They Called Me "The Puberty Lady"

Christine Hagstrom looks back on the puberty lessons she taught in Seattle-area schools and how an MPH is preparing her to reinvent how we educate adolescents, parents, teachers, and advocates.

September 16, 2020

Prior to becoming a Columbia Public Health student, it was not uncommon for me to stroll through the grocery store in my neighborhood outside Seattle and to see a 10-year-old child point at me and whisper to their parent “that’s the puberty lady!” As an educator for Planned Parenthood, I taught puberty lessons to thousands of fifth grade students. Some common questions I received included “does a period hurt?”, “what do I do if I start my period at school?”, and “how does a tampon work?” Answering questions like these were easily the most rewarding part of my job because I could see the relief wash over their faces as they realized that the changes occurring during puberty, including menstruation, are normal and healthy, and more importantly, that they are not alone. By educating students and answering their questions, I often left the classroom feeling confident that they had the information they needed to manage their menstruation successfully.

For my practicum this summer, I worked as a Lerner Center Research Fellow with the Program on Gender, Adolescent Transitions, and Environment (GATE) in the Department of Sociomedical Sciences. In this role, I analyzed qualitative data from GATE’s Growing Girls study examining the menstruation and puberty experiences of low-income adolescent girls across the U.S. Many of the questions, concerns, and experiences voiced by girls in our dataset directly mirrored my own experiences in the classroom every day. This illustrated to me the shared reality impacting the daily lives of so many girls growing up across our diverse country.

Through my experience with GATE, I began to examine these issues through a different lens, recognizing that there is much more than education that girls need in order to feel supported and confident in managing their menstruation, especially while at school.

In Seattle, one of my objectives as a puberty educator was to advocate for puberty lessons to be taught in a gender-inclusive environment, meaning not separating students into different classrooms by perceived gender. I successfully persuaded 15 schools to change their practice in this way. My rationale was to create a safer learning environment for trans and non-binary students and to build empathy among students by educating them about the challenges they were each facing. Girls frequently told me that they felt like boys didn’t understand menstruation and often teased them about it. So, during lessons, I had conversations with students about what they should do if they noticed a student had a menstrual bloodstain on their clothing. Later, I was heartened by an email from a teacher stating that a student noticed his classmate had a period stain on her pants, and instead of making a joke or telling his friends, his response was to discreetly give her his sweatshirt so she could tie it around her waist. While building this kind of empathy among students is important, I failed to consider why that student had stained her clothes in the first place. Maybe she didn’t have the menstrual products she needed or was too embarrassed to ask her teacher for a pad. Maybe her teacher wouldn’t let her go to the bathroom because she had already used her hall pass for the day. Or maybe she was afraid to go to the bathroom at all given that they can often be hostile or uncomfortable environments in schools.

I thought that by educating students on puberty in a gender-inclusive environment, I was supporting trans and non-binary students. But I didn’t think about the student who is struggling to manage menstruation in the boy’s bathroom where there usually aren’t any products or disposal bins available. I didn’t think about the fact that he might be fearful of having his identity outed if someone hears him opening a menstrual pad inside the stall. I also never questioned that perhaps even the grade for which I was providing this information might not be appropriate. In the U.S., most schools consider providing puberty education around fifth grade, although this grand-standard and the actual content provided, is rarely regulated. I now recognize that for many students, the fifth grade may be too late to be providing this information, especially given that adolescents, particularly Black and Latina girls, start puberty earlier than in previous decades. 

While I loved my job as “the puberty lady”, I knew that my reach was small, and I wanted to help more adolescents navigate through these transitions. I made the decision to pursue an MPH at Columbia Mailman in order to gain the experience and skills necessary to implement this kind of change on a broader scale, and research projects like the ones being conducted at GATE allow just that. Not only does this research give teachers, parents, and advocates the tools they need to fight for implementing puberty education in their school districts, but it uncovers the other challenges girls face during adolescence.

There is so much beyond puberty education that adolescents need in order to feel supported and empowered with managing their menstruation at school. As aspiring public health professionals, it is our job to analyze the entire system, rather than just one component impacting the health of our community. Adolescents deserve the right to manage their menstruation successfully and with dignity, and by amplifying the voices of girls and calling attention to the ways in which the school environment can be improved, we can work to ensure that right is realized.

Christine Hagstrom is a 2021 MPH candidate in the Heilbrunn Department of Population and Family Health. She earned her BA in Psychology at the University of Washington