• Primary sex characteristics refer to changes to the sexual organs themselves (uterus, vagina, penis, and testes).
• Secondary sex characteristics refer to other visible changes that mark adult maturation such as changes in height and body shape.
• Primary sex characteristic changes for boys include the enlargement of the testes, penis, prostate gland, and seminal vesicles. These changes are generally completed between ages 12 and 16 years.
• The most significant and noticeable puberty-related change for young men is spermarche, or the first ejaculation, which generally occurs between the ages of 12 and 16.
• The primary sex characteristic changes for girls includes the uterus starting to build a lining that will later be shed through the process of menstruation, and the vagina beginning to produce a mucus-like discharge.
• The most significant and noticeable primary sex change for young women is menarche, or the first menstrual period. On average, this occurs between ages 10 and 15 years for North American girls.
• One of the first noticeable secondary sex changes is a growth spurt in height. On average, the growth spurt for girls begins between the ages of 8 and 13 years; and in boys, between the ages of 10 and 16 years.
• Another obvious secondary sex change for both sexes is body hair. Youth begin developing pubic hair around their external genitals. For girls, this occurs between the ages of 8 and 14 years, and for boys between the ages of 10 and 15 years.
• Underarm hair appears in youth between the ages of 10 and 16 years.
• Boys begin developing facial hair between the ages of 12 and 15 years.
• For girls, breasts begin to bud on average between the ages of 8 to 13 years.
• Boys experience their voice changing, or deepening.

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• Parents can best support their children's effort to cope with puberty-related change by educating them and by being an accepting and understanding presence in their lives.
• Ideally, parents should teach children: 1. what puberty is and what changes to expect, 2. how to care for their bodies, 3. how to make wise and healthy decisions regarding their bodies, 4. how to understand sexual feelings and attraction, and 5. potential consequences of sexual activity.
• Children who have been educated regarding these points will have the foundation they require for making healthy decisions, and may be more likely than before to come to parents when confronted with troubling problems later on.
• Preparing children so that they know what they are dealing with regarding puberty doesn't make their adjustment problems go away, but it does give them a significant advantage with regard to the resources they can bring to problem solving.
• It is very important that parents and caregivers take time to coordinate their message.
• Educating children about puberty in a way that helps them feel empowered and cared for rather than embarrassed is actually a difficult task as it involves two way communication between parents and children.
• It's important that parents do what they can to stay relaxed, calm and normal throughout the process.
• When parents approach these topics in a relaxed matter-of-fact manner, children instead determine that talking about puberty and sexuality is routine, nothing to be ashamed about, and important.
• In our view, children need to learn about reproduction, sexually transmitted disease and birth control before they hit puberty and before their friends, or the media, provide them with false or misleading information.

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• Apart from communicating the basics of reproduction, parents also need to provide pubescent youngsters with practical information about how to cope with the puberty-related physical changes that their bodies will shortly undergo, and to teach children how to properly care for their developing bodies.
• Young men need to learn how to cope with spontaneous erections and ejaculations.
• Caregivers can teach youth to avoid embarrassment by suggesting ways to hide erections while in public and can also be taught how to hasten the end of a spontaneous erection by thinking or imagining about unpleasant or disgusting situations, which will be followed by a deflating biological response.
• The first spontaneous ejaculation often happens during sleep, hence the term nocturnal emission or "wet dream" and boys will generally be between ages 12 and 16 when this event first occurs.
• Caregivers should let youth know that wet dreams are just a natural part of growing up that happen to all young men at some point.
• Parents may want to teach their boys how to do laundry by themselves and have them get into the habit of routinely changing their own sheets prior to the typical age of their first wet dream.
• Parents should try to convey the following information at a minimum: 1) Masturbation is a normal part of sexuality the vast majority of adult men engage in it, at least on occasion. 2) Though it is quite common for men to use pornography as a masturbatory aide, it is best to not do so, or at least to use judgment while doing so. 3) It is best to clean up after one's self using disposable toilet tissue which can be hygienically flushed away.
• All pubescent youth need to learn that pregnancy occurs when sperm contained in the male's ejaculate comes into contact with the female's egg.
• Pubescent youth also need to be educated about sexually transmitted diseases (STDs) and how they can be prevented.
• Another aspect of teaching healthy sexuality has to do with helping kids to learn how to protect themselves from dangerous, abusive, invasive or controlling sexual relationships.

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• Pubescent girls need to learn how to cope with the unprecedented event of their first menstrual periods and other vaginal discharge.
• Caregivers will want to educate girls regarding the advantages and disadvantages associated with tampons and pads and about how to care for each product.
• It is particularly important for caregivers to educate their girls about possible health risks associated with improper tampon or pad usage, including toxic shock syndrome, unpleasant odors, and the signs and symptoms of vaginal infection.
• Young ladies will feel a greater sense of control and will be best able to preserve their privacy if they have already learned how to properly pre-treat and launder blood-stained clothing and bed linens.
• All pubescent youth need to learn that pregnancy occurs when sperm contained in the male's ejaculate comes into contact with the female's egg.
• Pubescent youth also need to be educated about sexually transmitted diseases (STDs) and how they can be prevented.
• Another aspect of teaching healthy sexuality has to do with helping kids to learn how to protect themselves from dangerous, abusive, invasive or controlling sexual relationships.

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• It is important for parents to teach their children how to recognize and decline to participate when people try to manipulate or seduce them into sexual activity that is not in their best interests.
• Boys and girls both may benefit from role playing troubling seduction scenarios in which they have the opportunity to assertively say "No".
• Useful role playing will go beyond simply teaching kids to say No, and additionally help children practice responding to seducers' (or predators') further manipulative taunts and shaming tactics. For instance, a boy who is being pressured to have unwanted sex might be told that his refusal to participate means he "must be gay".
• Similar manipulative remarks which children may hear from peers and ought to know how to respond to include, "If you loved me, you would do this", or "If you don't do this, I won't be your boy/girlfriend anymore".
• During puberty, most children will begin to assert their independence through numerous actions and efforts designed to demonstrate - to themselves and the world - that they are now grown up and no longer need or want parents and other authorities to make choices and decisions for them.
• Pubescent children very much continue to need parents to guide them, express concern, and provide consequences when they move in dangerous directions.
• Children's experimentation should minimally meet the following criteria: 1. Activities and choices must not be truly dangerous 2. They should not interfere with schooling or otherwise affect future well-being 3. It should not contradict the family's most basic values.
• These criteria afford children a great deal of freedom while also leaving room for parents and caregivers to "put their foot down" when children stray into non-negotiable areas where safety, future well-being, or values issues are at stake.

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• It is important to educate children so that they understand the nature of the danger, what their rights are, and what they can do to protect themselves.
• Boys and girls need to know they have the exclusive right to decide how to use their bodies, who they allow to see and to touch their bodies, and to decide what they are willing, and not willing to do, sexually.
• Children need to clearly understand that it's never okay to use physical violence, abusive language, intimidation, or emotional cruelty toward anyone; especially dating partners.
• Children need to be clear that when a friend or dating partner says, "No," to a sexual act or another act of intimacy, they must accept and honor their friend or partner's decision.
• Children should be taught that it is perfectly okay for them to refuse to participate in a sexual or non-sexual situation that makes them feel uncomfortable. It's okay to say "No".
• Youth need to know that if someone insists upon hurting them in any significant way, or treats them disrespectfully after being asked to stop, that person doesn't really love them properly (even if they say they do!) and they should not stay with that person.
• Parents can also help prevent their children from being victimized by keeping a careful and attentive eye on their children's relationships with both peers and other adults so as to learn who their children' socialize with.
• Parents should also take the time to educate children about the possibility of online sexual solicitation and sexual predators and take steps to monitor their children's Internet usage.

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• Though children may not speak about abuse, they may nevertheless communicate that something significant and disturbing has happened to them in a non-verbal manner.
• Changes in mood may include signs of depression: sadness, tearfulness, lethargy, anger, or mood swings.
• Behavioral changes which may indicate abuse include: significant changes in sleeping patterns and habits, significant or sudden changes in appetite and eating patterns, or significant weight gain or loss.
• When children have been sexually assaulted (raped) they may show medical signs of their attack including sexually transmitted infection, urinary tract infection and other hard-to-explain injuries.
• Some abused youth will act out their inner pain by self-harming; often by cutting themselves with a blade in an effort to distract from emotional pain.
• Parents who believe their children may have been sexually abused should take quick action.
• If the sexual abuse occurred within the last 24 hours, parents should immediately take their children to an emergency room, urgent care, or local child and family advocacy center, and do so before the child takes a shower, changes clothes or even has a drink.
• In addition to receiving vital medical attention, abused children should strongly consider talking with a supportive rape counselors or social worker whose job it is to help the entire family access the emotional support and treatment they need.

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• In striving to push beyond previous limitations, children sometimes push too far, and find themselves engaging in dangerous or unsafe behavior.
• In such cases, parents may wish to get support and guidance from professionals, such as family doctors, and behavioral health specialists including social workers, counselors and psychologists, who specialize in helping families cope with adolescent distress and illness.
• Parents should teach children why alcohol and drugs are harmful, express genuine concern for their welfare, and provide disciplinary consequences for substance use.
• Parents should recognize their children as having a serious substance abuse problem if they become aware that their child is using drugs and/or alcohol on a regular basis despite receiving parental discipline and warning that this is unacceptable, unsafe behavior.
• Parents should take seriously any suggestion that their children are involved in and cannot remove themselves from violent, abusive or obsessive relationships.
• Parents should consider professional help in the event that their children repeatedly break house rules, or put themselves in risky or unsafe situations, despite parents' previous attempts to discipline them.
• Children who show pronounced or exaggerated mood change, such as marked sadness, increased irritability or aggression, frequent tearfulness, or significant worry or anxiety, any of which lasts for a week or more, and which do not appear to be appropriate reactions to sad or worrying events, may be developing a mental health condition such as depression which would benefit from professional diagnosis and treatment.
• Changes in children's appetite, sleeping patterns, socialization, or motivation at school may also indicate that potentially serious problem are occurring that should be checked out.

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