Almost Grown

She barely manages to keep track of her water bottle, books, even her shoelaces—it breaks my heart that she now has to cope with managing sanitary pads. It hasn’t been easy, helping my daughter become an adult at nine," says Delhi-based home-maker Ishita Sawhney. The logistics of handling womanhood at such an early age, says this harried 36-year-old mother, has her little girl in a tizzy, and worse, very depressed. "I am at a loss too. I still don’t know how to manage best. Time was when we started menstruating well into our teens."

Nandita and Gaurav Deodhar, a Mumbai couple, consulted a paediatrician when their seven-year-old daughter Rhea started growing pubic hair a year ago. She was then referred to an endocrinologist, who, in turn, put her through a battery of blood tests to rule out ovarian tumours, known to force glands to secrete puberty-triggering hormones. The tests were clear. Eight now, Rhea has developed breasts and wears brassieres. Her parents are concerned: "Doctors assure us it is normal, we can’t help but worry. Rhea’s is a child’s mind in a woman’s body."

Meet today’s Indian girl child, on a hormonal fast forward. She’s attaining puberty earlier than ever before—by ten, give or take two years. Just a decade ago, the age for menarche—the first menstruation—was around 12 to 14. Two decades ago, experts say, it wasn’t unusual for the first periods to occur even at sixteen. But not any more. Today, an entire generation of pre-teen girls is dealing with budding breasts, pubic hair and puberty that’s premature when compared to erstwhile times. 

Parents needn’t worry, for these little girls aren’t ill, nor biological flukes. Growing numbers of young girls are today pubescent earlier than before. "Pubertal age for girls has dipped considerably," says Kamini Rao, president of the Federation of Obstetrics and Gynaecological Society of India. 

She should know. Her study of 5,000 school-girls in Bangalore last year indicated that girls attain puberty as early as age ten. Also, it showed up a problematic fallout of this trend: "Today’s girls are becoming physically mature while still mentally immature. Often ill prepared to cope with the bodily changes. The do’s and don’ts are specified—wear baggy outfits, no staying out after dusk. But the reasons aren’t." 

Delhi-based clinical psychologist Radhika Chandiramani’s field experience bears the truth of the survey’s findings. Calls pouring into her sexual health helpline tarshi have girls enquiring about their breast size, period pains, choice of sanitary pads etc, "much more than they used to, say, four years ago." Most little girls are left to ferret out such information from their friends: "Factual accuracy, emotional content of the information and a healthy attitude towards hygiene are usually the casualties." 

Parents too struggle, trying to deal with the uncomfortably early flowering of their daughters. Subhash Kumar Wangnoo, consulting endocrinologist at Delhi’s Apollo hospital, says every month four to five young patients with symptoms of early puberty are brought to his clinic by skittish parents. Five years ago, it wasn’t more than two to three annually. "These parents worry about the effect early menarche might have on height, sexual growth. Most can’t figure out why this at such a tender age."

What’s causing this change? Experts variously cite "better nutrition" and "obesity" as the most prominent reasons. It is suspected that early breast development may be encouraged by a protein called leptin, produced by the body’s fat cells and necessary for the progression of puberty. Also, experts feel that overweight girls have more insulin (a hormone that lowers the blood glucose level) in their blood and that appears to stimulate the production of sex hormones from the ovary and the adrenal gland.

Says Ramchandra Naik, consultant endocrinologist at the Bombay Hospital: "In urban India, increased socio-economic and improved dietary standards have girls attaining critical body mass much earlier than before. In turn, triggering hormones essential for puberty. World over, the lowest pubertal ages are in countries where diets are the heaviest." In well-fed usa, for instance, a much-cited survey of 17,000 girls by Professor Marcia Herman-Giddens at the University of North Carolina School of Public Health, concluded that today one out of seven Caucasian American girls starts developing breasts or pubic hair by age eight. 

In agreement with the better nutrition-early puberty link, R.K. Anand, head of the department of paediatrics at Mumbai’s Jaslok hospital, also cites the sedentary lifestyles of urban children as a reason for early puberty. "Athletes have delayed menstruation. Our children study, watch television and have no time for sports. When parents come to me with the problem of early menarche, I tell them it’s not a hormonal disease and suggest an increase in levels of activity." 

But other worrisome factors could be triggering early puberty. Environmental pollution, for one. Researchers around the world suspect that early puberty could be a pointer to how we are dangerously altering the fundamentals of life with our toxic habits. Chemicals in the environment, pesticides in our vegetables and steroids in our meat have often been cited as reasons for early sexual development. Chemical pollutants in the food chain, mainly dde, a breakdown product of the pesticide ddt, are suspected mimicking hormones that affect the development of the reproductive system. Also, a suite of chemicals used to make plastics, Bisphenol A (bpa), is held culpable. Like dde, it’s a chemical cousin of estrogen and is known to affect the reproductive systems of lab mice. 

Interestingly, studies in the West have even pinpointed explicit sexual content in the television kids watch, sexualised messages in the music they hear as psychosomatic triggers. Stimuli that make hormones take a leap-start into early sexual development. Sujata Sharma, a Delhi-based clinical psychologist, is loath to dismiss this linkage as too radical: "Seeing things can affect us psychologically. The mind-body connection cannot be underestimated." 

The causes could be an amalgam of some or all these reasons. But because it’s happening to many, it can’t be diagnosed as deviant. Though some endocrinologists admit to delaying menarche by administering the drug Lupride, they’re usually against meddling with the body-clock. "But some parents insist they don’t want early menarche to stunt their child’s height," saysWangnoo.

But more than height, it is childhood that’s perhaps being cut short. Bangalore’s Nanda was assigned a separate bedroom when she started menstruating at ten. Already jealous of her younger sibling, target of all parental attention, the segregation aggravated her feelings of low self-worth. It took the family a year of counselling to understand her needs. The Delhi-based Mukherjees are still baffled that their 11-year-old girl suffered in silence twice over before she confessed she had "hurt" herself and a brown sticky thing was flowing "from there." The parents hold themselves responsible: "Subconsciously, we must have taught her to be ashamed of her private parts."

Sunita Pandhe Gupta, a counsellor at Delhi’s Springdale’s Public School, observes that parents usually do little to prepare children for puberty. "They feel sexuality is best dealt with in school. The secrecy, shame adults feel is passed on to the child." Agrees Palomita Patel, with four years of counselling experience at the Bombay International School: "At most girls are taught how to use a pad, and when to throw it away. Teachers need to talk, parents need to tell."

But when do you talk? Says Chandiramani: "When your child begins asking questions, she is old enough to know the answers. She isn’t embarrassed by her sexuality, you might be. Your silence is about your shame, not about her age." Because, in the 21st century, she seems biologically destined to grow up faster than ever before. Better with you, than without.