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Puberty and Death with Julie Metzger

Julie Metzger has been teaching families about puberty for over 30 years. Her book, “Will Puberty Last My Whole Life?” and her course, Great Conversations, are amazing resources to help teens and families recognize and navigate the important transition to adulthood. In conversation, Julie and I draw parallels between puberty and death. Both are sacred experiences and periods of great transformation for our bodies and communities. We dig into the use of ritual, the importance of language when it comes to talking about the sacred, and a really fascinating thought exercise about what it means to be an adult. 

You can learn more about Julie’s work at


[00:00:00] Sarah Cavanaugh: Hi, I'm Sarah Cavanaugh, and this is Peaceful Exit. Every episode, we explore death, dying, and grief through stories by authors familiar with the topic. Writers are our translators. They take what is inexpressible, impossible to explain, and they translate it into words on a page. 

My guest today is Julie Metzger. She is a registered nurse and has been educating families about puberty for over 30 years. Her book, “Will Puberty Last My Whole Life?” and her course, Great Conversations, are amazing resources to help teens and families recognize and navigate the important transition into adulthood. 

I asked Julie to Peaceful Exit not to explain the ins and outs of puberty, but to draw parallels between two human rites of passage. Puberty and death. Very different milestones, of course, and very different points in life, yet so much to learn from each conversation. We dig into ritual and the importance of language when it comes to talking about the sacred and hard, somewhat taboo subjects. 

Julie also walks us through a really fascinating thought exercise about what it means to be an adult. 

Welcome to Peaceful Exit. I'm so excited to talk to you today.  

Julie Metzger: Oh, it's a pleasure to be here.  

Sarah Cavanaugh: So your work focuses on the transition from adolescence to adulthood. to adulthood. And my work with death is the last transition as a human being. Um, you know the story of how I got into this conversation. How did you get into this work? You've been teaching families about puberty for over 30 years.  

[00:01:49] Julie Metzger: I have always had a passion for adolescence, for preteens and teens. It's been something that's been wired into me since I was one. I feel connected to that age group. I just have always had that underlying in who I am. And when I was in graduate school in the School of Nursing at the University of Washington, my faculty advisor, she said, I'm working on a women's health study. 

Why don't you take the questions and look at them more carefully around this idea of when did you, as a woman who answers this question, large study. When did you learn about menarche, the beginning of periods? What did you know? Did that change your experience? You know, those kinds of questions. I was looking at the data and the vast majority of people at that moment in time had reported that they had learned about puberty and periods and all that related kind of content from their mothers. 

And I can remember smiling in that moment, just immediately picturing people sitting with their mothers in the car on the five hour car trip, or briefly in the kitchen, or not at all, or handing you a book. And then I thought, what would it be like if you actually sat in a class, different than the one in school, where you're learning these things amongst your peers, but what if you actually sat with an adult that was a part of your family or, or a close adult and learned it together? 

And what if you were able to create conversations just from the shared experience of being together and talking about those things? And I knew right then, I said, I could do that. And I especially could do it if it was fun and funny. And I think it would break all barriers if somehow the conversation was normalized in a spirit of both respect and joyfulness. 

[00:03:41] Sarah Cavanaugh: I love that. And I also feel the same way about these conversations about death. The depth of people's grief sort of mirrors the depth of their joy. And, you know, listening to this podcast, they're probably wondering, what does puberty have to do with dying? But I think there's a, There's something about talking about really difficult topics and I feel like puberty is further along than the conversation about death. 

I don't know if you'd agree.  

[00:04:10] Julie Metzger: I think first of all, both are about our humanity and that puberty is a human being experience and so is death. That this idea of sharing our humanity, its full expression of who we are, then it offers up also a full expression around it, whether that is joyful or grief or even neutral. 

This idea that you could be matter of fact about something related to death and related to puberty sometimes is as abnormal for someone to hear that. That it could be a neutral experience or a neutral expression around that whole experience. That's when you know you're in an important conversation that's sacred because it's more fully about who we are as a human. 

[00:04:58] Sarah Cavanaugh: Do you think some of the trivializing and joking and all of that kind of gets us away from really sitting with that? Oh, for sure.  

[00:05:06] Julie Metzger: I get asked all the time, why are there bad words? body parts. And I said, well, we don't have bad words for our elbows or for our ears. And so when you look more closely at what we have, nicknames or bad words or trivializing, it's around our sexual parts or our part of how our cultures define sexuality. 

So breasts are a great example of they functionally are not sexual. but they are sexualized. And so all the words for breasts are just endless, right? And they are trivializing the idea of breasts. And I think when we have sacred things, we tend to make them smaller because you can look at other sacred things that have to do with faith or whatever. 

So when you think of swear words, they're often around sex or God. And I think they're a way to make them smaller to be able to handle it. or cast them off so I don't have to actually sit with it, or somehow diminish so that I can say those words out loud and somehow get away with it. I find all that very fascinating. 

[00:06:17] Sarah Cavanaugh: Me as well. Language is so, so important and how we language something.  

[00:06:22] Julie Metzger: And I think it's super true also around deaf. I think right on in thinking of ways that people skirt. real talk, but it's become so ingrained that they don't even hear it as that. Somehow by creating a euphemism about it, it keeps you from actually being authentic with it and holding it. 

I think showing up in your most authentic self means that you actually have a language that reflects your matter of fact normalization of those parts of who you are. And they can be done with joyfulness and humor, but there is a real line here between respect and curiosity and joy. 

[00:07:20] Sarah Cavanaugh: And not holding on to those euphemisms is really what I'm about in these conversations. 

And beyond that, being really honest and open about what's happening, especially when it comes to death. What I imagine is that if my mother had come to me and said, I am dying, it would have shifted the entire conversation. We would have had such an opportunity for intimacy that we never had.  

[00:07:48] Julie Metzger: Yes. That when we are not speaking From that authentic reverence, we lose the opportunity for intimacy. 

So in reverse, when we speak from a place of reverence, from our authentic selves, with language that reflects that, we choose intimacy. That's true for our sexual partners. That is true in death. That is true for our greatest friendships. That is true for colleagues at work. That is true in puberty. That is true in every aspect of the human experience. 

[00:08:40] Sarah Cavanaugh: And this culture tends to deny Many rites of passage.  

[00:08:44] Julie Metzger: Oh, for sure. There are traditions all over the world that have acknowledged adolescence, the finishing of adolescence, or the advent of menarche. And our Western culture, and particularly in the U. S., has almost never seen that. completely gotten rid of that. 

But that happens in a pluralistic society where after a while you're sharing cultures when we marry other cultures or marry other faiths or whatever, and after a while those get sometimes dropped off or eliminated. But I think there's opportunities for people to rebuild even within a single family unit where you say, In our family, we're going to celebrate that or we're going to acknowledge that and find places to bring together a moment or an acknowledgement, an event. 

It could be a gift, but this idea of honoring the sacred.  

[00:09:41] Sarah Cavanaugh: Do you have any stories of rituals that really stay with you?  

[00:09:47] Julie Metzger: some of the cultural expressions around the world. Um, there's red rice in Japan for when a girl starts her period that means good fortune. Um, I have a red seated bracelet that the Maasai adult women give to a girl when she starts her period. 

There are traditions in Eastern Europe where you get a slap across the face that says welcome. When you think of a bar mitzvah, bat mitzvah, it's an acknowledgement that you've become an adult and you are seen as an adult within your temple and your synagogue. There are the quinceañera, the traditions in East India where you get to wear a sari and get gifts of jewelry, things like this. 

So we walk through all of that and I invite the families to say, how will you acknowledge this moment? No matter your gender or whatever, how will you acknowledge this kind of transition to adulthood?  

[00:10:36] Sarah Cavanaugh: I know your class used to be sorted by gender, and now everyone is together in one class. Did that change the way families acknowledged the transition into adulthood? 

And how did that transition to one class with everyone go?  

[00:10:51] Julie Metzger: You know, in this age group, there's so much to absorb on your own body parts that that felt like the natural thing. And, but it was already problematic. There were adults that didn't find a space in that. There were kids that didn't find a space in that gender separate idea. 

And this idea of a mom coming with daughters or dad coming with sons, this whole idea of having to delineate by the gender that you are or that you saw yourself as. It was problematic. But in 2020, when we had to shut down in person and we created a virtual environment for families to come, we immediately went all gender. 

And, you know, it's a lot easier because people aren't elbow to elbow. You know, you're not in an auditorium. You're in your own kitchen and less conscious of the people around you. And what I love about virtual is that sometimes you look on our screen as we're teaching because it's live virtual and we see the whole family sitting on the couch and the dog and the little brother and the someone holding a baby. 

Everybody's learning at once. Yeah. Yeah. Yeah. I can't get enough of that.  

[00:11:55] Sarah Cavanaugh: Yeah.  

[00:11:56] Julie Metzger: So we ran that for three and a half years like that. And then when we went. To in person, we were like, this is so much better. It's so much richer. It's so much more interesting. It's so much more full throated and beautiful. And we talked quite a bit about what we would both gain and lose in that. 

It felt like the most natural thing, and so helping people catch on to the spirit of that and to understand it became our greatest challenge, but we've now had, I don't know, a thousand families go through the in person, and I think we've had three people say something about it not working for them that works for them. 

They were all genders in the room. Yeah. Also, the way we talk in class has changed a lot because of this idea around gender that we are continuously honing our language around this. But this idea that we have everyone in the room gives us an opportunity to, again, it brings full circle to what we talked about at the beginning about this being a human being experience. 

And that there's actually more that we share the same in puberty and in death than is separate by our gender. There are specific body parts that we have that will perform differently, but that's actually a smaller section of things than what we actually experience in puberty that's the same. So we really try to unify that language and lift up people around those ideas. 

[00:13:25] Sarah Cavanaugh: Yeah, let me pull that thread about specific connections that you see between puberty and death.  

[00:13:32] Julie Metzger: When we are in puberty, when we are feeling our vulnerability of our physical selves, that's a profound idea that we get to look to each other and rely upon each other for information, for support, for supplies, for logistics, for acceptance. 

Both death and puberty are a change of body, a transition of body, a connection to becoming something new or something different. So I see them similarly. I have been with adolescents in puberty while they've been dying, in my own experience as a nurse, and this idea of having the profound connection between both ideas. 

young people who are experiencing puberty, whose lives get disrupted also with a serious illness or a chronic illness or a end of life moment who are experiencing the full idea of body that you can't count on for the same things that you could have before. You know, there's a lot of kids who come to our class who are afraid of puberty. 

And I think there's lots of people who are afraid of dying. So this idea also of sharing with others that fear or that uncertainty or having a hard time picturing yourself in the next phase, whatever that is, whatever that transition looks like. I remember Uh, this one girl wrote on the card, Will I still love the things I love now when I'm finished with puberty? 

And then in parentheses she wrote, Like turtles. We all feel a little bit like that. Will I be the same person that I know now, that loves turtles, when I become more of a grown up? Who am I at my most essence now? And when I transition in puberty or death, what will remain of my essence? Beautifully said. 

[00:15:49] Sarah Cavanaugh: What is your story around death? Were you raised in a family that talked about it, or?  

[00:15:54] Julie Metzger: My parents are both health care providers, and the idea of our bodies, ourselves, our humanity, in both being born and dying, was just a natural part of our conversations. It was a dinner table thing. My parents also very much were a part of supporting and helping their community of friends in their illnesses and deaths. 

So I grew up around that as well. They were very instrumental in helping people in their worst and best moments around the idea of end of life. And my mother still today, she'll be 90 in June. She is very much woven into being a advisor consultant to many, many people around this idea of end of life. We, we also, Grew up in Oregon and Oregon has always had a culture that supports end of life ideas in interesting ways. 

We've been part of the founding parts of two nonprofits that support families with kids with cancer and huge exposure over my whole life around people who are standing there wondering, you know, what is life? What is death? What is healing? What is cure? Are healing and cure the same thing? These are just kind of everyday explorations for me. 

Yeah. Yeah.  

[00:17:20] Sarah Cavanaugh: Earlier we were talking about rituals that sort of celebrate puberty, celebrate the coming of age. But what about the grief that comes in losing your childhood? It's as if a death happens as well, in parallel, almost.  

[00:17:35] Julie Metzger: I think that in our culture, all the markers of puberty for boys, for boy bodies, for people with a penis. 

When people with a penis go through puberty, all the things about their body changes we celebrate because they get bigger. They get taller, they get bigger, they get broader, they get stronger, they get hairier, they can have sex in a way that our culture sees as a really big grand positive. And that when menstruators go through puberty, it's less celebrated in our culture because they get bigger. 

They add fat, they get hips, they get breasts. And these ideas are becoming more womanly. in a 12 year old, 14 year old body are less celebrated. And so, therefore, there is grief, I think, in that, in my viewpoint of the world, that we don't celebrate the full bodied, becoming adult body of a menstruator. I think that feels Like, there's room then to feel sad about not remaining small because our culture celebrates small. 

Here's another thing. As we go through adolescence, we do become more self conscious and part of that is the way our brain is changing. There's this incredible study at the University of London that put middle school girls through an MRI and tried to see when their brains would light up. And so they said to them words like, the table is black. 

The room is cold. Your friends have just seen you picking your nose. And of course, the table is black, the room is cold. There's not much brain activity, but when they say your friends have seen you picking your nose, your brain goes completely wild. I don't think anyone would be surprised at that. Then they took the mothers of those same girls and put them through the MRI and said the same things. 

And the mothers barely registered on my friends have seen me picking my nose. It was still a flat line for them. So what is it about adolescence that makes you more self conscious? And there's some work that's been done to identify that our brains really are different as an adolescent and that being self conscious and being aware of what's around me and how people are seeing me is both more than when I was six. 

and will be less than when I'm 46. So this idea of feeling grief around who I was, I can equate that to a self consciousness. I look different. How will I be seen by others? And perhaps there is sadness around that, that this idea that, why should I have to care what other people are thinking about me? So I think that's real. 

But most kids look forward to, um, This idea of becoming more adult.  

[00:20:36] Sarah Cavanaugh: Well, and I'd take it to another place too, that since you are a nurse and you have been with adolescents who are dying, is it a perception that those kids grow up really quick? I mean, I'm sort of curious from a brain science point of view, if we were to scan those brains. 

Whether they would be as self conscious, because they know that their death is coming. And the awareness of that feels like, oftentimes, you know, they feel like the oldest child of the family because they have this wisdom knowing that their time is short.  

[00:21:08] Julie Metzger: I think, let's not underestimate the siblings of those same kids who also grow up very fast. 

The entire family has an opportunity to be changed. For these families with kids with cancer, before that diagnosis, you're on this journey. You've packed your bag, you know the language, you have a vision of your journey and where you're going, you have this idea of the snacks that you've brought in the car because you know you're going to be out for so long and where you're headed. 

And that diagnosis is the It's as if the car gets picked up and moved onto a completely different road, and they're not even speaking the same language, and they brought the wrong clothes, and they don't know what's wrong, and they don't know where they're headed. That this idea transforms everything about what they thought they were about. 

So that new identity of being in this car. And going on a road that they hadn't planned on and have no idea where they're headed and don't have any of the same resources that they thought they would need. And the parent that described that to me, it was like such a big aha. And she said, the biggest aha comes when I realize I'm never going back to that other road. 

I'm never going to be that person in that car that I was before. And there's an equivalent there. It's quite powerful with puberty. I now am six feet tall. I've gained 45 pounds. I have these new capacities. I'm never going back to that body. And yet this journey is also interesting. Perhaps grief comes when you think, gosh, once I realize that I'm not going back to that other space, I have to spend a minute, for sure, imagining that felt happy go lucky or I didn't realize how much I wasn't worried about what people were thinking or any of that. 

But now that I'm on this road, I actually can find joy.  

[00:23:12] Sarah Cavanaugh: You did a fascinating exercise with eighth graders. Can you share a little bit about that? Asking them about what age you become an adult.  

[00:23:19] Julie Metzger: Eighth graders today will be one of the first generations that live to a hundred. So given that the fact that I live a hundred years, I put a timeline up zero to a hundred. 

When do you think you become an adult? Let's just kind of map what that looks like. And so some people would say 16, when you drive, uh, 18, when you can join the military, when you can vote, 21, when you can be seen in public. society drinking and you can actually go into spaces that otherwise are unlimited to you. 

Late 20s when many people are getting married or changing their life or getting a job post college. Somebody said 35 when you could become president. And so we would mark all those on this big whiteboard. And I said, is there any time when you are no longer an adult? And there are a lot of conversation around that. 

A lot of people who said yes, after 65, when you start to lose some capacities and certainly when you may. not, no longer be able to make your own decisions. And that's always fun and funny and fantastic to hear how they pictured this idea of no longer becoming an adult. Because of course, I, I had never even considered the idea that you would ever not be an adult. 

Even if you weren't able to make your own decisions, you're still an adult. But that's not really how many of them saw that. And that was interesting. So then I said, Is there an age where you become sexual? And we again plot it out. Some people said, well, you're sexual just by being a human. So you're, you know, below the age of one, you're a sexual human being. 

And then some people would say, no, not until you begin puberty or end puberty. Perhaps some people are saying, well, no, not until you actually have sexual relationships with people. And so They defined what that looked like for them. And some people would say, oh, that's high school or that's college age, or that's older than college, or that's only when you're married. 

So all those ideas came out. And then I said, is there a time when you are no longer sexual? And again, 65 was a pinpoint for them that they couldn't imagine that people over 65 were sexual or had sex or, uh, and again, just writing that down of this And what did that mean? And the discussion around that was just beautiful, fantastic. 

And I assured them that people after 65 did have sex. I felt like it was my job to tell them that people had sex after 65. Yeah. Um, so then I said, at what age can you be in love? And again, really amazing conversation. Could you be in love at four? to elementary school. What does it mean to be in love? You can see it that maybe 20 and 35, there were a lot of people. 

So I said, you're, you're entering into this space where you're becoming an adult, sexual and in love. And so how will you get ready for that? So that becomes its own amazing conversation. So then the next day I come back and I said, let's look at that across time. And then I start with people who live in caves. 

And then all the way until 2024. And I put up some key moments and dates because I knew some of those fun facts. And so I said, you know, when you live in a cave, your lifespan was only so long, 30 years, whatever. And that you became an adult probably when you moved out of the cave of your family, or. You most likely partnered with somebody that knew your family. 

So being in love, being sexual, and being an adult kind of all came together. And so then I'd skip all the way up through time to Romeo and Juliet, who, you know, want to be in love outside of the family. what their families want. Juliet probably achieved puberty at 14, 15, and they got married, had sex, and died on the same day. 

And then I go all the way up to 1776. I think the state of Rhode Island had an age of consent of 10. Some kids said you were an adult when you became a landowner. And I said, that actually was quite true in 1776, right? A man owned land, but for a girl, she was able to menstruate, gets married, marry someone within their community. 

And then I take it all the way to 1940. 1940 is the first time that we really start talking about a teenager as a space of time. Because other than that, you're just a child to an adult. And about the time that in the 20s, 30s, 40s, when we start to define what an adolescent is, a teenager, there's actually a space between childhood and adult that you might have a gap before you menstruate and get married. 

But there's also this idea that if you were German Lutheran, you were going to marry another German and another Lutheran. And it's not until 1960, it's legal to marry outside of our own race, right? And then we keep moving it up, uh, the year that we're able to marry our same gender. So that we get to the age of now. 

And I said, the average age of achieving puberty for a menstruator is twelve and a half. When you're menstruating, and probably let's say 13, 14 for someone with a penis, so then you are finishing up puberty by the time you're in early high school, high school, the average age of getting married in the United States is 27. 

So it's the longest period of time between the time you achieve puberty and the time you get married ever in the history of love. Now, if you're finished up with puberty at the age of 12 and you're not going to get married to 27, that's a very long time to be sexual without having sex. If you still go by the rule of not having sex before you get married, right? 

So what will your relationships look like? What will your challenges be? What will your physical self be? Who will you be partnered with? What will you consider friendships? Who are you as a sexual person? I mean, it's a profound conversation. And the idea that you could marry someone outside your own country, your own religion, your own race, and within your own gender, and the fact that you could meet them online is transformative to the history of love. 

So our kids, their definition of what is a life. And what is a well lived life is profoundly different than most likely their grandparents and certainly their parents.  

[00:30:07] Sarah Cavanaugh: I love how you frame that and I'm curious how you would frame the future. The over 65s that are, it's still an unknown. We're still working on the language of how we define our later years, especially if we all live to a hundred. 

We may not, but our kids may.  

[00:30:24] Julie Metzger: You know, I think this is so exciting and fun because we get a chance to be a part of writing what this looks like. And I think our parents also were a part of that. My parents, have really been contributing members in their communities and well into their 80s. And I think that this idea of being a contributor and having a sense of relevance and this idea of being a respected elder. 

It doesn't mean productive in the way that we have perhaps thought of it before, but it goes back to that idea of I still have something to offer in terms of my contribution and that there are different ways I can use my voice. And we can certainly look to other cultures who honor elders differently than classic American values. 

Although there are many Americans who express culture, I think of our indigenous communities. We get exposed here to the Alaskan Indigenous communities that very much respect and honor what elders bring to their family life and their work and their world. What does end of life look like there? How do we honor all the way through? 

So it's super fun. That would be a really fun conversation to have all of that with a group of older adults. I think it'd be fantastic.  

[00:31:53] Sarah Cavanaugh: Yeah, it's so interesting that they think. adulthood kind of ends, then what?  

[00:31:57] Julie Metzger: It says a lot, doesn't it? Yes.  

[00:31:59] Sarah Cavanaugh: Yeah. Yeah. Well, and also the age of retirement. Nobody wants to retire at 65 anymore. 

18, 21, 65, all the numbers that are planted in our legal system of, you know, when you can get a driver's license, when you can do this or that, it becomes the marker on the timeline versus how you feel in your body. And like, what is your experience?  

[00:32:23] Julie Metzger: Well, there's some real truths to all of those rules. So there's real truth to the fact that our brains aren't finished developing until we're into our mid-twenties. 

So it's a natural idea to think that we might hold off some of these things until, For instance, 21 to drink, let's say that, or 16 to drive, that some of those are some natural truths about who we are physically and emotionally and developmentally. There's some truths to the idea that our bodies decidedly change in terms of our brain function, our physical function after 65. 

So what I find interesting is how can we look at creating longevity for. Some of those parts of who we are that are actually already researched, already known. We know some really practical things. People who can do a certain number of squats, people who can walk a certain speed, those people have longer lives. 

So how can we put some of those same ideas to work to help us maximize our possibilities?  

[00:33:27] Sarah Cavanaugh: You're so right. There's so many practical things we can do, depending on how we feel in our body. So I'm going to ask you the question I ask all of my guests. What does a peaceful exit mean to you?  

[00:33:41] Julie Metzger: In our family, we often quote Frederick Buechner. 

The place you are called is the place where your deep gladness and the world's deep hunger meet. And I peacefully could exit standing in that intersection right now, because I've had a chance to stand in that intersection where my deep gladness and the world's deep hunger have met.  

[00:34:09] Sarah Cavanaugh: I think we should take this conversation on the road. 

Sure. It's been such a pleasure to have this conversation with you today.  

Julie Metzger: Always, Sarah. Always. Thank you so much. It's a pleasure.  

Sarah Cavanaugh: Thank you for listening to Peaceful Exit. I'm your host, Sarah Canavaugh. You can learn more about this podcast at And you can find me on LinkedIn, Facebook, and Instagram at A Peaceful Exit. 

If you enjoyed this episode, please let us know. You can rate and review this show on Spotify and Apple podcasts. This episode was produced by the amazing team at Larj Media. You can find them at The Peaceful Exit team includes my producer, Katy Klein, and editor, Corine Kuehlthau. Our sound engineer is Shawn Simmons. 

Tina Nole is our senior producer and Syd Gladu provides additional production and social media support. Special thanks to Ricardo Russell for the original music throughout this podcast. As always, thanks for listening. I'm Sarah Cavanaugh, and this is Peaceful Exit. 


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