As a urologist, I’ve spent my career talking to thousands of men about their health — even those who rarely go to any other doctor appointments. But one of the most important conversations should happen long before they become adults or see me.

Puberty is a huge transition for boys — I know since I’ve been through it myself. It’s an intense, confusing roller coaster of emotions and physical changes. Those growth spurts, voices cracking and new body hair where there wasn’t any before can sometimes be a lot for tween or teen boys to handle. And for many, no one has prepared them for what’s coming.

Because so many parents are too embarrassed to talk about all those changes, too many boys get their information from the wrong places: friends, social media, free porn sites and internet-based adult films all painting an unrealistic picture of what’s normal for boys and men.

So, how do we fill in those gaps and make sure boys get the information they need to feel confident about themselves and their health? It starts with parents and mentors having honest conversations about the changes boys go through and making sure they know it’s OK to ask questions (to us, not a search bar on social media).

The midnight surprise

When it comes to puberty, there are some things you just can’t prepare for — like that first erection. It can catch boys completely off guard. And while it might feel awkward or embarrassing, the reality is that it’s a normal, natural part of puberty. Erections can happen for no reason at all, and they can show up at the most unexpected times and places.

Instead of leaving boys to wonder if something is wrong, we need to normalize these experiences. Let them know that it’s just one of many surprises that puberty will shine their way. I know it doesn’t help convince boys it’s normal or anything to be embarrassed about. But they do need to be told that what they see is simply biology doing its thing. This reassurance is crucial for their self-confidence, especially when they’re questioning so much about themselves.

How much detail to go into is up to a parent or caregiver. But remember, whether you have this conversation or not, boys almost certainly are hearing about it from friends and through social media.

What to do about that extra skin

Whether boys are circumcised or not, it’s important that they understand how to care for themselves properly. In the United States about 58% of male infants are circumcised at birth compared with an estimated 37% to 39% of males globally. But many boys and their parents don’t know that being uncircumcised requires extra attention in the hygiene department.

For boys who are uncircumcised, it’s important to gently retract the foreskin and clean underneath to prevent infections. They also need to know that extra foreskin, if they have it, is not abnormal. Some boys may feel pressure to get circumcised by their partners or from what they see as “normal” in others. In this case, parents can stress there is no need to get circumcised because of peer pressure.

Routine body hygiene

As puberty hits, acne and body odor become more common. Getting boys into a simple hygiene routine — such as washing their faces daily, using deodorant and remembering to brush their teeth — goes a long way in helping them deal with those changes and feel more confident about their appearance. These small changes can make a big difference, especially as they navigate social pressures during their growth spurt. Proper hygiene practices can also help boost their self-confidence and set them up for professional success.

Monthly self-exams

When I was growing up, I remember having to go through awkward yearly school physicals and hernia exams. But I don’t remember being told that I should check my testicles for lumps every month. That’s a shame because testicular cancer is the most common cancer in young men between 15 and 35. If we teach boys to get into the habit of doing monthly self-exams, we’re giving them an essential tool for saving their lives early on and protecting their long-term health.

Self-exams are not about scaring boys — they’re about giving them the knowledge and tools to be proactive. If they notice something unusual, like a lump or swelling, they’ll know to get checked sooner rather than later. This simple habit can save lives and vital organs.

Building healthy relationships

Puberty is when boys may start new relationships, and it’s vital to teach them about consent and respect early on. According to a study by Planned Parenthood, fewer than a third of all teens receive any formal education about consent before their first sexual experience. That’s a huge communication gap.

Teaching boys about consent doesn’t have to be complicated. It can start with small lessons — such as asking for permission before using someone’s belongings — and grow into deeper conversations about respect and consent in romantic relationships. And if you haven’t started those conversations, it’s never too late to begin.

Controlling their emotions

We often forget that boys are dealing with more than just physical changes during puberty. Their emotions are all over the place thanks to surging hormones. It’s normal to experience mood swings, feel angry or sad for no reason, or struggle with new feelings of attraction. But for boys, there’s often pressure to “tough it out” and keep their emotions bottled up.

We need to let boys know it’s OK to feel everything they’re going through and that it’s important to talk about it. Encouraging them to find healthy outlets for their emotions — whether that’s talking to a trusted adult or mentor, engaging in sports or writing down their feelings — can make all the difference. Mental health matters just as much as physical health, and boys should know it needs to be a priority.

Nutrition and exercise

During puberty, boys’ bodies grow rapidly, and they need the right fuel to keep up. A healthy diet, regular exercise, good hydration and sleep can make a big difference in their overall energy and mood. Studies have shown that teens who exercise regularly are less likely to suffer from depression and anxiety, leading to improved confidence and self-worth.

The influence of social media

On social media, boys are constantly flooded with images of what they’re “supposed” to look or act like. Whether it’s Instagram influencers with chiseled bodies and “hot” women next to them or YouTube celebs showing off an exaggerated version of masculinity, it can be tough for boys not to compare themselves with the others. All this “influence” has led to adolescent boys feeling insecure about their bodies.

The answer is simple but often hard to do. Reducing social media use by 50% for three weeks led teens and young adults to feel much better about their weight and overall appearance, according to a 2023 study in the journal Psychology of Popular Media. (It’s just one of many studies showing the negative effects of social media and the positive effects of limiting its use.)

Boys need to understand that what they see online isn’t always real. Filters, editing and highlight reels create a distorted view of reality. It’s vital we encourage boys to focus on being the best version of themselves — not trying to live up to an impossible standard set by others.

Potential effects on fertility

As puberty hits, boys are likely not thinking about children or how their current habits will affect their future fertility. Smoking, drug use, poor diet, obesity — these all can contribute to fertility issues later in life. That’s why it’s never too early to start teaching boys how their lifestyle choices can affect their reproductive health.

Encouraging open dialogue

At the end of the day, the most important thing we can do is keep the lines of communication open. Boys need to know that it’s OK to ask questions — whether it’s about feelings, their changing bodies or anything else. No topic should be off-limits with parents and caregivers.

By creating an environment in which boys feel comfortable talking about their health, we’re giving them the tools they need to navigate a time of massive change. With the right guidance, boys can become stronger, healthier and more confident young men.