Caroline Lovett, a psychosexual and relationship therapist, discusses how to talk to your child about puberty and body image when they are going through bone marrow failure treatment which could impact their changing bodies.

It can be really difficult to think about the long term implications of your child being on treatment, particularly when we're thinking about children in relation to puberty, fertility and their choices as they get older. 

How do we start to have these conversations in a really inclusive way? Like most things, we start gently. You don’t need to  approach it as a big, massive conversation, it can be a little bit at a time in a way that works for you and your child.

A good starting point is a conversation with your medical team. They would have had these conversations hundreds of times before, and will be able to give good advice on talking points you can then take forward in an age appropriate way with your child.

What’s age appropriate?

When it comes to talking to your child, it's really important to think about what feels age appropriate. You know your child, so use the language that feels right for them. Start slowly and build on those conversations. I always say to parents: take yourself off to a bookshop or library and have a good look at books that might also be useful as conversation starters.

There’s a lot of information out there on the internet and not all of it is helpful. It’s wise to be cautious of introducing your child to online content around these topics. Find trusted resources you can explore together.

When it comes to raising the subject of fertility, you might want to start the conversation along the lines of: “This probably isn’t something you’re thinking about now, but when you’re older, you might start thinking about what it means to have your own family.”

Think about what your child may need to know in five, ten or 15 years time, start gathering this information now so you can act as advocates for their future selves. You can then answer more of their questions as they arise.

How might bone marrow transplant impact puberty?

Having treatment for bone marrow failure can affect us on a physical and emotional level. This can be particularly challenging for young people if it interrupts, delays or stops puberty altogether. 

It can create a sense of feeling different compared to other young people. That can be frightening and confusing. Being able to really talk about these things with your child or your adolescent is important. 

Be prepared for the fact that they might not want to talk to you. They might feel embarrassed or self conscious. So how do we make sure that they're getting the support and information that they need? 

It might be worth talking to your medical team. They may be able to direct you to support groups, particularly support groups for young people. Sometimes it’s helpful for young people to talk to others who have gone through a similar thing. Or maybe they have other trusted adults you can speak with to open up the possibility that they could have these conversations on your behalf.

Be aware of any changes in your child that might make you worried. Either physically or emotionally. This can be tricky, because teenagers can go through all sorts of changes that we might not necessarily recognise. But if you keep communication open and help them to build their own support network, this will help them find the information they need and access trusted people who can look out for them alongside you. 

More articles and videos from Caroline

More advice for parents

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Further advice and support

• Goaskalice.columbia.ed - sex education for teens
• Scarleteen - sex education for teens
• Sex Etc - sex education for teens
• Amaze.org - Sex education for young people. Including Amaze Jr - aimed at younger children - to watch together with parents/carers.