In one pivotal moment, the confusion of adolescence clashed with the uncertainty of the COVID-19 pandemic for 13-year-old Mia Xuan. She started her period last April, just weeks into the pandemic’s first wave.
Her body changed. And so did the world around her. With the province’s stay-at-home order extended until May 20 and the return to in-person teaching postponed indefinitely, intimate conversations between friends during recess or extracurriculars are no longer possible. This comes at a time when demand for children’s mental health services has soared across the province with more kids reporting anxiety, stress and depression than ever before.
For kids going through puberty, an already stressful time can become even more so.
"For Mia, it’s awkward to talk about personal things by message or phone call. She prefers to talk in person with a friend, someone who can understand her emotions and feel the same," said Mia’s mom, Hui Xing. "With the fact now we’re in a pandemic, this is not possible."
Mia hasn’t been able to enjoy some of her favourite hobbies, like joining her Grade 8 friends for a soccer game, since the province shut outdoor recreational amenities April 16. The lack of access to communal activities and in-person support has been especially challenging for Mia and her age group as they process physical and emotional changes.
Like many young girls across the province, Mia and her friends have turned to social media platforms to fill gaps in understanding and connections, to "know they’re not alone," said Xing, a 46-year-old realtor.
"Mia uses Instagram, she uses Snapchat ... kids don’t like to talk to parents. Same with Mia. So now, I don’t know. Is she getting reliable answers? Is it appropriate for her? It worries me."
Dr. Dina Kulik, pediatrician and founder of Kidcrew Pediatric Medical Clinic in Toronto, said adolescents rely on their peers for advice and support, less so their parents. But now, the fact they’re unable to "hang out" with friends, go to a movie or play sports together, is leaving kids feeling "disconnected."
"There’s certainly more kids and parents coming forward, telling us that they are feeling more anxious, more sad, more emotional," Kulik said. "That will certainly have a long-term impact, especially given the fact that there’s a lack of services for all these many people that are feeling the challenges."
Youth suicide attempts seen at McMaster Children’s Hospital were four times higher during the second wave of the pandemic compared to the same period in 2019, according to data from Children’s Mental Health Ontario. The increased prevalence in attempts has also been observed by Michael Garron Hospital in Toronto and Hands, a publicly funded mental health service provider in North Bay. Hands recorded a 184 per cent increase in the number of bookings for walk-in mental health services from April to early December, averaging about 120 new requests for services each month.
A preliminary analysis published in the Italian Journal of Pediatrics in March suggests there was a "significant increase" of precocious puberty, or early puberty, in girls during the first few months of the pandemic. Precocious puberty refers to the onset of puberty before the age of eight for girls and nine for boys.
Between March and September 2020, 246 female patients were referred to the Endocrinology Unit of Bambino Gesu Children’s Hospital in Rome for suspected precocious puberty, compared with 118 consultations recorded in the same period in 2019. The researchers cited school closures, lack of sports, more opportunities to consume high-caloric food, increased use of electronic devices and stress as possible factors. They concluded further investigations are required to draw a correlation.
Kulik said "it’s too early to say" whether the pandemic has led to more instances of early puberty locally.
"There’s some evidence that stressful situations can maybe advance puberty, but I wouldn’t say in my own practice that there’s been more girls getting their periods earlier or anything out of the normal," she said.
The pandemic has had an impact on kids in other ways. While some have thrived during the switch to online learning, others have been challenged by it, which can affect confidence and self-esteem, Kulik added.
"Some kids have difficulty with having the camera on them. It can create social anxiety," Kulik said. "Not learning in a way that’s most conducive to doing the best they can, that can prove challenging for kids that have underlying emotional, mental health or learning challenges."
But it’s not all bad — the pandemic has brought with it advantages too, specifically for teens who may find it more comfortable to learn about their new bodies from the comfort of their homes, like girls experiencing various stages of puberty, or boys whose voices are changing.
"When she started her period last April, Mia was nervous. She was scared," Xing said. "The one advantage is it gave her more time to adapt, for example, to learn how to use tampons."
Mia echoed her mom’s sentiment about the advantages of going through puberty at home.
"It’s given me the opportunity to prepare myself, going through puberty in a comfortable environment," she said. "I think that going through this pandemic had made me more self-aware."
Kulik agreed there’s a silver lining for children going through puberty at this time — more bonding time with family.
"The ability to be with parents or caregivers more has been very beneficial for a lot of teens," Kulik said. "It has brought a lot of families closer together and that’s a win for sure."
Still, with health classes moving online, it’s more difficult for girls going through puberty to get the answers they need to personal questions, said Chloe Beaudoin, 22. She’s co-founder of an online "tween" bra store called Apricotton, and a virtual community that, during the pandemic, aims to "ensure no girl goes through puberty alone."
"It’s a lot harder to send your teacher an email asking what to do on your period, than asking them in person," Beaudoin said. "Education for girls is so important ... Tweens can slip through the cracks, especially when they’re dealing with so many changes."
Apricotton’s blog features a series titled "Older Sister Advice," first-person accounts written by women in their mid-20s of their experiences with puberty, and articles sharing tips on all kinds of topics, like "home remedies for period pain" and "how to handle peer pressure." Through platforms like Instagram and TikTok, Beaudoin and co-founder Jessica Miao answer young girls’ questions more directly.
"We’ve had girls ask us, for example, about why their chests are cone-shaped and if that’s normal," said Miao, 22. "I’ll respond and say, yeah, when I was younger it was like that, too. Don’t compare yourself to models who are wearing push-up bras."
"It can be difficult for teens to reach out to family members, teachers and even friends," Beaudoin added. "It’s important to be aware of that and help them find resources and open up conversations for them."
Maria Sarrouh is a Toronto-based staff reporter for the Star. Reach her via email: firstname.lastname@example.org