Until a child’s body starts the enormous changes involved in puberty, the sexual organs grow in size only to keep up with general body growth and change very little in their physiological activity. Though the body begins internal changes to prepare for puberty as early as age 6 or 7, the first outward signs of puberty begin at 9 or 10. In girls, breast buds appear, and pubic hair growth may begin. In boys, pubic hair growth generally starts a couple of years later than in girls, and, on average, girls experience menarche (which we discussed in Chapter 4) before boys experience their first ejaculation (often referred to as semenarche; SEM-min-ark). Preadolescent boys experience frequent erections, even to nonerotic stimuli. Common reactions to semenarche include surprise, curiosity, confusion, and pleasure—and typically most boys don’t tell anyone about this event (Frankel, 2002; Stein & Reiser, 1994). Pubertal changes can be frightening for both boys and girls if they are not prepared for them, and, even if prepared, the onset of puberty can be emotionally, psychologically, and physically difficult for many children.