Chairman McArthur: The first consideration of this discussion is: "Who shall take care of the menstrual problems of the adolescent girl?" Shall it be the gynecologist, the internist, or the pediatrician? My own feeling is that the pediatrician is probably the best qualified of all these specialists to handle adolescent problems. In the first place, he has usually known both the parent and the child for many years, and has gained a rapport of inestimable value in allaying the embarrassment of the patient and the anxiety of the parent. In the second place, the pediatrician has the developmental point of view. It is essential to treat adolescent menstrual disorders with patience and restraint—attitudes which come naturally to a specialist thoroughly accustomed to the vagaries of an evolving organism.
If we examine the following list, which enumerates the various sexual characteristics in the order in which they appear, we see the relevance of the developmental point of view to problems of sexual maturation. It becomes evident that adolescence is a process—not an event. Because the first menstrual period is such a dramatic occurrence one is apt to think that it is synonymous with sexual maturity, the ability to reproduce one's kind. Actually, this is not the case, as we know from several lines of evidence. Thus, anthropologists studying the inhabitants of the Trobiand Islands have found pregnancy to be rare in young girls until one to 2 years have elapsed following the first menstrual period. In these islands, it is customary for sexual congress to take place freely from childhood on.
- Copyright © 1953 by the American Academy of Pediatrics