How Early Puberty Affects Children’s Mental Health

Puberty is an intense time of transition for all children and adolescents, but it can be especially difficult for younger kids who are experiencing early puberty.

Early puberty, also called precocious puberty, is when a child’s body begins to mature at an unusually young age — generally before age 8 for girls and age 9 for boys. Until recently, the average age for puberty was age 11 for girls and age 12 for boys, but now many experts consider any age above 8 or 9 to be normal. Experts cite many possible causes for early puberty, including genetics, nutrition and/or obesity, environmental cues, and trauma. Early puberty can cause emotional distress and increase the risks for mental health issues like anxiety and depression.

Many studies indicate that the average age of puberty in the United States is falling. As more and more children are maturing earlier than expected, it’s important for parents to understand the emotional changes that puberty brings, and how to help kids develop coping skills to prevent long-term negative impacts.

Children experiencing early puberty may be going through physical and mental changes before they’re emotionally mature enough to handle them. Sandra L. Whitehouse, PhD, a clinical psychologist at the Child Mind Institute, explains: “With precocious puberty, they don’t have the executive functioning or self-control that would allow them to manage their intense feelings. It’s like a car where the accelerator is fully online, but kids can’t reach the brakes or steering.”

Beyond the physical transitions that come with puberty, there are emotional and social changes as well. Pubescent kids are starting to think about their identity — who they are, what they like, who they’re attracted to. They may have overwhelming feelings, moodiness, and outbursts. Their relationship with their parents may become strained.

It’s common at this stage of development to desperately want to fit in with your peers. Paul Mitrani, MD, PhD, a child and adolescent psychiatrist at the Child Mind Institute, says that kids may feel uncomfortable because their bodies are changing before their peers’ bodies. “It is a time where you really want to be like your friends, and if you can’t be, that can cause a lot more stress.”

Children going through early puberty may experience bullying or sexual harassment (especially girls). They also may find that some people think they’re older than they really are, which can lead to unrealistic behavioral expectations and risk of early exposure to mature behaviors like sexual activity and drug use.

“When someone assumes you’re older than you are, you’re exposed to different things and they may treat you in a different way,” Dr. Mitrani explains. “And you may be ostracized from kids your age if you’re taller or more developed.”

Early puberty puts children at an increased risk for emotional and mental health issues, such as anxiety, depression, low self-esteem, and poor body image or body dysmorphia.

As they continue to mature, children who went through early puberty may also be more likely to abuse substances, engage in earlier sexual activity (which is associated with higher risks of teen pregnancy), and suffer from eating disorders.

“It’s like you’re trying to fit into a certain mold, and when you can’t, sometimes you’re self-medicating or you’re doing other things to try to control your body,” explains Dr. Mitrani.

There can be important gender differences in the psychological impacts of early puberty. Some research indicates that early-developing girls seem to be more vulnerable to anxiety and depression, and that they can carry that risk for several years. For boys, early puberty may not be as distressing. “Early-maturing boys have some social advantages because they’re bigger and stronger,” explains Dr. Whitehouse.

But that doesn’t mean that boys aren’t at risk for emotional issues. With increased testosterone, they may have stronger emotions, a possible increase in aggressive behavior, and a sudden sex drive that they might not know how to manage. Since early puberty may cause stunted growth, boys may feel self-conscious about their height later on if they end up being shorter than their peers.

And for children who are transgender or nonbinary — who often experience extreme distress called gender dysphoria — puberty at any age can be especially difficult, and early puberty can exacerbate their challenges. “If you have gender dysphoria and your body is changing into something that is not aligned with your gender identity,” Dr.Mitrani adds, “it’s just going to be that much more stressful.”

A child’s racial or ethnic identity can also shape how early puberty impacts them. For example, Black girls often experience what’s called adultification bias — they’re perceived as less innocent and are expected to act older than they are. This can result in harsher discipline at school for the same infractions as their white counterparts. Undergoing early puberty only exacerbates this unfair treatment.

Parents can’t control the changes that puberty will bring, but there are many ways to help your child prepare for and manage the transition.

Regardless of their age, when you first start to notice that your child is showing signs of puberty, it’s best to check in with your pediatrician. For girls, puberty usually begins with growing breasts and underarm or pubic hair. For boys, larger testicles and body hair may be the first signs.

But the best way to help prepare your child for puberty starts long before the signs appear. “The earlier you can talk about these things in an age-appropriate way, the better,” says Dr. Mitrani. Start discussing puberty with your child early, even around seven or eight years old. It’s important to remove any stigma around it and allow your child to ask questions.

Keep in mind that you don’t have to explain everything to them at once. In fact, that might overwhelm or confuse them. Take it slowly and let your child’s questions guide the conversation.

“If your kid has a question, ask them why they want to know. Try to get more information about what they’re asking you, and just give them the information that they’re asking for,” advises Dr. Mitrani. “You want to have these conversations early, but you also want to read the room.”

If your child is undergoing early puberty and you’re concerned about their mental health, you can help arm them with coping skills. And consulting with a therapist is often an effective way to do that.

“A lot of what therapy is all about — cognitive behavioral therapy, dialectical behavior therapy —

is teaching kids the skills they need to become aware of themselves and aware of their emotions,” explains Dr. Whitehouse. “And to learn strategies for recognizing when they’re having thoughts that maybe they could challenge.”

Parents can start teaching these skills early on, but during puberty, communicating effectively with your child can get harder.

“The relationship gets stressed when puberty hits, because naturally the developmental task of teenagers is to separate and individuate from their parents,” Dr. Whitehouse says. “So they have a harder time talking to their parents, and there’s more conflict where there used to not be. Parents feel like their child was just taken over by a monster, and kids feel the same way about their parents! And so a therapist can help to bridge the communication.”

It’s also helpful for parents to reinforce coping skills and emotional regulation at home. One of the best ways is to model healthy coping skills themselves, since children pick up behavior patterns from the adults around them.