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American Journal of Sexuality Education
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/wajs20
Teaching Puberty for LGBTQIA + Diversity,
Inclusion, and Beyond: A New Model of Expansive
Pubertal Understanding
Maya A. Poran
To cite this article: Maya A. Poran (2022) Teaching Puberty for LGBTQIA + Diversity, Inclusion,
and Beyond: A New Model of Expansive Pubertal Understanding, American Journal of Sexuality
Education, 17:4, 415-434, DOI: 10.1080/15546128.2022.2053259
To link to this article: https://doi.org/10.1080/15546128.2022.2053259
© 2022 The Author(s). Published with
license by Taylor & Francis Group, LLC.
Published online: 31 Mar 2022.
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Teaching Puberty for LGBTQIA þDiversity, Inclusion,
and Beyond: A New Model of Expansive Pubertal
Understanding
Maya A. Poran
Psychology Program-SSHS, Ramapo College of New Jersey, Mahwah, NJ, USA
ABSTRACT
The following article presents a paradigm shift in order to
engage in more expansive pedagogy in the teaching
of puberty; specifically, to create a more inclusive and
affirming space for LGBTIQA þyouth. Attention to
LGBTQIA þpopulations has slowly been integrated into many
areas of research, theory, and teaching in psychology and
related disciplines. While positive strides have been made, les-
sons on adolescent psychology, and puberty specifically,
remain stuck in older binary models. The following is an
examination of the dominant approach utilized for teaching
puberty in senior-level high school and early undergraduate
adolescent psychology courses, a critique of that model, as
well as a presentation of a new model for teaching pubertal
development. A proposed Model of Expansive Pubertal
Understanding is shared here, and allows for a fuller, more
accurate, and more positive, approach to pubertal develop-
ment. It is further proposed that the information shared in
this model be infused much earlier in youth education, and
through a breadth of disciplines, to effectively promote psy-
chological and physical wellbeing among children and youth
of diverse genders, sexes, and sexualities.
KEYWORDS
Puberty; LGBT; adolescence;
sexuality; intersex; gender;
transgender;
intersectionality
Inclusion of diverse sexualities, genders, and to some extent sexes, has been a
relatively recent focus for many in education, psychology, health services, and
public policy. In this moment of both historic progress, and extreme backlash,
marked by both pro and anti LGBT legislations, and simultaneous increases
in bias-motivated violence (Gitari & Walters, 2020;HumanRightsCampaign,
2020), it is important to strengthen the wave of expansive education regarding
sexes, sexualities, and genders (Blum et al., 2019;Kågestenetal.,2016; Kosciw
et al., 2014). While there are particular areas of psychology and related disci-
plines in which sex, sexuality and gender have often found a home (such as
CONTACT Maya A. Poran mporan@ramapo.edu Psychology Program-SSHS, Ramapo College of New
Jersey, 505 Ramapo Valley Road, Mahwah, NJ 07430, USA.
ß2022 The Author(s). Published with license by Taylor & Francis Group, LLC.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives
License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction
in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
AMERICAN JOURNAL OF SEXUALITY EDUCATION
2022, VOL. 17, NO. 4, 415–434
https://doi.org/10.1080/15546128.2022.2053259
research on bullying, harassment, and discrimination), it is especially import-
ant to move beyond these for fuller information, representation, and educa-
tion. In the spirit of the American Psychological Associations’recent
Resolution on Gender Change Efforts (APA, 2021)—which recommends psy-
chologists treat gender diversity as normative in all areas of practice, including
clinical, supervision, research, and teaching—as well as the 2020 National
Academies of Science, Engineering, and Medicine’s Consensus Report on
understanding the status and well-being of sexual and gender diverse popula-
tions (2020), and the additions of sex, gender identity, and sexuality to the
2nd edition of National Sex Education Standards for k-12 (2020), the follow-
ing piece offers a new paradigm and model through which to teach about
pubertal development.
In the realm of Adolescent Psychology, there have been slow drips of inclu-
sive information regarding sex, gender, and sexuality in adolescent psychology
texts. Lessons in gender socialization, sexuality, and life stressors, are mostly
where one finds LGBTQIA þinformation (Lesbian, Gay, Bisexual,
Transgender, Queer, Intersex, Asexual, and more: LGBTQIAþ). One is more
likely to find inclusion of LGBTQIA þyouth regarding pubertal development
in the texts for Psychology of Women courses, Gender Studies, or other varia-
tions of Feminist Psychology and Sexuality studies in undergraduate and
graduate-level courses. When included, LGBTQIA þdevelopment often cen-
ters on lessons regarding health dangers due to the high rates of suicidal idea-
tion, suicidality, depression, anxiety, and substance use due to social hostility,
harassment, and bullying and stressors associated with pubertal growth
(D’augelli, 2002; Institute of Medicine (US) Committee on Lesbian Gay
Bisexual & Transgender Health Issues & Gaps & Opportunities, 2011). While
these are important issues and areas to discuss, it certainly should not stop
there. Lessons on primary elements of development, such as processes and
experiences of puberty, have been woefully barren in attempts at full inclusion
for sex, gender, and sexual minority youth (Deardorff et al., 2019). There is a
need for infusion beyond inclusion; For LGBTQIA þissues to be more fully
integrated into the life of subject areas. In addition, there needs to be a shift
to the paradigmatic approach of LGBTIQA þastheoutliers,theanomalies,
orthepeopleinduress,whichpreventsafullerandtruenewstartingpoint.
Students are coming into college classrooms with greater readiness to dis-
cuss LGBTQIA þissues, as their mainstream lives have greater representation,
both in mainstream media, social media, and interpersonal lives (GLAAD,
2021; U.S. Institute of Medicine, 2011). As a driving force for social change
for LGBTQIA þpeople, many youth are ready to learn and discuss
LGBTQIA þissues in many subject areas (i.e. sexuality, beauty, stereotypes, or
gender norms), however, educational approaches to adolescents going through
puberty have remained unchanged. A closer look at the earlier lessons that
416 M. A. PORAN
prepares students for this, such as children’s books on human anatomy,
pubertal development, and even higher-level psychology texts themselves, indi-
cate clearly why students are under false impressions. Information pertaining
to pubertal development focus on a binary sex/gender model of human devel-
opment and growth, a binary examination of the psychological relationships
to pubertal growth, as well as an unquestioned focus on heterosexuality.
Puberty seems “objective”and untouchable to LGBTQIA þteachings. The
lesson is essentially presented as follows: (1) bodies going through puberty
change by sex (female/male). (2) These changes are for the development of the
ability to procreate. (3) Sexual differentiation and pubertal development, as an
objective category, is then experienced either “on time”or “off time.”(4) Being
on time or off time with peers creates stress, but this stress will be temporary as
bodies will eventually reach the sexual maturity of adulthood.
Lesson concluded.
In this model, if intersex individuals are included, it is as an anomaly. If
transgender people are included, it is with brief mention of their suffering
because of their difference, and their very significant struggles with pubertal
change (Mirabella et al., 2020; Turban et al., 2020; van de Grift et al.,
2016). One would be hard pressed to find any information on pubertal
development that communicates overt lessons on sexual minorities.
LGBQA þsexualities are not discussed and are left possibly to a chapter on
sexuality itself. These lessons (overt and absent) communicate a clear
“normal”and clear outliers.
Importantly, it is not just inclusion into existing frameworks, and not
just full infusion into existing curriculum, but a revisioning and refashion-
ing of the main frameworks of discussion that is necessary. For a more
expansive, inclusive, and grounded approach, all sexes, sexualities, and gen-
ders must be learned and understood together, not in opposition; Not the
normal, and the aberration.
The following is a fuller communication of the dominant model utilized to
teach the psychology of puberty, a critique of this model, and a proposal for a
new paradigm which shifts conceptual images to learn puberty in a new way;
To understand the vast experiences, shared and different, among all sexes, sex-
ualities and genders. It is hoped that the model proposed will become a new
normal to teach pubertal growth and development, for LGBTQIA þequality
and empowerment of people of all genders, sexes, and sexualities.
The unassailable objectivity of puberty
The dominant model and the creation of pathologies
Puberty seems an objective physical transformation, simply a bodily change
for sexual differentiation among the human species. At stated above, the
AMERICAN JOURNAL OF SEXUALITY EDUCATION 417
dominant model of teaching puberty is dispassionately presented as follows:
there are two biological sexes, female and male, and they differ. Those dif-
ferences are amplified in puberty through sexual developmental and matur-
ational changes that further sexual differentiation. This occurs through a
surge of hormonal influence. Males experience a surge of testosterone,
becoming more of what is socially defined as masculine: penises will grow,
spermatogenesis takes place, and they will experience a major increase in
hair growth over all areas of the body. Muscularity and deepening of voice
are also highlighted. For females the surge of estrogens is emphasized, and
that these are responsible for changes which manifest contrary to those of
males. Female physical maturation is presented with a focus on what is
socially defined as feminine: the stages of breast development, menarche,
fat distribution and curves. Hair growth is generally not discussed, but for
acknowledgement of the development of pubic and axillary hair. These dif-
ferentiations between female and male bodies occur and culminate in the
ability to procreate (for examples see sections on puberty in contemporary
adolescent psychology textbooks Dolgin, 2018; Santrock, 2019, Steinberg,
2020). Most texts will also utilize particular diagrams based on “The
Tanner Stages”(a scale developed in 1969 that defines stages in pubertal
development based upon measurements of external sex characteristics) to
represent the main physical changes for females and males; these tend to
be represented by showing only female breast development, and male penis
development with pubic hair (Santrock, 2019; Steinberg, 2020).
From early teachings on puberty in preschool and elementary school, to
the classrooms of college, this presentation encourages students to think of
puberty as “just the objective physical,”and as the obvious oppositional
sexual differential between female and male people (the “opposite sexes”).
In addition, this differentiation is communicated as occurring for one pri-
mary “biological goal”: procreation via heterosexual sexuality. When discus-
sing puberty in relation to psychology, the level of analysis generally
centers on the experiences of these changes in the context of treatment by
others, on or off time maturation, and how girls and boys experience the
changes that are typical for their developmental trajectory (such as men-
struation and breast development in girls, and penis size and hair growth
in males) (Marceau et al., 2011).
This model is standard and appears to have remained static. Even con-
temporary LGBTQIA þdiscussions are grounded and examined through
this primary model. In this approach, there are essential elements omitted
which not only exclude sexual and gender minorities, but also create (or
build upon) a mindset of differentials which tend to amplify difference and
make most typical development seem (and feel) atypical. Those considered
“outliers”(namely intersex individuals, sexual minorities, and transgender
418 M. A. PORAN
people) are treated as such: an aberration or oddity in the otherwise nor-
mal pathway of pubertal development, and at best an “add on”to the dis-
cussion. Those who are “normal,”(traditionally/cis-gendered females and
males) are also set up to experience their growth negatively.
A foundational problem: gender masquerading as sex
Generally, students learn about psychological experiences in relation to
pubertal development through the eyes and lives of traditionally gendered
females and males (often referred to as cisgender). It is a given that normal
pubertal development will occur, and that even if one is a “late bloomer,”
one will get there eventually. One can find this language in texts for chil-
dren, college students, and even on online sites for parents and youth.
Even if one is “behind,”they will “catch up”and everyone will “even out”
eventually and in due time (Dowshen, 2015). While “on time”or “off time”
maturation is important to examine, the base on which it stands needs to
be examined first. The present models of pubertal growth and development
rest on the underlying assumption of normative gender appearance roles,
not just normative physiological development.
Dominant gender norms of physical appearance, and of stereotypical
physical attractiveness, infiltrate the pubertal lesson, and so influence not
only misunderstandings of sex and pubertal development, but further set
the stage for creating gender normative pressures through gender norma-
tive imagery. In addition, dominant norms simultaneously communicate
preference for lighter skinned or White-typed beauty norms, further mar-
ginalizing young people of color (Poran, 2006). Dominant racialized gender
norms in pubertal lessons themselves then contribute to adolescent devel-
opmental struggles among all sexes, sexualities, and genders.
The areas of emphasis are not only physiological changes, but they are
shared as if they are biological rules of order. Students learn that “girls
will”: develop breasts, menstruate, get wide hips for childbirth and the cap-
acity for childbirth, and they will get more body fat and become curvy.
These are the primary areas of emphasis. (Note: Only two of these are pri-
mary sex differences). “Boys will”: get lower voices, their penises grow, they
will generate sperm, they will get tall and muscular, they will get hairy all
over their body, and grow beards. These are the primary areas of emphasis.
(Note: Only two of these are primary sex differences).
In most texts and lessons there is an emphasis on some primary sex dif-
ferences, and a couple of secondary sex differences presented as if they are
primary: namely, breast development and hair growth. Anecdotally, it is
evident from over 26 years of teaching that many college students believe
breast development in females, and hair and voice changes in males, are
AMERICAN JOURNAL OF SEXUALITY EDUCATION 419
primary sex differences. Relatedly, many believe that estrogen is the “female
hormone”and that means that only females have it, while of course simul-
taneously believing that testosterone is the “male hormone”and so only
males have it.
This is not only a fundamental a misunderstanding of biology on their
part, but a full understanding of the lessons they have learned and the
approach to sexes as the “opposite sexes,”in which one form of physical
being is presented as completely in opposition to, and mutually exclusive
of, “the other.”These teachings and gender lessons co-create the myths and
pressures on youth to develop in a particular way. They tell us: this will
happen to you (and this will not) and this should happen to you (and this
should not). As extensive research on gender stereotypes indicate, such
visions are not just descriptive, but prescriptive (Eagly et al., 2019). This
creates not only hopes, but fears: hopes to become what one “is,”and fears
of becoming what one is “not.”These fears will loom large for people of all
genders, trans and cis. With this notion of the naturalness of gender-
ed ¼sexed physical changes, we create expectations of the norm, and of
course difficulties when appearing not to fit the norm.
The oft-examined struggle of “on time,”or “off time,”maturation, is
indeed not just a matter of timing. These struggles are primarily in regard
to physically manifesting what is anticipated to be the normative develop-
ment for a sexed/gendered body.On time or off time is actually code for fit-
ting gender norms in a particular time frame. Importantly, while most “late
bloomers”are assured that they will “become a woman”or “become a
man”one day, some actually never will. Some males will never grow
beards, some females will never grow breasts, and some intersex girls will
never menstruate, and so on. In addition, most humans who grow and
develop will grow elements of what appears to be “the other sex,”since so
much of pubertal development is actually shared (for example, extensive
hair growth).
Students learn to comprehend normative sex development as non-nor-
mative (again, this is gender in disguise) and so these lessons participate in
the creation of many of the sufferings which we study in adolescent psych-
ology such as: cisgender girls and body image (Suisman et al., 2014), or
hair disgust (Fahs, 2014; Tiggeman & Lewis, 2004), trans individuals and
body dysmorphia (Martinerie et al., 2018; van de Grift et al., 2016), cisgen-
der males and pressures of athleticism and muscularity (Carlson &
Crawford, 2005; Ricciardelli & McCabe, 2004), intersex individuals not fit-
ting dominant gender norms (Lee & Houk, 2008; Posch, 2019), and the les-
sons of veiled compulsory heterosexuality which can occur in an
environment of school, family, and peer life that is often hostile to notions
of sexuality and gender diversity (D’augelli, 2002; Kosciw et al., 2014).
420 M. A. PORAN
In the current, dominant model of teaching puberty and the psycho-
logical experiences of puberty, gender is quietly framing the discussion.
Developing “other gendered/sexed”traits becomes a great fear. All are set
up for exclusion or failure in the following ways.
Exclusions, impossibilities and pathologies
In this model of binary polarity, there are populations of human youth
who are missing in the pubertal discussion through misinformation, omis-
sion of factual information, and the creation of cognitive schema that pre-
vent understanding the range of pubertal physical development and
psychological possibilities.
Intersex youth
Intersex individuals (people whose bodies are unique in their configuration
of anatomical, hormonal, and/or chromosomal sex) (APA, 2020) and their
experiences of puberty are omitted in most texts and conversations about
pubertal development. This absence creates a space in which intersex indi-
viduals do not know what will happen to them, or why something is or is
not happening (Lee & Houk, 2008; Posch, 2019). In addition, if they are
included, they are often shared as oddities or outliers, or under the termin-
ology of Disorders of Sexual Development (DSD) that immediately indi-
cates pathology. In addition, most intersex individuals have been assigned a
gender and are often learning the pubertal lessons for their gender. They
may be keenly aware of not fitting in with girl or boy body types, and the
corresponding gender appearance norms for that which they were assigned
(Jones, 2018). It is apparent to any professor teaching about intersexuality
that most students in college have not learned about intersex people in
their formal education.
Importantly, the solution is not just to include more information on
intersex youth and puberty, but to reorient the discussion from the start.
The first point of misinformation is the absence of understanding biological
sex itself. “Sex”is presented as a particular version of female and male, as a
complete and singular construct in itself, and only those two types are pre-
sented in pubertal information. This misrepresentation of sex as a simple
binary in the human species creates problems of many types, primarily
exclusion (intersex youth are erased and receive the implicit message that
their bodies are abnormal). Furthermore, this erasure occurs in the essen-
tial setting of the normalized school space, where information and attitude
can actively assist them in their development. Even if intersex youth are
receiving health information in a medical setting by health care providers,
AMERICAN JOURNAL OF SEXUALITY EDUCATION 421
the validation, affirmation, and social well-being that comes from a sense
of belonging is curtailed by the exclusion from the curriculum.
Furthermore, for those who are sexed female and male, there is no learning
about people with diverse body types, and so there is also the creation of
false dichotomies and stigma.
Transgender youth
Transgender and gender diverse young people are likewise left out of the
puberty conversation. If they are included, it is primarily to emphasize
transgender youths’psychological sufferings in regard to pubertal develop-
ment, and the question of taking “puberty blockers”to help them get
through this time as they make further decisions regarding their gender
and bodily development (Martinerie et al., 2018; Rew et al., 2021; Turban
et al., 2020) and struggle through exclusion (Ryan, 2016). Importantly, it
highlights the gender binary and fear. Transgender youth are left out of the
pubertal conversation altogether unless they are included in terms of path-
ology or psychological difficulties with their changing bodies.
The conversation on transgender and gender diverse youth (if discussed
at all) centers on the individual in relation to their body, which is experi-
enced as changing without their consent in a direction that affirms a
“gender”they do not experience as the self. Importantly, trans youth are
presented as experiencing something radically different than their tradition-
ally/cis gendered peers, since they do not identify with the sex and gender
they were assigned at birth. As will be further noted below, in many ways
these experiences of puberty could be discussed as shared, since most youth
of all sexes and genders are experiencing psychological struggle as their
bodies do things they did not give permission for them to do; including
manifesting elements of the “wrong gender.”In the model as it stands,
trans youth are supra othered, as the pubertal layout all but guarantees
their stigma.
Sexual minority youth
Sexual Minority youth are likewise ill served by the present approach to
pubertal growth. Sexuality is often implied, but not directly discussed, in
relation to pubertal maturational change. It is discussed in a sideways fash-
ion, since puberty centers on sex development that is supposed to culmin-
ate in the physical ability to procreate. When sexuality is discussed in
psychological texts and pubertal lessons, the emphasis is on heterosexuality,
behavior, and desire. Bodies are often discussed as sexual signifiers that
indicate readiness for heterosexual mating.
422 M. A. PORAN
While many try to separate pubertal information from sexuality informa-
tion, especially in the earlier years of education, when looking closely one
finds that pubertal discussion is the groundwork for sexuality discussion, as
puberty is discussed in regard to physical growth toward the ability to pro-
create. If puberty is for the ability to procreate, then there is no need to
discuss anything other than heterosexual sex. This is often shared much
earlier in elementary school curricula, before the “sex talk”in sex ed. This
early education in part creates mental schemas and experiences of unques-
tioned heterosexist ideology attached to the body itself.
Sexual desire is often discussed in this context of pubertal development
and heterosexuality. Often it is written that there is an increased desire for
the “opposite sex,”or amusing anecdotes are shared of the things that boys
or girls do to get one another’s attentions. It is not only a lesson on the
physiological changes that may foster a sexual awakening or surging desire,
but there are linked lessons which communicate that ones developing body
will be desirous of specific people, and desirable to specific people. In doing
so, and focusing it on human mating, it becomes part of the normalization
of heterosexuality and the stigmatization of homosexuality, bisexuality, pan-
sexuality, plurisexuality, asexuality, and so on.
In summation, pubertal lessons are teaching difference and divergence of
particular forms. First, students learn that there are only female and male
sexes, that are completely discreet and opposite. It is often a non-question
that gender identities naturally flow from their bodies (vaginas are females,
and females “feel like,”or view themselves and identify as, girls; penises are
males, and males “feel like,”or view themselves and identify as, boys). Next
students learn that these natural developments in bodies are indicators of
what they will do with those bodies; and that they are not only opposites,
but opposites attract: girls and boys are naturally attracted to one another
for mating (Butler, 1990; Rich, 1980).
The above highlights how notions of normative physical pubertal devel-
opment, which has considerable shared overlapping processes, is learned to
be perceived and experienced as atypical by anyone who does not perfectly
match the model which, in actuality, is just about everyone. Traditionally
gendered girls and boys themselves will naturally show characteristics of
the “opposite”sex and experience the development of those characteristics
with worry and psychological stress in part due to the learned misunder-
standings of sex as well as the norms of gender. We know that most all
girls grow extensive body hair, up to 70% of boys experience breast devel-
opment (Lee & Houk, 2008), everyone’s voices will deepen. While these
changes are normative, they are perceived and experienced as abnormal as
they were learned as physical indicators of the “wrong”sex. The pressures
to maintain the differential by gender appearance norms are paramount,
AMERICAN JOURNAL OF SEXUALITY EDUCATION 423
and work with misconceptions regarding biology to strengthen these nega-
tive experiences.
It is then through these pubertal lessons that students learn difference
from each other, rather than learning a shared base, in a cultural context,
in which they develop differently together. The binary polarity of the fram-
ing of bodies and development sets the stage for not being able to perceive
natural variation and what is shared. A new starting point, and areas of
emphasis, can create a more inclusive experience for all growing people. To
that end, the model below calls for a recasting of the normal as one that
expands and includes all sexes, sexualities, and genders.
Model of expansive pubertal understanding
Based on the issues stated above, it is proposed here that one starts at the
beginning with a model which is grounded in the context of both the vari-
ability within biological sex, and the dominant context of gender norms.
The following is a Model of Expansive Pubertal Understanding, developed
over 26 years of teaching. The essence of the lesson is as follows:
Physiological sex development as context
Sex is multilayered, not unitary; sex is variable, not binary; sex is homolo-
gous, not anachronous; sex is a process, not a static thing.
Social gender norm expectations as context
Dominant western gender norms are binary; gender intensification pres-
sures youth to adhere to dominant—and “sub”cultural, co-occurring or
competing—appearance norms of gender; bodily developments are then
measured and experienced in relation to those norms.
Sexual function and desire
Function and desire are not the same; development of sexual anatomy
often, but not always, allow for procreative physiology; desire may or may
not increase, and the focus of desire may be self or other; others may be of
any sex or gender.
Similarity and variability (in body and mind)
Based on the previous 3 steps of the model: all physiologies and all psy-
chologies grow; all humans share physiological sex similarities as all origin-
ate from similar embryonic sex beginnings/homologues; variations will also
424 M. A. PORAN
occur in body and in psychological relationship to the body; all growths
and relations are possible and the goal should be on health and wellbeing.
A detailed view of this expansive model of pubertal growth incorporates
the following:
Full discussion on physiological sex and contexts of gender
Starting at puberty, in the discussion of puberty, is starting too late. To
ground the conversation, and to disrupt and reorganize schematic informa-
tion, one must begin earlier in the physiological sex conversation. The dis-
cussion must begin with two foundational understandings: the context of
origins of biological sex development in utero, and the context of gender
norms that frame our understandings of sex development. These will give
students the ability to understand pubertal changes, to see similarities as
well as diversity, (diversity and not just “difference”), and comprehend how
the experiences of these changes are framed in the context of a gendered
society. This will help with understanding of physiological information, as
well as self-understanding, understanding others, and help to create a peda-
gogical space for full inclusion. It lays the groundwork for many bodies,
many trajectories, and many psychological relationships to those bodies.
Sex
First students need to learn that sex is not a unitary “thing”but a layered
part of the human body and a condition that changes over time in many
ways; it is not just something, but it is a process (Fausto-Sterling, 2000,
2013; Preves, 2016). Students are often surprised to learn of the sexual
pathways and transformations in utero, or that puberty is not the “end”of
sexual development, and that elements of human sex (e.g., hormones, hair
growth, body composition, fertility, libido, and more) transform and
change over the lifespan. Exceptionally surprising to most students is that
everyone has phalluses and they all grow during puberty (students have,
for example, learned that the “opposite”of a penis is a vagina, and have
never thought of a clitoris as a phallus). Informing of the multilayered and
transforming qualities of sex allow it to be a dynamic system in itself, a
dynamic part of the self, and one that is marked in part by its changes.
This allows it to be part of the growing self, not just a “thing”that we “are”
or “are not.”This provides a welcome space for all sexes and experiences
of ones sex.
These reframings, seeing the connections of the labia and scrotum, the
clitoris and the penis, the ovaries and the testes, and so on, helps to
inscribe a new image in the mind to prepare it for the understanding of
AMERICAN JOURNAL OF SEXUALITY EDUCATION 425
puberty. Here, many forms of sex development are automatically a part of
the conversation, rather than an “add on.”Intersex people are a normative
part of the sex spectrum and possibility, as are all forms of sexed bodies. In
order to learn the variations, we must first understand the similarities.
These similarities will help to teach, and learn, puberty and adolescent
psychology in a comprehensive way for all sexes.
Gender norms
For true transgender inclusion, as well as a more expansive understanding
of traditionally gendered people, a focus on gender as context for puberty
is essential. Importantly, it should be noted that ultimately it is gender
norms that create a paradigm of pubertal strain for all genders, as people
of all genders (trans and cis/traditionally gendered) are afraid of manifest-
ing the bodies of the “wrong”gender. Many trans masculine young people
experience body dysmorphia, and gender dysphoria with the onset of breast
development (Pulice-Farrow et al., 2020; van de Grift et al., 2016), many
traditionally cis-gendered girls experience body image disturbance and dis-
gust with hair growth perceived as masculine and unhygienic (Fahs, 2014;
Tiggeman & Lewis, 2004), trans feminine young people may experience
dysphoria with the development of facial hair, and traditionally gendered
cis-males will likely feel such strain with normative breast development
(Lemaine et al., 2013). All of these are bodily developments which have
been presented as separators by gender normative body expectations, and
so are experienced in particular ways. While it is often seen as a
“separator”by gender/sex, it can ultimately be understood as shared and
discussed together.
In order to understand the body, and experiences of the body, one needs
to discuss the context(s) in which bodies grow, and the norms and expecta-
tions for physical appearance by gender. These are the contexts that give
meaning to the changes and create, and highlight, the psychological experi-
ences of them. Menstruation taboos, penis size, hairlessness, breast size and
shape, all of these and more, can be understood from this vantage, and for
all genders. In addition, dominant cultural and “sub”cultural norms should
be part of this conversation. The dominant power of “normative”imagery
creates unique challenges for all youth, though the nature of these chal-
lenges may vary depending on the individuals’culture, race and ethnicity,
socioeconomic status, and/or dis/abilities.
Discussing misconceptions, binary gender stereotypes, expectations, and
gender intensification pressures, helps to further set grounding context
from which to understand experiences of puberty. To restate from earlier:
Such expectations are even part of the form of textual expressions on
426 M. A. PORAN
lessons on puberty: Girls “will”develop breasts in the breast-bud to breast
stage (with diagram), boys “will”develop strong musculature and body hair
(with diagram). “Will”implies a fait accompli, or something one will abso-
lutely experience depending on ones’sex. This has implications for experi-
ences of sex, gender, and sexuality. These “wills”create an image of what
constitutes normal bodies, as well as bodies in opposition: that which one
has, the other lacks (and should).
A gender conscious perspective then provides a fuller space to talk about
gender pressures and gender identities, and to discuss that bodies do not
mean how one relates to that body and/or that one must identify as the cul-
ture expects one. This also creates a space to look at physiological transfor-
mations through a more interrogative lens, supporting fuller understanding
and conversation on cultural framing of bodily changes and how we per-
sonally experience it. Again, this allows everyone to learn together, from a
shared grounding, rather than girl/boy being the normal genders, and the
others as add-ons and oddities.
Sexuality
Many misconceptions of sex and puberty, pressures and gender norms,
center on beliefs about sexuality and heterosexuality. Pubertal development
itself may manifest a body capable of sexual reproduction, and that is of
course something that needs to be discussed in any lesson on pubertal
development. While this is so, the physical ability itself clearly does not sig-
nify sexuality.
It is also essential to discuss the various levels or forms of desire. Desire
itself is variable, not only between people (such as asexual individuals or
people with high levels of sexual drive), but also within people (and over
the life span). It is important that these are overtly recognized, and that an
increase of sexual desire that is often accompanying pubertal physical trans-
formation is not given a “target”. Sexual desire may be strong or light or
not present, sexual desire may be focused on the self and self-pleasure, or
relating to others. Those others may be of diverse bodies and genders. Just
because the body can procreate, does not mean that it is heterosexual in
desire. For example, when talking about lubrication from the Bartholin
glands, one cannot assume that that lubrication is preparing the vagina for
a penis. Similarly, when talking about ejaculation, one does not assume
that it is occurring inside a vagina. The conversation on sexual ability,
desire, and direction, allows for a much richer and more inclusive conver-
sation; also one that is better framed for discussions about sexual consent.
This new conversation can welcome many sexualities into a positive
AMERICAN JOURNAL OF SEXUALITY EDUCATION 427
discussion on puberty, and one which puts health, physical, and psycho-
logical wellbeing, at the forefront.
Similarity and variation
Pubertal development is then presented from a shared starting point, and
one from which students can connect through similarity, and grow in
understanding of variation. It is a body in context of itself, and from where
it originates. It is a body also in context of a culture in which it grows,
learns, knows, and expresses itself. The direct integration and examination
of the gender normative framework helps students to explore and grow
with greater confidence, and hopefully in greater solidarity and connection
with one another. A place of belonging, rather than a place of alienation.
Sexes can be understood in development much more holistically, and all
sexes become conceptually clear when being aware of origins. Human sexu-
ality is recognized as having tremendous variation in regard to presence or
level of desire, forms of attraction, and orientations. Genders are expansive,
and can be perceived together, rather than in opposition. Traditionally gen-
dered women with much body hair may learn that element of self as nor-
mative, and not “manly.”Traditionally gendered males may learn that
breast development does not make them a “freak,”but is actually experi-
enced by a large majority of males. Such an examination of body develop-
ment, and body image issues and struggles related to pubertal development
can then, for example, be examined as forms of gender dysmorphia and
dysphoria similar in origin for all genders, and perhaps similar even in
kind but diverse in degree. Dominant sexes, genders, and sexualities are
understood from the same frame as intersex, trans individuals, and people
of varying sexualities. Such equal footing allows for new views and voices
to meet at the center. This framework also welcomes fuller intersectional
understanding, and opens welcome spaces for discussions of similarities
and variations in relation to dominant gender, sex, and sexuality norms
and ethnicity and race(ism), diverse dis/abilities, classes, and so on. Who
knows what insights are to come. Wherever the thinking will go, there is
opportunity for fuller understanding from a core starting point, from which
all can grow together, even in different directions.
Conclusion: moving forward
Pubertal growth and development has been marked by deep psychological
pain and struggle for all sexes, genders, and sexualities. It is proposed that
these struggles are not just naturally occurring responses to bodily changes,
nor only evoked by culturally imposed expectations represented in
428 M. A. PORAN
dominant forms of popular media or social norms, but are also grounded
in the very lessons taught to young people through academic, medical, and
psychological educational sources. It is therefore further proposed that it is
the responsibility of these educational sources to provide accurate informa-
tion that allows for knowledgeable and affirming experience of develop-
ment. The model shared does so through the primary lenses of gender, sex,
and sexuality, grounded through emphases on similarity and variation. In
addition, in order for the Model of Expansive Pubertal Understanding to
be truly expansive, thoughtful approaches to language, visual imagery, and
intersections of experiences should guide and frame these lessons.
Words and pictures matter. As we assist youth in understanding their
experiences of growth and development, we must share these lessons
through thoughtful and accurate information via considered and concise
language and visual representation. One of the first steps in thought is the
language we learn to think with, and the images we use to represent and
understand concepts. Language such as “opposite sexes,”or “female
hormones”may be laid to rest and replaced with more accurate verbiage.
“Disorders of Sexual Development”may be replaced perhaps by “Diversity
in Sexual Development.”In addition, creative language to emphasize
uniqueness rather than anomaly can be helpful. For example, using the
term “distinctive”or “unique”genitals rather than “ambiguous”or
“anomalous”can share the same information without contributing to (or
creating) stigma.
Similarly, visual imagery may be drawn afresh to share diverse represen-
tations of the pubertal body, and transformations from the body of a child
to the body of an adult. New diagrams can be more inclusive and showing
much fuller variation: with diverse bodies by size, shape, dis/ability, ethni-
city and race, alongside actual accurate and diverse representations of sexes
and characteristics such as body hair, breast shapes, phalluses of many
types, and so on. It is a profound opportunity to show true diversity in
imagery, and to discuss full diversity in the psychological experiences of
pubertal transformations. It is a reorganization of the mind through words
and pictures, allowing and preparing the ability to cognize, and even be
capable of perceiving, variation; To know that these variations are part of
the norm, and that the struggles with variations are a socially created strug-
gle in which all are a part.
Lastly, for the model to be truly expansive, it is proposed that an inter-
sectional approach be taken in relation not only to sex, gender, sexuality
and pubertal growth, but how they are intertwined with race/ethnicity,
socioeconomic status, dis/ability, and other forms of status and power.
Intersectional analyses further empower when moving beyond mere inclu-
sion of diverse identity categories, but also integrate, examine, and give
AMERICAN JOURNAL OF SEXUALITY EDUCATION 429
voice to the complex relationships to the norms, statuses, and power struc-
tures that we experience, inhabit, and embody in relation to those identities
(Fine et al., 2021; Mareck, 2016).
Experiences of, and responses to, puberty vary by culture, ethnicity, dis/
abilities, and status. One cannot disconnect pubertal development from, for
example, racism and other forms of discrimination (Seaton & Carter, 2019;
White et al., 2012). Similarly, when discussing gender norms as framing
notions of normative sex development, White-typed ideals of what consti-
tutes a normative masculine or feminine body would need to be part of the
discussion (e.g., skin color, hair texture, and other phenotypes) (Poran,
2006). Discussions within the frame of this model can pursue a variety of
intersectional trajectories, so that the similarities and variations of pubertal
development may be examined and understood through diverse lenses.
Doing so will allow the conversation to continue and provide a fuller and
more empowering space for youth to name, to know, to declare their
growth experiences, and engage positively with their fuller more holistic
selves, and with each other.
While the present model has been generated primarily from work and
teaching at the college level, the model can (and should) be implemented
in younger grades. An obstacle for teaching at the higher levels, such as
later high school and early undergraduate courses, is that years of misinfor-
mation must be undone before the more accurate and expansive model can
be taught. In addition, of course, most traditional college age students have
already gone through pubertal growth and development, and have person-
ally struggled with what such misinformation has wrought. Ultimately,
youth would benefit from a developmentally appropriate tiered model, in
which the foundations of early learning can be accurate and grounding,
creating a clear path into later teachings and understanding of diverse per-
sonal experiences.
A general view of a tiered age-graded model could be approached as fol-
lows: First, in the early primary school age, children can be grounded in
three basic yet essential foundational pieces of information: (1) sex and
gender are not the same, (2) sex is not binary (there are more than two),
and (3) sexes are not opposites, but share similarities. This basic and simple
factual information can then be built upon in the first lessons on puberty,
often introduced in schools in the 4th–5th grade. Teachings on puberty can
revisit and restate these basics, which provide a foundational framework
through which to learn about normative and similar bodily changes (such
as body hair growth, breast development, and so on), as well as areas of
greater distinctions (spermatogenesis, menarche, and so on). These teach-
ings can also emphasize that genetically there is significant and natural
human diversity with regard to how and when secondary sex characteristics
430 M. A. PORAN
develop. Such a presentation allows youth to conceptualize greater com-
plexities, and learn the fact that sex is not a “yes or no”question, or a sim-
ple “check of the box,”but rather is comprised of many components
(chromosomal, anatomical, hormonal, and so on).
In an ideal world, classes would be gender and sex blended, but even
if they presently remain segregated, one can still impart this information.
Clearly high school and college lessons will be able to examine and pre-
sent this model in greater detail. Importantly, by the time a student
would reach the more complex lessons, as well as deeper conversations
on gender and sexuality, the tiered approach has laid the groundwork so
that they do not have to first unlearn an inaccurate binary model in
order to progress in a more expansive direction. There are wonderful
starting points for such inclusive curricula, such as New Jersey’smandate
for inclusive sex education (SIECUS), the Real and Healthy Youth Act
legislation (2021),andtherecentlyrevisednationalstandardsforsexual-
ity education that includes attention to sex, gender, and sexuality
(National Sex Education Standards, 2020) and it is hoped that the cur-
rent wave of progress will continue and open further opportunities for
such educational opportunities.
In conclusion, it is overdue time for a re-creation of the approaches to teach-
ing, and learning, puberty. Longstanding models have rested upon the misap-
prehension of gender norms as signifying sex, and sex as an opposing binary
foundation. Lessons on pubertal development “other”every sex, gender, and
sexual orientation in their experiences of developmental transformation, cast-
ing normative growth and development into the realms of oddity. The reor-
ganizations outlined in the proposed model allow puberty to be taught through
more accurate and inclusive physiological information, through emphases on
similarity and variation, in a way that is also positive and affirming.
It is a small set of steps, to share accurate information on biological
development, which can radically alter not just the teaching of, but the
individual psychological experiences often associated with, the fascinating
and gut-wrenching processes of growth and development: To go beyond
post hoc “inclusion”and to instead normalize all bodies, identities, sexual-
ities, and struggles from the start. Teaching the expansive and connected
range of normality can eventually supplant, rather than support, the very
cultural pressures that have thus far made them so obscure. What a gift
that would be, for everyone.
Acknowledgment
Deepest gratitude to Dr. Avy Skolnik for extensive and exceptional feedback and genuinely
enthusiastic support of this work, special appreciation to Dr. Michelle Fine for support and
encouragement, and much thanks to student Juheui Lee for her assistance.
AMERICAN JOURNAL OF SEXUALITY EDUCATION 431
Funding
The author(s) reported there is no funding associated with the work featured in this article.
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