajorproblems.
Insomewaysearlypubertyismoststraightforwardforfamilieslikethose
ofthekindergartneronLeuprolide.Shehasadiagnosis,atreatmentplan.In
Greenspansoffice,Iaskedthegirlsfatheratwhatagehemightchoosetotake
hischildoffthedrugsandletherpubertyproceed.Helaughed.Thenhespoke
formostparentswhenhesaid,Woulditbebadtosay22?
Sowhyaresomanygirlswithnomedicaldisordergrowingbreasts
early?Doctorsdontknowexactlywhy,buttheyhaveidentifiedseveral
contributingfactors.
Girlswhoareoverweightaremorelikelytoenterpubertyearlythan
thinnergirls,andthetiesbetweenobesityandpubertystartataveryyoung
age.AsEmilyWalvoordoftheIndianaUniversitySchoolofMedicinepoints
outinherpaperTheTimingofPuberty:IsItChanging?DoesItMatter?
bodymassindexandpubertaltimingareassociatedatage5,age3,evenage9
months.Thisfacthasshiftedpediatricendocrinologistsawayfromwhatused
tobeknownasthecriticalweighttheoryofpubertytheideathatoncea

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girlsbodyreachesacertainmass,pubertyinevitablystartstoacriticalfat
theoryofpuberty.Researchersnowbelievethatfattissue,notpoundage,sets
offafeedbackloopthatcancauseabodytomature.AsRobertLustig,a
professorofclinicalpediatricsattheUniversityofCalifornia,SanFranciscos
BenioffChildrensHospital,explains,fattergirlshavehigherlevelsofthe
hormoneleptin,whichcanleadtoearlypuberty,whichleadstohigher
estrogenlevels,whichleadstogreaterinsulinresistance,causinggirlstohave
yetmorefattissue,moreleptinandmoreestrogen,thecyclefeedingonitself,
untiltheirbodiesphysicallymature.
Inaddition,animalstudiesshowthattheexposuretosome
environmentalchemicalscancausebodiestomatureearly.Ofparticular
concernareendocrinedisrupters,likexenoestrogensorestrogenmimics.
Thesecompoundsbehavelikesteroidhormonesandcanalterpubertytiming.
Forobviousethicalreasons,scientistscannotperformcontrolledstudies
provingthedirectimpactofthesechemicalsonchildren,soresearchers
insteadlookforsocallednaturalexperiments,oneofwhichoccurredin1973
inMichigan,whencattlewereaccidentallyfedgraincontaminatedwithan
estrogenmimickingchemical,theflameretardantPBB.Thedaughtersbornto
thepregnantwomenwhoatethePBBlacedmeatanddrankthePBBlaced
milkstartedmenstruatingsignificantlyearlierthantheirpeers.
Oneconcern,amongparentsandresearchers,istheeffectof
simultaneousexposurestomanyestrogenmimics,includingthecompound
BPA,whichisubiquitous.NinetythreepercentofAmericanshavetracesof
BPAintheirbodies.BPAwasfirstmadein1891andusedasasynthetic
estrogeninthe1930s.Inthe1950scommercialmanufacturersstartedputting
BPAinhardplastics.SincethenBPAhasbeenfoundinmanycommon
products,includingdentalsealantsandcashregisterreceipts.Morethana
millionpoundsofthesubstancearereleasedintotheenvironmenteachyear.
Familystresscandisruptpubertytimingaswell.Girlswhofromanearly
agegrowupinhomeswithouttheirbiologicalfathersaretwiceaslikelytogo

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intopubertyyoungerasgirlswhogrowupwithbothparents.Somestudies
showthatthepresenceofastepfatherinthehousealsocorrelateswithearly
puberty.Evidencelinksmaternaldepressionwithdevelopingearly.Children
adoptedfrompoorercountrieswhohaveexperiencedsignificantearly
childhoodstressarealsoatgreaterriskforearlypubertyoncetheyre
ensconcedinWesternfamilies.
BruceEllis,aprofessorofFamilyStudiesandHumanDevelopmentatthe
UniversityofArizona,discoveredalongwithhiscolleaguesapatternofearly
pubertyingirlswhoseparentsdivorcedwhenthosegirlswerebetween3and8
yearsoldandwhosefatherswereconsideredsociallydeviant(meaningthey
abuseddrugsoralcohol,wereviolent,attemptedsuicideordidprisontime).
Inanotherstudy,publishedin2011,Ellisandhiscolleaguesshowedthatfirst
graderswhoaremostreactivetostresskidswhosepulse,respiratoryrate
andcortisollevelsfluctuatemostinresponsetoenvironmentalchallenges
enteredpubertyearliestwhenraisedindifficulthomes.Evolutionary
psychologyoffersatheory:Astressfulchildhoodinclinesabodytowardearly
reproductioniflifeishard,besttomatureyoung.Butsuchtheoriesaretough
toprove.
Socialproblemsdontjustincreasetheriskforearlypubertyearly
pubertyincreasestheriskforsocialproblemsaswell.Weknowthatgirlswho
developaheadoftheirpeerstendtohavelowerselfesteem,moredepression
andmoreeatingdisorders.Theystartdrinkingandlosetheirvirginitysooner.
Theyhavemoresexualpartnersandmoresexuallytransmitteddiseases.You
canalmostpredictitthatearlymaturingteenagerswilltakepartinmore
highriskbehaviors,saysTonyaChaffee,associateclinicalprofessorof
pediatricsatUniversityofCalifornia,SanFrancisco,whooverseestheTeen
andYoungAdultHealthCenteratSanFranciscoGeneralHospital.Halfofthe
patientsinherclinicareorhavebeeninthefostersystem.Sheseesinthe
outlinesoftheirearlydevelopingbodiesthestressesoftheirlivessingle
parentornoparent,littleornomoney,toomuchexposuretoviolence.

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Someofthismaystemfromthesamesocialstressesthatcontributeto
earlypubertyinthefirstplace,andsomeofitmaystemfromotherfactors,
includingthecommonnightmareofadolescence:beingdifferent.AsJulia
Graber,associatechairwomanofpsychologyattheUniversityofFlorida,has
shown,allofftimedevelopersearlyaswellaslatehavemore
depressionduringpubertythantypicallydevelopinggirls.Butforthelate
bloomers,thenegativeeffectwearsoffoncepubertyends.Forearlybloomers,
theeffectpersists,causinghigherlevelsofdepressionandanxietythroughat
leastage30,perhapsallthroughlife.Someearlymaturinggirlshavevery
seriousproblems,Grabertoldme.MorethanIexpectedwhenIstarted
lookingforclinicalsignificance.Iwassurprisedthatitwassosevere.
Researchersknowtheresarelationshipbetweenpubertaltimingand
depression,buttheydontknowexactlyhowthatrelationshipworks.One
theoryisthatgoingthroughpubertyearly,relativetootherkindsofcognitive
development,causeschangesinthebrainthatmakeitmoresusceptibleto
depression.AsElizabethSowell,directoroftheDevelopmentalCognitive
NeuroimagingLaboratoryatChildrensHospitalLosAngeles,pointsout,girls
ingeneraltendtogothroughpubertyearlierthanboys,andstartingaround
puberty,girls,asagroup,alsoexperiencemoreanxietyanddepressionthan
boysdo.Graberoffersabroaderhypothesis,perhapsthebestunderstanding
ofthepubertydepressionconnectionwehavefornow.Itmaybethatearly
maturersdonothaveasmuchtimeasothergirlstoaccomplishthe
developmentaltasksofchildhood.Theyfacenewchallengeswhileeverybody
elseisstilldealingwiththeusualdevelopmentofchildhood.Thismightbe
causingthemtomakelesssuccessfultransitionsintoadolescenceand
beyond.
Overthepastyear,Italkedtomotherswhotriedtoforestalltheir
daughterspubertyinmanydifferentways.Sometrainedwiththemfor5K
runs(exerciseisoneofthefewinterventionsknowntohelppreventearly
puberty)otherstrimmedmilkandmeatcontaininghormonesfromtheir

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daughtersdietssomepurgedfromtheirhomesplastics,pesticidesandsoy.
Yetsoonerratherthanlater,mostthrewuptheirhands.Imempatheticwith
parentsindespairandwantingasenseofagency,saysSandraSteingraber,an
ecologistandtheauthorofRaisingElijah:ProtectingOurChildreninanAge
ofEnvironmentalCrisis.Butthisideathatwe,asparents,shouldbe
scrutinizinglabelsandvettingbirthdaypartygoodybagstheideathatallof
usinourhomesshouldbeactingasourownEnvironmentalProtection
AgenciesandDepartmentsofInteriorisjustnuts.Evenifwecouldread
everylabelandscrutinizeeveryproduct,ourkidsareinschoolsandrunningin
andoutofotherpeopleshomeswheretherearebrominatedflameretardants
onthefurnitureandpesticidesusedinthebackyard.
Addingtotheanxietyisthefactthatweknowsolittleabouthowearly
pubertyworks.Afewresearchers,includingRobertLustig,ofBenioff
ChildrensHospital,arebeginningtowonderifmanyofthosegirlswithearly
breastgrowthareinpubertyatall.Lustigisamanpronetobig,inflammatory
ideas.(Hebelievesthatsugarisapoison,ashehasarguedinthismagazine.)
Tomakethecasethatsomegirlswithearlybreastgrowthmaynotbein
puberty,hestartswithbasicscience.Truepubertystartsinthebrain,he
explains,withtheproductionofgonadotropinreleasinghormone,orGnRH.
ThereisnopubertywithoutGnRH,Lustigtoldme.GnRHisliketheballthat
rollsdowntherampthatknocksoverthebookthatflipsthestereoswitch.
Specifically,GnRHtripsthepituitary,whichsignalstheovaries.Theovaries
thenproduceestrogen,andtheestrogencausesthebreaststogrow.Butas
Lustigpointsout,theestrogenthatiscausingthatgrowthinyounggirlsmay
haveadifferentorigin.Itmaycomefromthegirlsfattissue(postmenopausal
womenproduceestrogenintheirfattissue)orfromanenvironmentalsource.
AndifthatestrogendidntstartwithGnRH,itsnotpuberty,endofstory,
Lustigsays.Breastdevelopmentdoesntautomaticallymeanearlypuberty.It
might,butitdoesnthaveto.Dontevengethimstartedontherelationship
betweenpubichairgrowthandpuberty.Anypaperlinkingpubichairwith
earlypubertyisgarbage.Garbage.Pubichairjustmeansandrogens,ormale

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hormones.Thefirstsignofpubertyingirlsisestrogen.Androgenisnoteven
onthemenu.
FrankBiro,leadauthoroftheAugust2010Pediatricspaperanddirector
ofadolescentmedicineatCincinnatiChildrensHospital,beganhavingsimilar
suspicionslastspringafterheflewtoDenmarktogivealecture.Followinghis
talk,BirolookedoverthepublisheddataonpubertyofhiscolleagueAnders
Juul.InJuulsstudy,someofthegirlswithearlybreastdevelopmenthad
unexpectedlylowlevelsofestradiol,thepredominantformofestrogenin
womensbodiesfromtheonsetofpubertythroughmenopause.Birohadseen
apatternlikethisinhisdata,suggestingtohimthattheearlybreastgrowth
mightbecomingfromnonovarianestrogens.Thatistosay,theheadwatersfor
thepubertalchangesmightnotbeinthegirlsbrains.Heisnowrunning
modelsonhisowndatatoseeifhecandeterminewherethenonovarian
estrogensarecomingfrom.
Thepossibilitythattheseearlynormalgirlsarereactingtoestrogens
thatarenotcomingfromtheirovariesiscompelling.Partofthecomfortisthat
agirlwhoisnotyetinpubertymaynothavedevelopedanadolescentbrain.
Thismeansshewouldnotyetfeeltheacutetugofherownsexualurges.She
wouldnotseekthrillsandrisk.Still,theideathatthereareenoughtoxinsor
fatcellsinachildsbodytocausebreastdevelopmentishardlyconsoling.
Besides,someofthepsychosocialproblemsofearlypubertyderivefrom
whatshappeninginsideagirlsbodyothers,fromhowpeoplereacttoher.If
agirlis10andshelooks15,itdoesntmakeanydifferenceifherpituitaryis
turnedonorifsomethingelsecausedherbreastgrowth,Birosays.Shelooks
likeamiddleadolescent.Peoplearegoingtotreatherthatway.Maybeshes
notinterestedinreciprocalsex,butshemightbepressuredintosex
nonetheless,andhersocialskillswillbethoseofa10yearold.
Sowhatarefamiliesofearlybloomerstodo?Doctorsurgeparentsto
focusontheirdaughtersemotionalandphysicalhealthratherthanon
stoppingorslowingdevelopment.Inthisway,theconceptofanewnormalis

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notjustabrushoffbutanencouragementtosupportagirlwhoisvulnerable.
Iknowtheycantchangethefactthattheirdaughterstarteddeveloping
early,buttheycanchangewhathappensdownstream,LouiseGreenspan,the
pediatricendocrinologistatKaiserPermanente,toldme.Parentscankeep
theirdaughtersactiveandathealthybodyweights.Theycantreatthemthe
agetheyare,nottheagetheylook.Theycandefendagainstaculturethatsells
pushupbikinisfor7yearoldsandotherwisesexualizesyounggirls.Mostof
thepsychologicalissuesassociatedwithearlypubertyarerelatedtorisktaking
behaviors,Greenspancontinued,andparentscanmitigatethose.Iknowit
soundscornyandoldfashioned,butifyoureinasupportivefamily
environment,whereyouareeatingfamilymealsandreadingbookstogether,
youactuallydohavecontrol.Earlybreastgrowthmaybejustthatearly
breastgrowth:disconcerting,poorlyunderstood,butnotaguaranteeofour
worstfears.Youdontgodirectlyfromthefirstsignsofearlypubertyto
anorexia,depression,drinkingandearlysexualdebut.
InFortCollins,Tracee,Ainsleysmother,triedtostayfocusedonthe
positive.Atonepointduringmyvisit,shedisappearedintoherbasement,the
headquartersforhercompany,T.G.R.Body,andreturnedwithapinkhatbox
filledwithchemicalfreesamplesofPeppermintPimplePopperandBadHair
DayMiraclePowder.Ijustwanttobepartofthesolution,Traceesaid,
rubbingasampleofsilverhairstreakinggelonmywrist.Imsotiredof
runningaway.IneedtohavesomethingAinsleyismovingtoward.
Motherswhohavebeenthroughiturgecandor.Behonestwithher,and
byhonestImeanbrutallyhonestaboutwhatsgoingtohappentoherbody
whilestillbeingkind,saysthemotherofagirlwhorecentlyturned10but
whofirstshowedsignsofdevelopingwhatshecallsashapeatage3.You
dontwantyourdaughterexperiencingsomethingforwhichshes
unprepared.
Patienceandperspectivemaybethegreatestpalliatives.Thethingwith

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28/02/2016

PubertyBeforeAge10:ANewNormal?TheNewYorkTimes

pubertyisthateverybodyisgoingtogothroughitatsomepoint,another
mothertoldme.Threeyearsagothiswomanwasinstallingsmalltrashcansin
herthirdgradegirlsschoolbathroomstallssothatherdaughtercould
discreetlythrowawaymenstrualpads.Butnowthatdaughteris12,inthesixth
gradeherbodyseemslessstrange.Ifeelsomuchbetter,andsodoesshe.By
anothertwoorthreeyearsdowntheroad,alltheothergirlswillhavecaught
up.
ElizabethWeilisacontributingwriterforthemagazineandtheauthorofanew
memoiraboutmarriage,NoCheating,NoDying.
Editor:IlenaSilverman
AversionofthisarticleappearsinprintonApril1,2012,onpageMM30oftheSundayMagazine
withtheheadline:TheIncredibleShrinkingChildhood.

2016TheNewYorkTimesCompany

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