For kids growing up in the San Francisco Bay Area, there's a standard introduction to puberty at many schools: an educational play called Nightmare on Puberty Street.
It's a fictional play, and in it, character Natalie raps about how quickly her body is growing and how her classmates call her names.
"I didn't pick how my body would grow, and I don't feel normal, 'cause I'm not in control."
In many area schools, Nightmare on Puberty Street is staged starting in the sixth grade, but the organization that produces the play, Kaiser Permanente Northern California, is getting requests to bring the play to audiences as young as those in fifth grade.
That's because the changes kids grapple with in the play are beginning earlier than a generation ago. Researchers are debating the possible links to environmental chemicals, stress and obesity. But regardless of cause, more and more kids are already well into puberty by the time sex education begins in school.
While scientists try to find what's causing early puberty, schools are left to deal with what looks like a new normal. And in the meantime, kids are left wondering if they are normal.
Still Playing Dress Up
Rachael is 15 now, but one morning when she was 8, she woke up and noticed something different about herself.
"I actually, honestly don't really remember this, but what my mom told me is that I woke up and I was like, 'Hey, Mom, what are these, like, things on my chest? I don't know what they're doing there.' And she had to explain it to me."
When Rachael started puberty, she was still playing dress up.
"Fairy princess clothes tend to be kind of not well-made and revealing and stuff like that, so I was playing dress up even though I'd already started developing," she says. "So there are some pictures of me in dress-up clothes that are revealing or too tight in some areas."
Rachael stood out at school, too.
"Some of my friends had parents who they weren't as comfortable talking about this kind of stuff. I was the person who answered a lot of other people's questions," Rachael says a weird position for a kid.
Some girls show signs of puberty even younger than Rachael did like Jaidyn, who was 6 when she got underarm hair and started wearing deodorant, "and about 9 when I started wearing a bra," she says.
But by fourth grade, Jaidyn still hadn't received any puberty education at school which left the conversation to her mom, Marella.
"Honestly, it made me feel a little uncomfortable, but I did my best," Marella says. "I just brought her home some bras and I said, 'Here!' And she put them on. You know, I made it as easy for her as possible."
But handling these conversations isn't easy for parents or kids. That's partly why schools offer puberty education to help keep kids from freaking out as their bodies change.
Anne Peacock, who teaches puberty education at Redwood Heights Elementary in Oakland, Calif., recommends that every fifth-grade girl carry a personal pouch containing pads and a fresh pair of underwear, since periods can start at any time for girls this age.
"My personal view is that we should do some form of sexuality education from kindergarten onwards and that they are made to feel comfortable," she says.
'Fifth Grade Is Way Too Late'
Dr. Louise Greenspan, a pediatric endocrinologist with Kaiser Permanente in San Francisco who is studying the causes and effects of early puberty, agrees. "I really feel like I'm on a mission now to make sure that people understand that teaching kids about puberty in fifth grade is way too late," she says.
To be clear, Greenspan is not saying little kids should be learning about sex in school. Instead, she says they should get the message that being physically mature doesn't mean they're ready for adult relationships.
Greenspan also notes that kids who start puberty early don't necessarily have a medical problem.
"But is it a disorder, as in, there's something wrong with our environment or there's something wrong with what's happening in the world? Maybe," she says. "Something's changed. So the girls don't have a disorder but maybe our world does."
Last spring, on the playground at San Francisco's Flynn Elementary, fifth-grade students Mila and Isabel talked about the puberty class they were about to start. "I feel like it's important to learn, but it's sort of, like, an awkward lesson," Isabel says.
So why don't kids want to talk to their parents about periods and the other changes they're experiencing?
"It's just one of those kinds of things you don't want to talk to your mom about," Mila says. "It's like boyfriends. You don't want to talk to your mom about your boyfriend."
"Because then they might be like, 'Oh, my God, you're growing up!' " Isabel adds.
But kids are growing up often way before they even hear the word "puberty" in class.
The audio for this story was produced by Youth Radio.