Cara Natterson, MD, had a few different motivations for her new book Decoding Boys: New Science Behind the Subtle Art of Raising Sons. For one thing, as a pediatrician and author of other books for children and parents stumbling their way into puberty (Guy Stuff, The Care and Keeping of You 2: The Body Book for Older Girls), she saw a real hunger for information that is evidence-based, thoughtful and crafted for boys growing up in 2020. And, of course, as someone who has raised a son, she knew first-hand how invaluable it’d be to get in there and look at the data — since too often there’s a lack of communication between boys going through puberty and their parents.
In a conversation with SheKnows after her book dropped, Natterson talked about her major takeaways from the book, some handy advice for parents navigating the communication gap between themselves and their pubescent or pre-pubescent boys (and why, culturally, that’s still such a thing) and some advice for how to make the puberty experience a little bit less painful for all parties involved.
SheKnows: How did young boys and puberty come on your radar and why did you decide to start telling this story?
Cara Natterson: It became very clear to me in a very different way than I had ever recognized before just how little boys and their parents talk compared with girls and their parents. And it’s not that no boys and their parents talk — ’cause of course there are people who are all over the spectrum here. But, on average, parents tend to engage with their daughters in a number of conversations that they just don’t go there with their boys. It became very obvious to me that not only was this the pattern, but that in today’s world that was putting our boys at a serious disadvantage.
SK: When you started doing the information gathering and figuring out how to structure this book, what was on your mind? What were the things you were hoping to communicate to parents of boys through the book?
Natterson: My main hope is to communicate sort of three things in increasing order of importance. So the first is, what happens when boys enter puberty. Then, slightly more importantly: the fact that they’re entering puberty earlier than ever before and why that matter and why we even need to know about that. Then the third and most important thing is why we need to talk about it. Ultimately, what’s the solution to all this? Knowledge and it’s talking — and why and how do you do that?
SK: What were your biggest takeaways from each of those three categories?
Natterson: So what happens during puberty? If you need one nugget, no pun intended, it’s that the testicle start to grow. That’s the secret little indicator that your son is in puberty and that because the testicles are the machinery that make testosterone and testosterone that tips boys into puberty. And, you know, sort of a side note, most parents don’t know that testicles are growing, which is entirely appropriate. They don’t, they’re not close enough to know that, boys are covering and getting private and shutting the door to use the bathroom or the shower or whatever it is — and that’s totally appropriate and it’s fine. But that’s the first sign and it’s far less obvious than breast growth, which is typically the first sign of girl puberty (although not always, but typically).
The second bucket, which is: When is it starting? The answer is it’s starting a lot earlier than it used to and a lot earlier than parents realize. So the data from the 1940s and 50s and 60s, that kind of set in place the rules about the ‘right’ time for puberty to start, that data suggested that boys were entering puberty on average around 11 and a half. And we know now that boys are actually entering puberty today or sometime around 10-ish on average if they are white, around nine on average, if they are black, and somewhere in between if they’re Hispanic. And that is all the data that we have from big studies. So I can’t speak to other populations, but that’s a lot earlier. The notion that girls tend to hit puberty earlier has been known for 20 years and people talk about it a lot. But the notion that boys are entering puberty earlier has also been known for a long time and no one talks about it. I think we should talk about it. And the reason I think we should talk about it is the fact that testosterone circulating through the body — and therefore in and around the brain — changes the way boys feel and respond and react. Testosterone works directly in the brain and changes the actual wiring the brain. So there are reasons to understand that there is a new drug in your body that is going to impact the way you behave and the way you feel.
For the third, which is the talking. The fact is that girls have gotten really good at talking about this stuff over the past few decades. Even when I was a teenager, we were finding our voice. But increasingly girls, my daughter is 16, she and her friends and girls their age across the country talk very openly about what’s happening to them through puberty and beyond — not just to their bodies but also to adolescence, which is the whole sort of emotional maturational piece of it.And they are very articulate about all the changes they face and the downstream impact of all of that — their mood swings, their periods. They use these incredible phrases. When people point out what’s going on with their bodies they say ‘don’t shame me.’ They have no shame. They might be self conscious, right? They might not want you to look there. But it’s really shifted for girls but for our boys? None of that. Like I don’t hear that language or that conversation at all for our boys. I think that language is wonderful for girls and I think our boys deserve it. I think they will grow up healthier and happier if they have it.
SK: What are some misconceptions about puberty that maybe reinforce the old attitudes about puberty — the shame, silence, lack of transparency?
Natterson: So the first thing is that parents only believe that they see (which is fair) but because it can be a couple of years between when the testicles start to grow and when you start to see the impact of testosterone — you know, things like increased bulk in muscles or dropping of the voice because the vocal cords stretch and shift — most parents are in complete denial that their sons are in puberty. This is very interesting because then they often delay conversations that their sons want to be having and need to be having.
Another sort of stereotype (but stereotypes exist often for a reason) is that we talk a lot about social risks: things like exposure to pornography. And a lot of parents will talk about it in the context of ‘I hear this is happening, but there’s no way it’s happening to my son.’ And that’s important to recognize that while we all want to see our children as immune to some of these forces, the issue with pornography is that the free pornography that’s easily accessible and not behind a paywall today tends to be quite violent and aggressive and it’s not modeling the kind of sex you ever want your child to have. So when we don’t acknowledge that they’re being exposed to it, then we’re not giving ourselves permission to begin the conversations about what they’re seeing and helping them to write a different story about what sex is and what it will be for them.
Yeah, they are in puberty, yeah, they have testosterone and yes, they are exposed to this content and those things all intersect. And it’s important to talk about it.
SK: We sat down Peggy Orenstein earlier this year to talk about her book Boys & Sex and she talked about how learning to be silent about their emotions, their bodies and their thoughts on intimacy is a major (and often damaging) moment for boys as they grow up. What do we know about what that culture of silence does to boys and their mental health?
Natterson: It’s not that there is one known outcome for this disconnect, this lack of conversation. The reason why is no one studies quiet. It’s not that sexy a topic. No one studies why boys get quiet and shut their door for a little bit of time and retreat from the conversation and then they emerge and they seem okay. You know? So they don’t look at the biology of it and they don’t really look at the consequences of it. I really hope that data will be coming at some point, but there isn’t a lot to sink our teeth into in terms of the science around it.
But I will tell you that it’s very clear to me from the conversations I’ve had with both boys and their parents that boys want to talk. I have a monosyllabic 14 year old living in my house. I completely get it when parents say to me ‘that cannot be true’ because I live it too and I understand it at the most base level. But when we bring up these subjects over and over, which is the key here, it’s not a one and done on any one of these topics. It’s small conversations that evolve over time, very slowly and gradually over years. As we bring them up more and more often, what I find is, on any given topic, there’s sort of a watershed moment where you get in — you find your way in as a parent and you get access to your son. And suddenly you’ve got a son who is articulating many of the things that a daughter might articulate. And, again, there are boys who talk endlessly with their parents and are very expressive and don’t really seem to go through this phase.
SK: How can books like Decoding Boys be a tool for parents trying to initiate those conversations?
Natterson: Decoding… is really designed to give that basic information. There’s information about what testosterone is and what it does. There’s information about why you start puberty earlier than anyone realizes. There’s a lot of information about why late blooming, which is sort of the last two and a half percent of boys to go through puberty, and why it’s hard. It’s hard to be an early bloomer. It’s hard to be an average bloomer. It’s hard to be a late bloomer. There’s a lot of information about brain development and how kids make decisions and why, based upon the maturation of their brain, they are more likely to be slightly impulsive or do things that feel good without really thinking about the longterm consequences — and that chapter, more than any, kids should read, because when they understand how their brains make decisions they are able to game it so that they can make better decisions. There are strategies they can use to stop themselves from making dangerous, short-term impulsive choices.
SK: So what is the one bit of advice that you can give that you’re like, ‘damn, I wish I knew this going into parenting’ or that you just think ‘this is what moms need to know’ as they approach puberty?
Natterson: I’ll give you two. I’ll give you a light one and I’ll give you a heavy one.
The light one is: They do not know that you need to use soap in the shower. I am kidding but not kidding: Unless you tell them, take a shower means you use soap, there is nothing intuitive about it and they will smell. So that’s a good one. Boys and girls, they all reek by the way.
SK: Oh, all teenagers smell so bad. You just don’t know how to not smell bad.
Natterson: They do. And if that is one thing I change in this world, oh my God, have I done my part. Fifth grade teachers everywhere will thank me. And my bigger piece of advice is it’s never too early to begin to talk about any of this. It’s not the ‘talking about it’ that needs to be timed out — it’s just how you talk about it. So we need to apply the principles that we have used for our daughters to our sons. And that means you start talking about consent when they’re in preschool and it’s lessons around sharing and borrowing things and you know, reaching out and touching someone or hugging someone or letting someone hug you. You just frame them in terms of consent instead of in terms of their other language that we’ve used up until now — but you start to give them some early tools on all of these topics that become really hot button issues once they’re in puberty.
If you can take the time when they are in preschool and grammar school and middle school to lay the ground work for these bigger conversations is very simple ways. You then are not introducing enormous new concepts exactly at the moment that they are turning their attention away from you and toward their friends who may not be guiding the way as you would like. But if you have a 16 year old and you’ve never had any of these conversations, just start. You don’t miss a boat here.