A new puberty guide for kids aims to replace anxiety with self-confidence

The authors of a new book on puberty had trouble coming up with a name. The guide to growing up, for pre-teens 9 to 13, is written for all kids – girls, boys, nonbinary youth. It's inclusive of the gender spectrum and the trans experience.

Titles like "Hello Hairy," and "The Rollercoaster Called Puberty" weren't cutting it, says Dr. Kathryn Lowe, one of the book's three co-authors, who are all physicians and parents.

They settled on You-ology: A Puberty Guide for Everybody. The slim, 150-page guide, published Tuesday by the American Academy of Pediatrics, is one a handful of recent puberty books that aim to be more inclusive. It explains body parts and how they change in clear, accessible ways, while assuring kids that there's a wide range to what is normal. Big feelings, big questions and growing faster or slower than other kids are all part of it.

"We talk about how every body is different," Lowe says, "Breasts can come in all different shapes and sizes. We try to normalize the variety of [ways] the human body goes through puberty and how there is no one right way."

The text is strewn with colorful diagrams, fun facts ("Some people call an erection a 'boner,' but there's actually no bone in the penis!") and stories from a diverse cast of fictional characters navigating puberty.

Two of the authors, Dr. Trish Hutchison, a pediatrician and Dr. Melisa Holmes, an OB/GYN, teach puberty classes and co-founded an online puberty education hub called Girlology. The third, Lowe is a pediatrician who helps steer the AAP on lesbian, gay, bisexual, transgender health and wellness. The idea for the book grew out of interacting with kids and seeing the need for accurate information that avoids shame.

One early reader endorsed the book. Stella, 12, a sixth-grader from Chicago, who identifies as nonbinary and uses them/them pronouns, read an early copy (their mom is an acquisitions editor at AAP).

"I'm excited about growing up and also kind of nervous about the changes," they said, "The book was, like, very reassuring because it told me that everything is normal and your body is doing what it needs to be doing."

Stella thought the book was a good complement to what's taught at school. They identified with some of the book's characters (like Oliver, who had glasses like Stella's and a shared interest in cosplay). Stella also found a diagram about gender identity and expression especially useful, along with a section on "puberty gear" that explains things like bras, binders, athletic cups, period underwear.

"Tampons still freak me out," Stella says, but adds they're feeling more clear about what to expect for themself and their friends.

A few years ago, when it was in the planning stage, "we wanted this book to be in every school in the country, so that any kid could pick it up and see themselves and their peers," says Hutchison. That's unrealistic today, amid a growing tide of anti-trans and anti-LGBTQ legislation, including restrictions on what books can be used in schools. Now, "there are certain states out there where you can't even say [some] of these words," Hutchison says.

"Regardless of what's going on in state capitals, our jobs are to be pediatricians, and to teach kids about their bodies and how to take care of themselves," Lowe says.

NPR spoke with Lowe and Hutchison about the book, the language of inclusivity, and how using real names for body parts helps combat shame.

This interview has been edited and condensed for length and clarity.

Why did you write this book? What gaps did you see that you were trying to fill?

Trish Hutchison: We started Girlology as an extension of our busy clinical practices because we realized that puberty, periods, anxiety, anatomy, reproductive health – all these aren't easy topics for parents and we had such little time in the office to cover these topics.

When we started [teaching puberty classes in 2003], we separated [kids] by gender. But that was long before there was a better understanding of gender, and the language for it. I think within the last three to five years, it's really become [clear that] we need to be more inclusive of everybody.

When we put our boys and girls together [in puberty classes], they were fine with it. You know, kids are so much more comfortable with these conversations. It was the parents that were freaking out about it, and I think it's because they hadn't unpacked their own baggage about their puberty education. Kids today are open.

Kathryn Lowe: There's a real need for all kids to understand about periods and erections, so we all understand each other's bodies. That really sets the stage for healthy communication and intimate relationships, if they so choose, growing up.

I think the other big need is kids who don't fit into a gender binary. With this book, we're trying to change that language to be more inclusive. With traditional puberty education, whether it's in schools or in books, we talk about how girls get their periods and boys get erections. But some girls – for example, transgender girls – might not get their periods. They need to understand about erections and those changes in their bodies. So we wanted to fill this void in puberty education so that kids, regardless of their gender, can see themselves in a book and learn about their bodies.

Let's talk a little bit about that baggage that comes from past iterations of sex ed. I'm in my 30s, and I remember getting my first puberty class in the fourth grade – it felt awkward and embarrassing. What do you remember about your puberty education?

KL: Fourth grade is also in my memory. We were all nervous about it for months leading up to it. One day girls went into one room, they turned off the lights and they showed a movie. Boys went in a different room, turned out the lights and showed a movie. It felt so shameful and secretive and I got the feeling we shouldn't even ask or be curious as to what is going on in the other room. Yeah, it was a very uncomfortable experience.

PH: I'm in my fifties – mine was a reel-to-reel movie in the cafeteria, where [boys and girls] were separated from each other. I already had breast buds, and I was pulling my shirt down so my buds wouldn't show through my shirt. Friends talked about it, but there wasn't a whole lot [of information] out there. Are you there, God? It's me, Margaret by Judy Blume – that was my education.

Part of the baggage is that our parents didn't teach us about puberty, so as parents today, [we] have no idea how to talk about puberty. Parents don't have the tools to have these conversations, they're just not ready for them and kids are walking around with [a cultural] education that goes way beyond puberty. I think parents are overwhelmed and scared, and they are putting that shame and that embarrassment into their conversations about puberty, which is definitely not beneficial to our kids.

How did you craft the message to be more inclusive of gender diversity? What words and phrases did you choose?

KL: There's lots of different ways you can use language to be more inclusive than traditional language when it comes to talking about puberty. The style we settled on is to use terms like "for most girls, this happens; for most boys, this happens."

And then we wanted to be even more purposeful in including transgender, non-binary, gender diverse kids. So we came up with characters throughout the book – a lot of them are cisgender. Some are transgender, some are non-binary.

So we would say "most boys and kids like this character" as a way to really intentionally include gender diverse kids as well.

PH: A lot of people use language like "people with ovaries do this, people with penises do that," and to us, that phrasing just didn't flow well. When Katie came in we had a few spats and arguments on how to make this for everybody. But I think it was really important that we were able to navigate by using these characters.

KL: And then a lot of the time we also simply talked about body parts and what happens with ovaries and penises, because that's all completely accurate and is inclusive language also. You don't have to use gendered words.

I want to ask about the current context into which this book is being released. Some states are really pushing back against gender-inclusive education. What kind of a statement does the book make, coming at this time?

KL: These times are very scary for gender diverse youth, for sure. I'm well aware of everything that's going on that's targeting gender diverse kids in our country. Regardless of what's going on in state capitals, our jobs are to be pediatricians, and that means educating kids about their bodies and how to be healthy and how to take care of themselves; teaching them about anatomy and physiology. This is what we've trained for and what we've been doing for many years.

PH: It's sad that the government has to step into our physician-patient-family relationships. We're not trying to make a political statement. We're just trying to take care of kids and their families – the cis kids, trans kids, gender diverse – everybody. And the more they understand and normalize the changes in their bodies, the more they face it with confidence and less anxiety.

KL: I think this book is awesome to be out there in the midst of this climate. It's an amazing resource for every kid in our country and especially for gender-diverse kids to see one more great book coming out that acknowledges them, includes them and normalizes them. I speak as a pediatrician, I speak from my knowledge and from my experience. I will continue to try to stand up for every kid and try to make every kid feel seen and heard and loved and supported unconditionally.

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