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Early onset puberty has increased since COVID-19


Puberty can be scary for kids, especially when it comes earlier than what's perceived as normal. Since COVID hit, some medical experts have reported a rise in the number of kids undergoing early onset puberty. For children who will develop periods, that's earlier than age 8. In one study, scientists reported that across five pediatric centers in Italy, the number of early onset cases doubled between 2019 and 2020. In another, also in Italy, scientists observed upticks in medical centers in Florence and Rome. Dr. Adiaha Spinks-Franklin is a developmental behavioral pediatrician at Texas Children's Hospital, and she joins us now.

Welcome to the show.


RASCOE: So what have you been seeing at your own clinic?

SPINKS-FRANKLIN: I noticed during the 2020 lockdowns over the summer and fall of 2020 that a number of my girls who have developmental disabilities began to have their periods. And it happened at such a surprisingly early time. These girls had already started the early stages of puberty. They already had breast buds. They were already developing pubic hair, but we weren't expecting their periods for about another year.

RASCOE: Wow. And so, you know, I mentioned the two studies out of Italy show an increase in early onset puberty. But those are just two studies, and only one is based on empirical data. So are we sure that COVID is really speeding up puberty, or is it just kind of a question right now?

SPINKS-FRANKLIN: It's still a question right now, but a number of pediatricians across different specialties are observing this phenomenon anecdotally among their own patient populations. And we're not sure of the why or the how. And in those Italian studies, not only did they see early onset puberty happening to more girls. They also observed them advancing through puberty more rapidly.

RASCOE: You said there are some hypotheses on why this might be happening. What are some of the thoughts on what could be happening? Could it be stress? Could it be just such a rapid change?

SPINKS-FRANKLIN: Initially, among my colleagues, we thought it was related to the stress of the pandemic lockdown, the significant stress that children were under, where, suddenly, the entire world was turned upside down. And we know that stress can do lots of things to children's bodies. And that was our initial thought. And then there's also a thought that it could be related to increase in body weight. There are a lot of different ideas that physicians are thinking about, but we don't have enough information to be able to figure out an underlying mechanism at this juncture.

RASCOE: So what can be done to make it easier on kids who are going through this? Is it about destigmatizing the period, just having that family support, medical support? What can be done to help?

SPINKS-FRANKLIN: I strongly believe in early education for students about their bodies. By the time a child is 3 years old, they should know the proper names and the basic function of their body parts, including intimate body parts. I encourage the parents that I see in my clinic that once they notice that their daughters have breast buds, start talking about the period coming. Have the daughters start wearing panty liners every day, a very thin panty liner, so that she begins to appreciate or gets desensitized to having something in her underwear that she's never had before, learns how to put on, take off of, dispose of a pad appropriately. And this begins to mentally prepare her for the period coming. There are also children's books written about puberty and changes in the body that I encourage parents to read along with their children so they can understand all of these physical and mental and social changes that take place in the body.

RASCOE: Dr. Adiaha Spinks-Franklin is a developmental behavioral pediatrician at Texas Children's Hospital. Thank you for joining us.

SPINKS-FRANKLIN: Thank you for having me.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.