125. Cara Familian Natterson: Physician to Puberty Influencer

Show Notes:

Cara Natterson moved to New York City where she worked for a drug rehabilitation center, and later moved to Baltimore, where she studied at Johns Hopkins Medical School. She eventually returned to L.A. and practiced pediatrics there. Her writing career began at the age of 31 when a co-worker asked her to read his manuscript, which inspired her to write her own book about raising kids.

The Body Book Series and Less Awkward Company

In 2008, Cara decided to leave clinical medicine and become a full-time writer. In 2011, after speaking at Mattel, she was signed on to write for the Body Book series from American Girl, which has since sold millions of copies. Cara then started touring the country, focusing on puberty education. During this time, she discovered that there was nothing else available for kids whose bodies, brains, feelings, and friends were changing. She launched her own business, Less Awkward, a company that created direct-to-consumer products designed for comfort and health like bras and socks. Cara has since expanded the company to focus on content across social media, podcasting, newsletter, and school curriculum.

Health and Sex Education Curriculum

In the past year, she has rolled out two platforms: a health and sex education curriculum for schools, which is already implemented in three states, and a membership for parents and trusted adults. Cara talks about the importance of understanding and discussing puberty in young people. She highlights the slower pace of puberty, with girls entering puberty at an average age of 8-9, and boys at an average age of 9-10. She emphasizes the importance of discussing the first signs of puberty, such as breast budding or testicular growth. She also highlights the importance of discussing the issue of first porn exposure, which is a significant concern for parents, family members, coaches, mentors, healthcare providers, and educators. She emphasizes the need to educate children about free porn, which is generally violent and aggressive, and calls for a less awkward approach to discussing this topic. By engaging in conversations about this topic, adults can help their children navigate the challenges of puberty and promote healthier lifestyles.

Launching a Direct-to-Consumer Product

Cara talks about the shift from a pediatrician to writer to entrepreneur. She initially went to medical school but, although she found it interesting, she also realized that she was more of a creative type. However, her background combined with her creative mind led to the drive to develop comfortable and healthy products. After a chat with a friend about bras, she was convinced that there was a need for comfortable bras for young girls. The two women partnered with a sewer who made a comfortable and healthy bra for their daughters, and later pulled together a team that developed the product over many years. They patented the product and launched the company during the COVID-19 pandemic. It was initially launched as a mask company, focusing on distribution and production channels instead of bras to supply the then current demand. Six months later they launched their bra products. She talks about the journey from design and development to launching the product and what she learned along the way. Cara’s business ethos has always been to do well and to do good at the same time, and she has found this to be a recipe for success.

The This Is So Awkward Podcast

The conversation turns to Cara’s podcast which she started with her partner, Vanessa Kroll Bennett. The podcast addresses the confusion about the length of puberty. It features background episodes and guest appearances with experts from various fields. In October 2023, they published a book called This Is So Awkward: Modern Puberty Explained, which explores the changes in puberty and how to talk about them, and it includes essays by kids about their experiences with acne, first periods, and heartbreaks. The podcast has expanded along with content on Instagram and TikTok. All of this content is also available on the website LessAwkward.com. They also have a school-based health and sex education curriculum called That Health Class.

Navigating Today’s Cultural Complexities

Cara emphasizes the importance of pediatricians in understanding and managing the changes in puberty. She explains that kids and their adults are overwhelmed by the complexity of the world and the increased access to a wide and diverse range of information. Pediatricians often lack the time or bandwidth to provide anticipatory guidance for children, an especially big issue given the mental health crisis among children. Cara mentions that pediatricians often turn to the LessAwkward website where they have trained an AI bot on their content. Pediatricians are starting to use it as a healthcare solution when they don't have the time to answer questions but their patients want to be able to anticipate what's coming. The bot is reliable, gated, and trained on good data, making it engaging and entertaining. The levity and warmth of the content make it a valuable tool for pediatricians to recommend.

Factors that Contribute to Early Puberty

The American Girl Body Book series launched just after a 1997 study showed that girls were entering puberty earlier. It stated that the average age has shifted from 11 to 10, and a follow-up study in 2010 found it to be between eight and nine. The reason for this change is under investigation, but it is believed to be due to a number of factors, including stress, adverse childhood experiences, and antibiotics. Stress causes cortisol surges, which can either trigger the release of hormones like LH and FSH, or cause sex hormones to surge. Adverse childhood experiences, such as witnessing trauma or drug abuse, can increase the risk of entering puberty early. Evolutionary theory suggests that the human body is meant to reproduce before life ends, and so it makes sense that the general stress response might drive earlier development. She mentions Louise Greenspan, a woman who has been researching puberty for decades, has written a book called The New Puberty which further explores this topic.

The Male Side of the Story

Cara’s parenting podcast has a diverse audience, with nearly 20% male listenership. She shares her experiences with male listeners and the challenges they face in connecting with their children. She wrote Decoding Boys, and states, with a degree of jocularity, that there is no data on the connection between testosterone and silence, but it is common among males, especially in their tween years. She shares personal strategies to help connect with tween or teen boys, as they do want to talk and share their thoughts with trusted adults. In the book, Cara shares strategies she has used, and in this conversation, she shares a personal experience on how she encouraged her son to talk to her. 

Influential Harvard Courses and Professors

Cara's career highlights her interest in sociology and biological anthropology, which she combined at Harvard. She wrote a junior paper about female genital mutilation in Africa and a thesis about HIV prevention in teenagers in Boston suburbs. She had a vivid memory of her thesis advisor, Irven DeVore, who was an interesting thinker and helped her fit her thesis idea into the curriculum.

Timestamps:

02:12: Transition to Entrepreneurship 

05:46: Insights on Puberty and Parenting

09:20: Launching Less Awkward 

15:42: Content Creation and Engagement 

29:05: Raising Boys and Communication Strategies 

35:15: Daily Routine and Collaboration 

37:19: Impact of Social Media and Content Creation 

39:14: Influence of Harvard Education 

Links:

Website: https://lessawkward.com/

Podcast: https://lessawkward.com/podcast-this-is-so-awkward-2/

Instagram: less.awkward

TikTok: less.awkward

Cara’s Instagram: caranatterson

Featured Non-profit:

The featured non-profit of this episode of The 92 Report is recommended by Chris Hull who reports:

“Hi. I'm Chris Hull from Harvard's fabulous class of 1992. The featured nonprofit of this episode of The 92 report is The Fund for American Studies. TFAs is an educational nonprofit that develops courageous leaders by providing students who otherwise wouldn't get a chance to come to DC to learn about how to make a difference. I've been honored to have worked with TFAs for more than three decades, since they've allowed me to study at Georgetown. At the same time, I did an internship in Washington, which helped transform my life as it has for so many others over the last half century that it's existed, who otherwise couldn't possibly afford to do such a thing. You can learn more about their [e-mail].”

To learn more about their work, visit: [e-mail]