Understanding Middle Adolescence

You’ve made it through early adolescence! Now what? While teens during this stage have gotten used to many changes happening in their bodies, they may still have questions about their growth and development and may start to desire more space and independence.

Middle Adolescence (Ages 14-17)

Middle adolescence is often synonymous with the "teen years,” a stage where growth and development continue toward completion. By now, most girls should have started their period, though it may seem irregular or inconsistent at first. Boys should have begun their growth spurt. They may notice their voice cracking, and for some, gynecomastia (temporary breast enlargement) might occur, which could be a source of stress or self-consciousness.

Socially, teens begin to spend more time in mixed-gender groups and may feel increased pressure to fit in with their peers. Romantic relationships and curiosity about sex often increase during this stage. Curiosity can involve more questions about sex, exploration of sexual identity, or self-exploration, like self-stimulation or masturbation.

Cognitively, teens start thinking more abstractly and planning for their futures. However, they may still make impulsive decisions, even when they understand the consequences. Risk-taking and a sense of invincibility (“other teens will get pregnant or get STI’s, etc. not me”) may be present. This can lead to poor decision-making. While teens in middle adolescence can articulate consequences and display more logic, strong emotions and impulsivity can override sound judgement.

Parenting tips:

• Normalize physical changes. “Normal” periods for teen girls can be variable at first. Encourage your child to track periods closely. Boys may need reassurance that gynecomastia (breast enlargement) is temporary and usually resolves in a couple of years.
• Foster open communication. Create a space for open communication about romantic relationships, sexual identity, and sexual curiosity. Explicitly discuss the importance of giving and receiving consent and the qualities of healthy relationships.
• Discuss sexual health. While many teens learn about sexually transmitted infections (STIs) and other consequences of unprotected sex—like pregnancy—in school, hearing it from caregivers can be impactful. Remind teens that while some infections have cures, others, like the herpes simplex virus (HSV) or the human immunodeficiency virus (HIV), cannot be cured.
• Establish clear boundaries. Conflicts between parents and teens may intensify. Establish clear, consistent boundaries. Teens thrive when they know the limits and what is expected of them. Explain to them why rules exist and the importance of following them. As teens show the ability to operate within safe limits, gradually expand opportunities for them to gain more independence and responsibility.
• Allow natural consequences. When safe, allow teens to experience natural consequences, like receiving a bad grade for not studying. This helps them learn how to make better choices.
• Honor individuality. Most importantly, honor your teen’s individuality and what makes them unique! If they make a decision that isn’t dangerous and doesn’t break any pre-established rules (e.g., changing a hairstyle or dressing in a way that allows self-expression), try to be flexible and give them that freedom.

When to Consult Your Doctor

• If girls have periods that are more frequent than every 21 days or less frequent than every 45 days, encourage a doctor’s visit. Likewise, very heavy periods (bleeding through a pad or tampon every 1-2 hours) or periods lasting longer than 7 days necessitate a doctor’s visit.
• If boys experience gynecomastia that doesn’t improve or resolve within two years, causes significant anxiety or distress, or if there are other concerning symptoms like rapid development or nipple discharge, he should be evaluated by a doctor.
• Abnormal vaginal or penile discharge, pelvic pain, pain with urination or other concerning genital or urinary symptoms should be assessed right away.
• While increasing conflict can be a normal part of development, reach out to your child’s pediatrician if there’s concern regarding blatant disrespect, disregard for house rules or others’ property, or difficulty controlling anger or emotions.

While middle adolescence can be a challenging time, it can also be fun and exciting. Continue to learn about your child’s evolving passions and who they are developing into. While it can be easy to focus on the negatives, try to shift the focus to your child’s strengths. Celebrate successes and support your growing teen!