Supporting AFAB Children with Disabilities Through Puberty

Puberty is a significant and sometimes overwhelming stage of life, for both young people and their caregivers. For children and young adults AFAB who are living with disabilities, puberty may come with unique challenges, including sensory sensitivities, communication barriers or physical difficulties.

As a parent, guardian or support person, its completely normal to feel unsure about how to approach this stage of life, especially when it comes to sensitive topics like menstruation, breast development or sexuality. But here is the good news: you don’t need all the answers, just a willingness to learn, support and have honest, respectful conversations.

This blog post breaks down puberty using Who, What, When, Where, Why and How to give you the tools to guide the young person in your care with confidence and compassion!

You’ll find more information about sex ed when kids have a disability, on our disability resource page.

Let’s get started!

Who is this post about?

This post is for anyone caring for a child or young adult who was assigned female at birth and lives with a disability, whether it be intellectual, physical or anything else in between. This post is also perfect for young adults for their own reading, so if this is you, welcome! This post is about the young person themselves, someone who will experience changes in their body, emotions and relationships as they move through puberty. They may need extra support, more time or tailored communication but they still deserve to feel informed, e powered and respected through their development. Puberty is not a crisis! It is a beautiful transition. With the right tools and support, your child can move through it safely and confidently. 

What is puberty?

Puberty is the process where a child’s body begins to develop into an adult body capable of sexual reproduction. For those assigned female at birth, puberty typical includes

• Menstruation (periods)- the shedding of the uterine lining, usually monthly
• Breast development- tenderness, swelling or enlargement 
• Increased body odour and sweat
• Hair growth- underarms, legs and pubic area
• Body changes- hips may widen, body fat may increase 
• Emotional and mood changes- often caused by hormonal shifts 
• Sexual thoughts or curiosity- this can include self-pleasure or attraction to others

For some young people with disabilities, these changes can be confusing, overwhelming or distressing. They may not have the words to describe what’s happening or understand that the changes are normal.  Your job as a caregiver isn’t to stop these changes, it is to help your child understand, manage, and adapt to them in a healthy, respectful way.

When does puberty begin?

Puberty usually starts between the ages of 8 and 13 for those AFAB. However, some individuals may start earlier or later- especially if they have a disability that effects hormone production or development. You might notice early signs such as

• Breast budding or swelling
• Emotional sensitivity or mood swings 
• Body odour after physical activity 
• Pubic hair growth

Children with intellectual disabilities may experience puberty on a typical; timeline process it differently. Those with physical disabilities may need help with managing hygiene, changing menstrual products, or adjusting to bodily sensations. 

So, you must be wondering, when should I talk to them about it? Start the conversation early, before puberty begins. For most children AFAB, signs of puberty may begin as early as 8 years old, so it’s helpful to begin preparing them around ages 7-9, or even earlier if you notice early development. Children with disabilities often benefit from more time and consistent messaging, so starting earlier gives them a chance to gradually understand the concepts before changes happen. 

Try and use a “little and often” approach. Instead of having one big talk, try and have many small, simple conversations over time. Link discussions to everyday events or teachable moments, such as:

• Buying deodorant= Talk about body changes 
• Washing= talk about hygiene 
• TV scenes or books = spark conversations about relationships, boundaries, or emotions
• Bath or bedtime routine= good time to discuss anatomy or menstruation

Don’t wait for puberty to start, waiting until after physical changes can lead to confusion or fear, difficulty managing periods or hygiene or behavioural outbursts due to overwhelming or sensory discomfort. Instead, give your child a roadmap of what is coming, with clear, visual and concrete explanations suited to their age and developmental level. Think of it like preparing for a big life event, your child deserves time to learn, adapt, and feel confident in their body before it changes. 

Where does support happen?

Support needs to happen everywhere your child lives,, learns and grows. This includes 

• At home: Safe conversations, hygiene routines, and emotional support 
• In school: Educators and aids should be informed and equipped to manage privacy, period care and boundaries
• In healthcare settings: Doctors, therapists, and nurses should be disability-informed and inclusive 
• In the community: Youth programs, sports and clubs should promote dignity and understanding

Creating safe, inclusive places helps your child to become comfortable asking questions, asking for help or expressing distress. 

Why is this important?

Puberty doesn’t stop for disability, but too often, education does. Young people with disabilities are frequently excluded from conversations about puberty and sexuality, leaving them more vulnerable to

• Confusion and distress about bodily changes 
• Poor hygiene or period management 
• Shame, embarrassment or anxiety 
• Misunderstanding consent or boundaries 
• Increased risk of sexual abuse or exploitation

By teaching them about their bodies, you are not “overloading” or “sexualising” them, you are protecting them, empowering them, and validating their experiences. Knowledge is protection. All children deserve accurate, accessible, and honest information about their bodies!

How do I support them and talk to them?

Make sure you use clear, respectful language. Somethings you could say to them include:

• “Your body is changing. This is a normal part of growing up”
• “You might get your period soon. Let’s learn what that means together”
• “Everyone’s body is different, and that’s okay”

Using visual tools and routines can also be a great help, especially with those living with an intellectual disability. This might include stories about puberty, periods or breast development. Visual schedules or pictures for changing pads or showering. Adapted tools fo managing periods like period underwear or easy grip products. Books and videos may also be helpful for this. 

Teach hygiene and self-care step-by-step

• How to clean genitals during their period 
• How to dispose of pads or used period products 
• How to talk to an adult if they are in pain or confused.

Advocate for privacy and boundaries:

• Teach the difference between public and private behaviours 
• Reinforce bodily autonomy: “No one should touch your body without permission”
• Role-play or script ways to say “no” or ask for help

Build a supportive healthcare team:

• Doctors and specialists should be disability informed 
• Consider a gynaecologists who is comfortable supporting disabled youth
• Discuss any unusual symptoms (e.g very heavy bleeding or pain) early 

Final Thoughts

Puberty can feel overwhelming, but it doesn’t have to be scary. With the right tools, language and support, your child can move through this stage with dignity, understanding and confidence. They may need more time, more repetition, or more hands on help, but they still deserve to understand their body, their boundaries and their power. This may seem like a stressful time for you as a parent or caregiver, but fear not, you reading this blog is a great step in the right direction. You have GOT THIS!

References and Resources

SECCA: SECCA offers free, evidence based resources, social stories, and visuals specifically for people with disabilities. Their app, downloadable PDFs and toolkit designed to support puberty, relationships, consent and body safety in an inclusive way. 

Special Girl’s Business and Puberty and Special Girls by Fay Angelo, Heather Pritchard and Rose Stewart: Special girls’ business is a three part book series that explains puberty and menstruation in clear, age appropriate language. Originally designed for children with intellectual disabilities, this book uses visual supports, step-by-step explanations and inclusive illustrations to teach about periods, body changes and hygiene. 

Raising Children Network: The raising children network is an Australian government-supported website that provides free, up-to-date parenting guides, including articles on puberty, periods, and hygiene for children with disabilities. Information is easy to read, evidence-based and culturally inclusive. Overall a great website.

Family Planning NSW: Family Planning NSW offers accessible, downloadable booklets and tip sheets on puberty, periods, consent, self-care and relationships. They also provide training and workshops for caregivers and support workers. 

True Relationships & Reproductive Health: True relationships is a Queensland-based organisation offering visual resources, workbooks, and health education for people with disabilities. Particularly strong in menstruation education, relationships and consent. 

The Period Place: While this website isn’t disability-specific, this site focuses on accessible, inclusive period education for people of all genders and abilities. They promote menstrual equity, and some resources are suitable for adapting to neurodiverse and physically disabled youth. 

You’ll also find more sex education and puberty books for children living with a disability in this extensive booklist.