Most people wish to banish the awkwardness and confusion of puberty from their memories, but for Lauren Houghton, puberty has been the focus of her research for more than a decade. Fascinated by the opportunity it presented for biosocial inquiry, Lauren was struck by how few studies have taken a comparative biocultural approach. In a recent publication, Menstrual Health & Gender Justice Working group members, Lauren Houghton and Marni Sommer used mixed-methods in a study called the ABBY Project (Adolescence among Bangladeshi and British Youth) to compare experiences of puberty across cultures in a study of nearly 500 girls aged 5-16 who were either Bangladeshi, first-generation migrant to the UK, second-generation migrant, or white British (Houghton  et al. Social Science & Medicine (2020).

This mixed-method research speaks to the power of speaking with participants rather than just collecting data from participants. The authors had originally predicted the age at puberty to follow a steady decline with increasing time lived in the UK (age at puberty decreasing in this order: Bangladeshi, 1st generation migrants, 2nd generation migrants, then white British).  But the finding that first generation had particularly early puberty was completely unexpected.

The design of Houghton’s fieldwork- two years embedded in the East London school system – allowed for the simultaneous collection of qualitative and quantitative data. This in turn allowed the authors to suggest explanations for why first generation girls seemed to mature so early. One clear finding was that the stigma of being “Freshis” (recent migrants to the UK) expressed by second generation Bangladeshi peers was a source of psychosocial stress.  This stress could be one explanation for the early puberty.

Members of the GAL Club, an after school club offered to schools and participants in exchange for their participation in the ABBY Project.

The social stickiness of this stigma was strengthened by an overall rejection of Bangladeshi culture among the British-Bangladeshi youth. For example, girls denied eating “Rice”, short hand for rice and curry, in front of their friends even though they reported eating it the night before in the 24-hour food recall conducted as part of the study. While they rejected Bangladeshi culture, they embraced being Muslim. Wearing hijab reflected their respectful practice of Islam. In fact, girls living in the UK were more likely to wear hijab than girls in Bangladeshi. The girls explained a distinction between practicing the scarf (wearing it irregularly) and being dedicated to it (wearing it every day) (See Figure 1). This distinction became fertile ground to explore biocultural markers of puberty. Through an integrated mixed-methods approach it became clear that practicing the scarf aligned with the onset of adrenarche, a pre-cursor of puberty, and becoming dedicated to it aligned with the onset of menarche (a girl’s first period) for first generation girls (See Figure 2).  This is in sharp contrast to girls in Bangladesh among whom becoming dedicated to the scarf only occurred in early adulthood, if at all. The hijab emerged as a biocultural marker of first generation girls pubertal experience as they came of age in East London.

Ages at biological and cultural markers of puberty in Bangladeshi and British girls in the ABBY Project

Interpreting the results of epidemiological studies is standard practice, however, in this mixed-methods research the authors able to turn to sociocultural explanations explicitly observed and inquired about with the actual population understudy to interpret the quantitative findings. The authors did not have to surmise blindly based on their own biased perspectives, but rather could make culturally-informed interpretations. Furthermore, they were able to integrate the qualitative findings with biomarkers, in this case measures of stress hormones. In the era of “big data,” when methodological advances are leading to studies of multiple “-omic” fields (such as genomics, epigenomics, proteomics, metabolomics, and microbiomics) this study is an example of how qualitative methods can add to these omics. “Emics” comes from anthropology and is the mapping of on-the-ground perspectives derived from rich discussion with stakeholders directly affected by the problem under consideration. The ABBY Project illustrates how the incorporation of “emics” in addition to “omics” into studies of puberty and menstruation will lead to a more comprehensive understanding of this biocultural phenomenon.

This article was originally published on July 5, 2020 on the Columbia University Mailman School of Public Health Social & Spacial Epidemiology Unit blog. The original article may be found here. Authored by Lauren Houghton.