Adolescent Girls: A Biopsychosocial Understanding of Puberty


Puberty is both an exciting and nerve-racking time for young girls as the changes in this stage are some of the most significant and rapid an individual experiences.  This blog will look at the different factors impacting adolescent girls as they transition into adulthood from a Biopsychosocial lens.  A biopsychosocial analysis allows one to consider all of the psychological, biological, and sociological factors of adolescent girls in puberty to have a holistic understanding of the event.  Stemming from physical characteristics that change during this time, internalized perceptions that society puts on young women can significantly impact one’s mental health.  Understanding how best to support adolescent girls during this intense transition period is important.  Aside from physical and mental changes, this time becomes even more complex as individual Identity becomes a major focus of who and what young people want to become.

Biological aspects:

Puberty is a natural biological development experience all healthy humans and animals experience.  Puberty accompanies adolescence’s developmental stage, a marked developmental change in primary and secondary sex characteristics, and the beginning of reproductive maturity.  Initial physical indicators of early puberty for girls are the appearance of breasts, growth of pubic hair and axillary hair, growth spurt, changes in skin tone including acne, body odor, storage of body fat, and the arrival of the first period.  These physical, biological aspects of puberty can be very impactful as the young girl sees herself and society seeing them turning into a young woman.

There are a commonly discussed five stages of puberty.  The first stage happens for girls on average in America around their 8th birthday.  In this stage, there are minimal observable physical changes, but a variety of hormonal changes are happening behind the scenes.  The brain signals to the body to prepare for changes.  The hypothalamus begins to release a hormone called gonadotropin and sends it to the pituitary gland.  Here, the pituitary gland then gets the signal to produce two more hormones, setting the stage for physical changes.  Stage two begins physical changes, typically between years 9-11.  The physical changes of this stage are the first signs of breasts.  It’s normal for this area to be tender and itchy during this stage, and breasts grow at different rates.  The uterus also begins to grow larger, and pubic hair may develop in the pubic region.  In the third stage of puberty, these physical changes become more apparent.  Breasts become larger, and pubic hair becomes thicker and curlier; hair may begin to form under the armpits, acne may appear on the face and back, hips and thighs may begin to store fat, and overall height may increase at a rate of 2-3 inches per year.  In stage 4, typically around the age of 13, all physical changes continue to grow, and many girls will experience their first period.  In stage 5, roughly around age 15, girls reach their adult phase of physical appearance.  Approximately 1-2 years after the first period, a girl will be at their final height, and their period becomes regular six months – 2 years after their first period.  All the reproductive organs have become fully mature.  Around this stage, puberty begins to be complete, and the biological aspects of being a woman have reached maturity.

The timeline outlined above for the five stages is the national average, and there will be obvious discrepancies as puberty doesn’t start simultaneously for everyone.  This fact alone can cause internalized challenges as a response to an individual experiencing the stages of puberty at different times than their peers.  For example, someone experiencing early pubertal maturation may internalize shame about experiencing these physical changes before the rest of their peers.  Similarly, those who have delayed pubertal development may experience a similar sense of internalized shame.

Psychological Aspects:

Within the five stages of puberty, alongside the physical changes, several psychological changes occur in this development stage.  A prominent aspect of this would be mood swings; mood can be impacted due to the changes in hormone levels in the brain and body.  Mood swings can manifest around interpersonal relationships with friends, teachers, family, and budding romantic relationships.  In addition to mood swings, adolescent girls going through puberty may experience heightened sensitivity to the world around them.  Another aspect of the variety of puberal maturation age, which impacts girls psychologically, is self-esteem.  In comparing with peers how puberty affects them, one can cast an initial judgment on self or others, which can significantly impact self-worth and self-image.

Additional risks are associated with this stage, as cognitive and emotional coping skills may still develop behind the physical maturation.  It can lead to maladaptive gender role-linked coping skills like ruminating, silencing, and avoidance.  These gender-specific coping skills can also encompass other unhealthy coping skills challenging for this age group, including substance use and risky sexual behavior.  The early formation of these coping skills can stick into adulthood, leading to difficulty later in life and the internalization of psychopathology.  For example, as a result of witnessing the physical manifestation of sexual maturity, without the fully developed cognitive aspects of mental and sexual maturity, girls experience a wide range of internalized symptoms like emotional distress, depressive symptoms, anxiety symptoms, major depressive disorders (Natsuaki, 2014)

Sociological aspects:

It’s important to bring into the conversation the developmental stage simultaneously occurring during the typical ages of puberty.  Erik Erikson is a psychologist who created the stages of psychosocial development theory.  This theory states that a conflict must be addressed at each developmental stage of life to evolve into a traditionally healthy developmental experience.  During adolescence, Erikson established this development stage as Identity vs. Identity confusion.  During this phase, the individual begins to remove themselves from solely identifying with their family unit and connect more with their peers.  Choosing which aspects of their family identity they want to hold onto and which new aspects of their environment they want to identify with, including values, beliefs, and this idea of “finding themselves.”

While the amount of time spent around peers increases, this can introduce a common phenomenon known as peer pressure.  Peer pressure can be even more present if certain aspects of self-esteem and self-image are already impacted due to other influences of puberty and adolescence.  Peer pressure can pose a challenge by feeling forced to do things other people around you are participating in.  It includes the use of substances, intense academic performance, sexual behavior, and how one dresses, amongst others.

In addition to psychological impacts, emerging female-specific body changes, mentioned earlier in the five stages of puberty, align these young women with a socially constructed gender role of a sexually mature female.  It is where overall societal aspects of gender roles come into play: how our society views women, how women view women, and how men view women.  It is a very complex topic as adolescent girls begin to experience their existence in society as women for the first time.  It increases sensitivity and vulnerability with how they view themselves and their world.  It includes the media and social media.  How society discusses and considers women’s physical appearance can greatly impact an individual’s self-esteem.  It can often lead to challenges with body image and sometimes restrictive or controlling relationships with food.  It can also lead to attention-seeking behaviors to validate this internalized pressure placed upon girls in adolescence.


Puberty is a complex time for adolescent girls to navigate, as so many experiences happen for the first time across the biopsychosocial spectrum.  To best support this population, evidence-based practice heavily focuses on an open and educational conversation between parents and their daughters.  It starts with active listening, extreme openness, validation, and empathy from their parental figures.  It’s important to provide as much information as possible to normalize their challenges and changes.  If more significant concerns feel overwhelming, know that parents and their daughters are not alone.  Reach out to resources at school or a mental health professional to assist with this complex yet exciting time.


Ashley.  (2021, August 19).  Why girls’ social struggles intensify during adolescence. Shop.

Eriksons stages of psychosocial development – StatPearls – NCBI Bookshelf.  (n.d.).

Natsuaki, Misaki N., Danielle Samuels, and Leslie D. Leve, ‘Puberty, Identity, and Context: A Biopsychosocial Perspective on Internalizing Psychopathology in Early Adolescent Girls’, in Kate C. McLean, and Moin Syed (eds), The Oxford Handbook of Identity Development, Oxford Library of Psychology (2015; online edn, Oxford Academic, 5 Dec.2014),, accessed 15 Oct. 2023.

Marcin, A. (2023, February 10).  Stages of puberty: A guide for males and females.  Healthline.

Leave a Comment

transgender, journey, trans, lgbtq, lgbtqia, lgbtqia+, nonbinary, queer, gay, lesbian, cisgender, gender identity, gender orientation, gender affirming surgeycollege, application, search, campus, school, academics, stress, testing Call Us