Early Adolescent Sexuality: What is Your Child Going Through

If you want to make parents anxious, lock them in a room with their thirteen-year-old child, and tell them they must talk to their teenager about sex. It's an issue that few parents feel comfortable and ready to discuss. And yet most parents know that they should, because of the importance of sex and intimacy in adult relationships, and because of the sexually charged environment we all live in. If kids don't hear about sex from their parents, they are going to hear about it from somebody else.

What are young adolescents going through? Below, two adolescent health experts explore this question.

Many parents don't think that children ten to thirteen years old are sexual beings yet. Are they?

DAVID BELL, MD: We are all sexual beings. Our kids are learning from us about good touch and loving relationships from almost day one. There are many exploratory behaviors that happen early in children. Parents need to be comfortable talking about sexuality with their children early on, and info adolescence.

JENNIFER JOHNSON, MD: I completely agree with Dr. Bell that sexuality is part of every human being's life, whether we're conscious of it or not, and that does include young children. But I think when kids are actually approaching puberty or have already reached it, they need some concrete information about what's happening to their bodies and what's going to happen.

Cognitively, I don't think that seven or eight-year-olds are ready to handle that information yet. It's just too hard for them to understand.

DAVID BELL, MD: I don't disagree with you. I think it's a developmentally appropriate conversation, and that as the child grows older, your way of talking with that child changes.

What are the markings of puberty?

DAVID BELL, MD: Some of the first changes for females are breast development, and one of the first changes is breast bud development. One of the later changes that people notice and appreciate more is the start of their first menstrual cycle.

For guys, it's sometimes a lot less noticeable, since the first change is growth in testicular size, and then, much later on, hair and muscle development. The growth spurt happens much later for males.

And there's a great degree of variation?

JENNIFER JOHNSON, MD: Yes, there is. In fact, for girls, the first sign-the development of breast buds-can occur as early as eight-years-old. It can also occur at age twelve or thirteen.

There is a big difference in the age of onset of puberty for both boys and girls. But what's interesting is that once that process is started, it's a relatively consistent period of time from the beginning of puberty until its completion.

When do teenagers begin to have sexual feelings?

JENNIFER JOHNSON, MD: Puberty is the result of sex hormones developed by the body, and these hormones affect the development of organs like the breasts or the penis.

Those hormones are also acting on the brain and causing the beginnings of sexual desires that the child will not have experienced earlier, at least not in that same way.

We don't really understand completely what triggers sexual feelings and behaviors, and how the hormones work, but definitely, once the hormones are on board, then the desire is increasing.

At what age is masturbation fairly common?

DAVID BELL, MD: For males, age ten to thirteen.

JENNIFER JOHNSON, MD: Girls probably don't really begin experimenting with masturbation until they're more towards middle adolescence. I think that early adolescents are just kind of overwhelmed with what's happening to their bodies.

They're also making big transitions in their lives, going to a new, big school and being expected to perform very adult things cognitively and in their social world. I think they're just sitting there saying, "Okay, what's coming today?"

DAVID BELL, MD: Psychologically, they aren't quite there in early adolescence to experiment with sexuality. They may talk about it more. I know that, for females, since they are developing faster or at an earlier time, their desires are there, they're talking more about boys. And at that same period, boys are not talking about girls, usually. They're waiting.

But there are girls and boys having sex in these early adolescent years. What does it mean?

JENNIFER JOHNSON, MD: In my clinical practice, and in the literature, it's very well documented that girls who have consensual sex before the age of thirteen are at much higher risk of having been sexually abused in their childhoods then girls who don't start having sex until they're thirteen and older. So whenever I have a patient who has had sex and she's under thirteen years old, that's when I really am careful in my questioning about possible sexual abuse. I ask that of every girl and every guy that I see, but it's the young girls who are having sex that I really have a red flag out for.

Is there a good way for parents to begin a conversation about sex?

JENNIFER JOHNSON, MD: Absolutely. Any kind of opener that a parent can use to start talking about sexuality is one that they should jump at. Menstruation is a great opportunity, for example. But I think that parents are more comfortable talking about the concrete processes of reproduction, or even the concrete aspects of having sex, than they are talking about sexuality itself.

Why do you think parents are reluctant to have this conversation?

DAVID BELL, MD: I think that they often aren't comfortable with saying the words "penis" and "vagina." They aren't comfortable having conversations about sexual feelings. They have the idea that talking about sexuality sort of encourages sexuality. I think it's important to emphasize that talking and sharing your values about sex and sexuality does not encourage sex and sexual behaviors in teenagers.

JENNIFER JOHNSON, MD: As a society, we are not generally very comfortable talking about sex with each other, either. It's something that lots of husbands and wives don't talk about. They have sex, but they may not discuss what feels good or what doesn't.

Sexuality is kind of taboo in our society, and so I think it's all the more frightening for parents to talk about it with their kids, even for parents who say sex is a normal, wonderful, healthy thing.

If a parent doesn't feel confident about having this conversation, should they find someone else who might be able to do a better job?

DAVID BELL, MD: I think that's a healthy choice.

JENNIFER JOHNSON, MD: Yes. And another approach is books. Anybody who goes into a bookstore is going to find a big selection of books written about sexuality for teenagers, and about reproduction and contraception for teenagers. What I suggest that parents do is just choose a couple of books that they like and give them to their child. My daughter has her collection in her bedroom, and we've looked at a few of them together. It was really fun, because one of them actually asked questions about both the mothers' and fathers' experiences in puberty. That was a great opportunity to bring my husband into it.

What do kids want to know?

JENNIFER JOHNSON, MD: I don't think ten to thirteen-year-olds are certain that they really want to know too much about sex, because especially the younger ones still have that childhood view that sex is something kind of yucky and messy. But they do want reassurance that what their body is going through is normal.

I think probably the number one health concern for early adolescents altogether is, "Am I normal?" One breast is bigger than the other: is that normal? And they want the facts about what's happening, but they're not very interested in talking about contraception and stuff like that in detail yet.