April 15, 2002

Little women

By Nicole MacIntyre
nmacinty@uwo.ca

When Wanda's 10-year-old daughter developed little bumps on her chest, it was cause for immediate concern. Panicked, the Saskatchewan mother rushed to the doctor. The diagnosis left both Wanda and her husband speechless-their little girl was becoming a woman.

"We were shocked. She was so young," said Wanda, whose second daughter entered precocious puberty only two years later. "They're your little girls. It's a hard thing to see your girls moving out of their little childhood and into womanhood. It was a little nerve-racking."

For a growing number of young girls, the momentous coming of age milestone is arriving earlier than ever before. A US study found that 28 per cent of African-American girls and 7 per cent of white girls had begun breast development and/or had pubic hair, the first markers of puberty, by seven years old. Within a year to two years, almost half of African-American girls and 15 per cent of white girls had started puberty.

While suspicions have long been raised that children are growing up faster than they used to, many adults still have a hard time accepting that children are beginning to enter puberty before they even leave elementary school.

"People don't even like to think about it," said Dr. Marcia Herman-Giddens who organized the 1997 study, which involved the examination of more than 17,000 girls across the United States between the age of three and 12. "There's a lot of denial. People like to pretend it isn't happening even when they can see it happening all around them."

Though the start of menstruation has not changed for white girls and is six months earlier for African-American girls in the past 20 to 30 years, it is the outward body changes which distinguish the beginning of puberty that concern health officials. While it can be hard for any girl to deal with the social reaction to breast development, it can be especially challenging for children who are not prepared for the changes or educated about their bodies. Years after the study, Herman-Giddens has been contacted by several participants who expressed their dismay over entering puberty prematurely.

"They felt like freaks. Their families didn't know what to do with them. They felt very different," said Herman-Giddens in a telephone interview from the University of North Carolina School of Public Health. She remembers the story of one girl who developed a very large chest at only 10 years of age. The attention from men, who constantly harassed her, left permanent scars. "It was a very negative, extremely negative, experience for her. In fact you could really consider that she was sexually abused because of the harassment that she had to endure."

Though researchers have confirmed little girls are indeed growing up faster, they still have been unable to concretely explain why this is happening.

"That is the big question and that's the reason this research is so important. It does indicate some pretty serious public health issues," said Herman-Giddens.

Many professionals argue that diet has had an important impact on puberty. In North America where fast food joints line every corner and frozen dinners can fill every fridge, some believe that younger girls are filling up on high-fat, low-nutrition food. The resulting heavier bodies can mean earlier puberty, according to the study that found girls with precocious puberty were on average seven pounds heavier than girls who develop later.

More controversially, some have argued the high consumption of meat, which contains estrogen and other additives, may be contributing to the phenomena. But Herman-Giddens said this possibility has never been fully explored, clearly to the benefit of meat producers. In the same fashion, all foods with additives have been questioned for their effect on the body, especially the young and growing body.

Especially suspect for researchers is the widespread exposure to pesticides and other chemicals that have estrogen properties. Studies have proven that estrogen-containing chemicals can interrupt the endocrine system and affect puberty or sexual behaviour in animals.

Families in Michigan learned the effects of chemicals on puberty first hand in the '70s after a frightful accident at a cattle farm. In 1973, a fire retardant containing polybrominated biphenyl PBB was mistaken for a feed additive and mixed with cattle feed. The contamination was eventually noticed after milk production went down and several calves were stillborn or born with deformities. But by that time at least 4,000 people had been exposed to the contaminated meat or dairy products.

In the years following the incident, researchers found that daughters exposed to PBB while still in the womb and then through breast feeding were more likely to have an early onset of menstruation and pubic hair.

The evidence also mounted with a discovery in Puerto Rico that associated premature breast development with exposure to phthalates, the plasticizer chemical found in many cosmetics, toys and plastic food containers.

Herman-Giddens has also thrown another, more controversial theory onto the plate. She believes that precocious puberty may be a result of a highly sexualized world that surrounds children. She points to research in adults that has found watching sexually graphic material causes hormone releases in the body. Though no similar research has yet to be done on young girls, Herman-Giddens believes it is undeniable that the sexualization of children has a profound effect.

"Obviously what we see can affect our physiological functions. So therefore we can look at children who are exposed to an incredible number of sexual materials and knowing that it can affect sex hormones in adults, it would make no sense to assume it has no effect on kids."

Until researchers have established the effect of a sexual surrounding, Herman-Giddens hopes that society will begin to consider the mixed messages it is sending children.

"People are very uncomfortable about the issue of children being sexual so early, like having developing bodies. Yet on the other hand the same people, the culture, us, our society, completely sexualizes children through advertising."

The effects of early puberty can be devastating according to studies that have found increased risk of emotional and social problems. The pressure of dealing with social reactions to their maturing bodies can be too much for some women who are also trying to deal with their own sexual feelings. Researchers have found early developers are more likely as teenagers to be sexually active, have problems in school, smoke and use alcohol and drugs.

Herman-Giddens says it makes sense that early bloomers would fall into an older crowd as their bodies mature, but she also believes it is important to balance the perspective that sexual activity is always a reflection of older male pressure.

"They are prey to older males, but on the other hand, the girls who have started their periods are sexually mature and obviously they are going to have sexual feelings," said Herman-Giddens, who is adamant adults not disempower women by always presuming they are victims. Yet she is also worried that in addition to forced attention from older men, young women are being force-fed sexual material in the media that they often model in their own lives for lack of a better example.

Beyond the behaviours that can stem from early puberty, research indicates early bloomers who do not understand what is happening to their bodies and do not receive adequate support can suffer from lower self-esteem. This can lead to depression, social withdrawal, moodiness and aggression in young women.

The emotional scars of puberty are still evident for 26-year-old Tina of Calgary. Now planning her summer wedding, Tina is finally able to accept her body and proudly announces that she looks good, really good, in her strappy wedding dress. That's a huge accomplishment for the teacher who was plagued with embarrassment and shame during her teenage years because of her large breasts that began to develop in Grade 5.

"It was really awful. I hated it so much."

For Tina the hardest part of developing breasts was the flat-chested classmates who surrounded her in elementary school. It was difficult not to feel uncomfortable when nobody else had started puberty. Though she desperately needed a bra, she refused to wear one until junior high because she feared ridicule for being the only girl to wear such a symbolic sign of womanhood. Hiding behind baggy sweaters, Tina became more ashamed and uncomfortable with her developing body.

"I felt totally isolated."

Gym class became Tina's nemesis as she progressed through puberty. As if the pain of changing in front of female peers in the locker room wasn't enough, the required runs made her feel ill. Jogging in front of male classmates was a nightmare for Tina as the real comments from classmates were dwarfed by the imaginary insults hurled by her own mind.

"I was so self-conscious . . . to this day it affects me."

But though she is still affected by her early development, Tina said she has finally come to peace with her body. After years of seriously considering a breast reduction, she has decided to not undergo surgery.

Photo by Nicole MacIntyre

Nurse Denise Walsh uses felt dolls to show children how their bodies will change during puberty.

Teaching children to accept their bodies is a mission for London public health nurse Denise Walsh, who regularly visits local schools to discuss puberty. Prepared for almost any question and armed with Fred and Freda, cloth dolls with removable parts that allow children to see what will happen to their bodies, Walsh faces curious groups of Grade 5 students who are eager to hear about puberty.

Honesty and simplicity are the two principles Walsh uses to guide her lessons because she says that educating children about their bodies is the best way to avoid potential emotional problems.

"Going through puberty can be a very, very scary time and if something is happening to you and you don't realize it's happening to other girls at the same time it can sometimes be very scary," said Walsh. "Personally, for young girls and young boys, I think it's very important they realize these changes happen and it happens at a different time for everyone."

Like other health nurses, Walsh notices a mix of maturity levels in the classes she teaches. While some girls have already started puberty, others are just beginning or are months, even years, away. For her, the objective is to normalize the reproductive systems, just as we do other body systems like the heart or lungs. She believes that when children are exposed to the truth about what is happening to their bodies they can escape some of the uncertainty and embarrassment that come with puberty.

For Wanda's younger daughter, Kelly, watching her sister go through early puberty made her early development easier to handle. Though she was angered to enter puberty so young, her mother's openness also made the experience far less daunting.

"I felt like it was the right time," said Kelly, who is representative of a large number of young women who handle early puberty quite well. Yet now at 14, Kelly admits that she was conflicted about developing at 10 years old.

"At that age you kind of want to hide it and kind of stay young, but at the same time you want to grow up and be like your big sister."

The task of correctly mixing sex education lessons, television images and parental chats can be daunting for young adults struggling to understand their own body and sexuality. Walsh recommends that parents begin to talk to their children about their bodies very young, using correct terminology--no "winky" or "flower" analogies allowed.

"It should never be something that just starts. It should be something that starts right from when they're born," said Walsh, who added the benefits are enormous for children who understand their bodies and are supported by open parents.

For Wanda, talking to her daughters was the easy part. As her girls grow up, the effects of early puberty are becoming distant memories. Now, of course, it is the man of the house who seems to be in the most distress.

"Well, three women under one roof," said Wanda laughingly. "It's on going. One of us is always crabby."