Pop culture, early puberty making girls grow up fast

By Jean Chow
Advertiser Staff Writer

Illustration by Jon Orque • The Honolulu Advertiser

Just a few generations ago, there tended to be more of a sentimental meaning when parents looked at their daughters and sighed, ah, they grow up so fast.

Today girls are indeed growing up faster than their predecessors — in more ways than one.

Researchers say that physically, girls are maturing faster, hitting puberty at earlier ages.

In addition, child-development experts say, girls are being influenced at earlier ages by a society that is more focused on sex than ever before, influencing them to dress, think and act beyond their years.

What's going on?

First, it helps to understand how puberty works: When a child reaches a certain age, the stimulation of a child's endocrine system releases hormones from the pituitary gland at the base of the brain. In turn, these hormones stimulate the creation of sex hormones and sexual maturation. For girls, this entails breast development and menstruation, among other changes, and typically occurs at age 11 or 12.

"The average age for puberty remains pretty constant," said Dr. Sorrell Waxman, a pediatrics endocrinologist at Kapi'olani Medical Center for Women and Children. "But recently, it seems more girls are falling into the bottom part of the (average) and hitting puberty earlier than before."

Precocious puberty, as it is called, is the premature onset of puberty and may begin as young as 8 years old in girls; in extreme cases, even earlier.

(The early onset also occurs in boys, but it is not nearly as common and does not happen for the same reasons, Waxman said. "For girls, it's almost always a normal occurrence that just happens earlier than it should, but for boys, the occurrence is usually due to a brain tumor or adrenal problem.")

Doctors' anecdotes and statistics reported on medical Web sites (including www.covenanthealth.com, a leading East Tennessee health care provider) suggest that for every 10,000 boys and girls, one child will experience precocious puberty.

Reasons for the apparent rise in reported cases of precocious puberty in girls are debated among researchers, and include estrogen-simulating hormones found in cow's milk and family stress. However, Waxman said, the most widely embraced theory by pediatrics endocrinologists is that the early onset of puberty is connected to weight.

"It has to do with obesity — when a child reaches a certain weight, puberty starts. Over the last 15-20 years, since McDonald's and poor dieting, and since people have stopped exercising, we've been seeing an increase in precocious puberty cases," he said.

However, researchers are unsure whether there has been an actual increase, Waxman added. "Now that we have therapy and treatment for it, there might just be more referrals (of cases)."

Waxman said early puberty has two major repercussions.

First, children with precocious puberty hit their growth spurts before their peers, which makes them taller or bigger in their younger years. However, these children also stop growing earlier and end up much shorter than their peers in the long run.

Second, if a child begins puberty early, it means that he or she may be sexually mature at age 9 or 10, which causes another set of physical and emotional complications.

There is treatment for precocious puberty, in the form of a monthly shot of a hormone that delays the progress of puberty. It's not cheap — according to Pharmacare, a home infusion and specialty pharmacy provider based in Honolulu, the average wholesale price of each shot can range from $624 to $1,247 depending on the strength of the dose, and not including how much one's insurance company will cover.

Waxman said that in the majority of his cases, parents with a child in precocious puberty have chosen treatment with the shots, which are given until either the child's peers have caught up in sexual maturity, or when the child reaches an appropriate height. Whereas boys' parents usually seek treatment because of concerns about height, girls' parents tend to worry more about the early sexual maturity. "Parents have to think about the fact that their daughter can now become pregnant," Waxman said.

He and other doctors recommend that a child showing physical signs of precocious puberty be taken to the pediatrician for an examination — not only to discuss treatment options, but to rule out more serious causes, such as tumors or genetic disorders.

Wanting to look like Britney

While girls are physically maturing earlier, society is also playing a role in pushing girls to grow up faster.

With images of scantily-clad pop singers, such as Britney Spears and Christina Aguilera, plastered on TV screens and magazines, many girls — including the pre-teens who make up a large part of these singers' fan bases — are swept up in the hype and want to be just like the divas who personify "cool."

"I've definitely been noticing younger girls trying to dress in more provocative and revealing clothes like the high school girls," said Tracie Saiki, a manager at a young women's clothing store in Pearlridge. "A lot is from the media — with Britney and Christina, little girls are saying, 'I want to look like that.' I hear that a lot."

"Just look at the covers of magazines that young girls are buying," agrees Josette Solis, director of the Aloha Pregnancy Care and Counseling Center. "'How to dress sexier,' 'What he likes' — we're telling them at an early age that this is the model, what they aspire to be."

Nationwide surveys have shown that youths are also becoming sexually active at earlier ages: According to the 1999 national Youth Risk Behavior Survey, 8.3 percent of students report having had sex before age 13 — a 15-percent increase since 1997. (The Hawai'i survey shows a decrease, from 7 percent to 6.8 percent.)

"We've had 13 year olds come in and have had phone calls from 11 and 12 year olds," Solis said. "You'd be amazed at the number of youths that come in. It's too common. They're not equipped with the emotional foundation that goes on with a sexual relationship, they're not able to deal with it."

Emphasis on sex education

So what's a girl — and her parents — to do?

Puberty and anything sex-related are sensitive issues that many parents and youngsters are uncomfortable discussing.

But all who were interviewed for this article agreed that education and communication are key to helping a child adjust to the physical and emotional changes that occur with puberty, especially with an early bloomer who goes through many of the changes before her friends.

She may feel isolated from her peers and be subject to teasing or inappropriate sexual advances, so parents should be alert to how their child is coping and help them understand the situation, pediatricians say.

"I explained what was happening (to her), and she was pretty understanding," said Janet Nakagawa of Mililani, whose daughter, now 19, began to show signs of breast development at age 7. "She didn't get her period early, but we warned her in advance, and I told her to come talk to me if she saw blood (on her underwear)."

For all children, regardless of whether they've begun puberty early, "sex education needs to start sooner," said Beverly Morton, director of clinical operations at the Hawai'i chapter of Planned Parenthood.

Morton points out that by the time children receive sex education, usually in the fifth grade in the public schools, those who started puberty at an early age have already experienced some of the changes the course discusses.

She also feels that parents should let children know that sex can be openly discussed at home to "give them tools of knowledge and self-confidence, and information that will help them make the best decisions."

Author and puberty educator Lynda Madaras, based in Los Angeles, suggests that parents arm themselves with knowledge about what their child is going through, and prepare to answer questions that may arise. Then, instead of having the one "big talk," parents can have a series of conversations with their child that happen naturally.

As always, pediatricians say, the most important thing a parent can do for his or her daughter is provide love, support and understanding as she comes across the big changes in her life and despite how she may physically appear, allow her to act her age and just be a kid.

Advertiser news services contributed to this report.