For Dr. Kela, understanding young women’s health means looking far beyond physical symptoms. After decades in medicine, her perspective has expanded to include the family dynamics, culture, finances, relationships, mental health and digital environments that increasingly shape how young people see themselves and navigate the world. She has watched social media transform adolescence, creating new pressures around appearance, popularity and success while exposing young people to an overwhelming stream of information.
In this conversation with Fashionablz Magazine, Dr. Kela discusses what adults may be missing about the emotional and social realities facing teenage girls today, from subtle changes in behavior that can signal a child is struggling to the ways curated online images can distort expectations of beauty and achievement. She also explores how parents can give their daughters room to develop independence, why difficult conversations should begin early, and how families can create stronger relationships built on openness and fact-based knowledge. Drawing from her work as a family physician, author and mentor, Dr. Kela offers a candid look at raising confident young women in a world that is changing faster than ever.
As a physician who has worked closely with families and young people, how has your understanding of health changed over the course of your career? When I first began to practice medicine, I followed strictly what I had been taught in medical school and residency training, which revolved around diagnosing and treating symptoms. As a young doctor, I was more optimistic and unconsciously viewed health and family dynamics via the lens of my stable upbringing, with allowances for cultural nuance, of course. Over the years, my outlook has evolved because the society I grew up in is not the same one families are living in now. The importance of addressing mental health ─ and the effects of not doing so ─ has become blatantly apparent. The ubiquitousness of social media has ushered in a number of problems: disease processes like texting thumb (inflammation of the thumb tendons from repetitive texting), digital eye strain in children and young adults from excessive screen time, and cyberbullying. Now that I am a few decades into my career, my understanding has shifted to more of a holistic approach versus the traditional medical model. We are conditioned to underestimate the impact of environment, family and social dynamics, faith, culture, economics, and stress on physical health. I had to open my mind and accept that a lot was left out of my medical school education.
We often talk about teenage health in terms of physical development, but what do you think gets overlooked when it comes to the emotional and social experiences of adolescence?
As I mentioned in the previous question, we tend to miscalculate just how much the environment, family, finances, faith, peer relationships, and cultural shifts are shaping the minds and lives of teens. There are certain human qualities that persist and will likely never change: the need to belong and feel significant, the drive to feel in control of one’s life, and the desire for knowledge and creative expression ─ all these are being impacted by social media in addition to everything else. We are overlooking the speed and depth at which these factors are affecting our children.
How do expectations around appearance, popularity, relationships, and success affect the way young women see themselves?
The media distorts these expectations. Teens often compare themselves to the curated images in the various forms of media marketed to them and begin to feel “less than.” In the past, traditional media like novels, magazines, television and movies were the reference points, but social media has added another dimension because there seems to be less of a velvet rope to separate everyday people from the celebrity class. This gives young women the impression that becoming famous is easy without the benefit of “seeing how the sausage is made”, so to speak. I will never forget what one of my patients who worked on magazine photo shoots told me. “Dr. Henry, God doesn’t make all those beautiful people, I do!” She went on to explain all the imperfections she fixed with her use of angles, various tools, and ingenuity so that the cover models looked perfect. There is a hidden cost to the appearance of flawless beauty, popularity, success, and satisfying relationships. If those trade-offs were honestly presented to the global audience of young women, they might see themselves differently and do less comparison.
What role should parents play in helping their daughters develop confidence while still allowing them independence to make their own decisions?
I think parents can best do this by helping their daughters build up resilience first. Confidence is defined as the belief in one’s skills and abilities before and during a task, whereas resilience is the capacity to recover and adapt after experiencing a setback or a failure. Since life is a journey of highs and lows, confidence and resilience are necessary traits to develop. Resilience is like a muscle — it doesn’t appear overnight, but it grows stronger every time it’s used. When teens face disappointment, failure, or change, that’s their opportunity to train that muscle. Parents’ role isn’t to remove every obstacle — it’s to coach their daughters through it so they can discover their own strength. For example, that might mean letting her handle a tough conversation with a teacher instead of stepping in or encouraging her to try again after not making the team. These moments build confidence, problem-solving skills, and emotional endurance — the foundation of lifelong resilience. It’s also important for parents to model resilience themselves. When teens see their mothers and fathers adapt to stress or setbacks without giving up, they learn that failure isn’t the end — it’s feedback. Parents can ask questions like, “What’s your plan?” or “What do you think you can do differently next time?” when their daughters encounter a bump in the road of her life’s journey. This is building her resilience muscle for the trials that lay ahead. Over time, this builds her confidence to meet challenges, set and achieve goals, make decisions, and stand her ground.
When a teenager is struggling, what signs might parents notice before their child actually says something is wrong? Parents and caregivers should be on the lookout for subtle shifts from their child’s baseline behavior and mood that persist for weeks at a time. Some examples are increased emotional lability (mood swings), excessive worrying, slipping grades or avoiding school, withdrawal from activities and hobbies they once enjoyed, pulling away from family and friends, lack of care about appearance, changes in appetite and sleep pattern, more frequent physical complaints like headaches or stomachaches with no clear medical cause, and negative self-talk (putting themselves down).
How can schools, families, and healthcare providers work together more effectively when it comes to supporting young women?
The foundation is the family with schools and healthcare professionals as background players. I say this because schools and healthcare are involved based on the authority of the family, since parents choose the school systems and doctors for their children. Parents being involved with school activities and meeting teachers is key, as it’s taking a keen interest in who is influencing your kids on a daily basis. Families can first support their daughters by planning for them before they are even born! Ask what kind of life you want for your daughter ─ is it one with relative safety, security, wonder, play, joy, music, color, warmth, bumps, bruises, disappointments, achievements, and growth? Or not? Start with the end in mind. Whatever you would like for her, choose the schooling and health care institutions accordingly. Then vet and build relationships with those members of your community. (Remember the axiom “It takes a village to raise a child”). Families must accept that their daughters are unique people with their own minds and personalities. Encourage her natural talents and interests, and equip her to spread her wings to fly someday. Prepare her for the world as it is, but guide her to be the kind of woman who works to remake the world into a better place. I feel I should mention here that given the prevalence of gender-based violence, all village members, family, educators, and health care professionals─ should believe young women, protect young women, and defend young women.
You have spent much of your career encouraging open conversations about subjects that families can sometimes find uncomfortable. Why do you think those conversations are so important?
These discussions are so important because the more fact-based knowledge one has, the better equipped they are to make sound decisions. It is nearly impossible to make sound decisions when you don’t have enough information or the correct information. Ignorance and fear are two of the most devastating deterrents to progress and to leading one’s best life.
What do you wish more adults understood about the way teenagers communicate and process information today?
Throughout history young people have always developed their own creative communication (slang), so that is not new. What I wish they understood is that teenagers today are attempting to manage an overwhelming amount of information coming from a source that is manipulating them in a way that was not available before (at least not for Generation X and older adults). For older people, we had mainstream and alternative media outlets. We could either passively watch or listen to the local TV and radio stations or actively consume books and magazines. In addition, there were homework assignments requiring exposure to certain works considered “classics.” We were exposed to our local libraries and taught research skills. Most importantly, there were more boundaries for kids in previous generations: sign off times, clear bedtimes, and restricted access to certain material for minors. Now content is filtered through an algorithm that is constantly pushing the same messages, and there is a mega load of it ─ good and bad─ coming at young people who are expected to rapidly digest it, like it, and share it without truly understanding it or realizing they are addicted to it. I am pleased that many of the social media platforms are being called to be accountable. It is coming to the forefront how these tech giants have been manipulating young minds to consume more content so that they earn more. This is morally unacceptable.
How can women who did not grow up having these kinds of conversations with their own parents learn to create a different experience for their daughters?
I am going to engage in shameless plugging here‒purchase a copy of my book Nia & the Numbers Game: A Teenager’s Guide to Education, Relationships and Sex, and read it together. Make it your own mother-daughter (or father-daughter) book club. Read chapters and discuss what you both took from the story and the Let’s Talk sections. One of the compliments I received more than once is that readers wished a book like this was available when they were teens. It makes sense to have these conversations as part of the mother-daughter bonding experiences like spa appointments, brunches, shopping sprees, or just relaxing at home. These events are usually more relaxed, so approaching the conversations can be viewed as less awkward or scary.
When you look at young women you work with today, what gives you the most hope about the next generation?
Although I talk a lot about the negative effects of social media, I am pleased that it does provide online environments where curious, creative, passionate, brave young women of all backgrounds can find and build community across the world and learn about one other in the process. I am hopeful that these connections will produce more women leaders, and I am hopeful about the awakening of young women as they rewrite their programming, challenge the status quo, and advocate for themselves and each other.
Dr. Kela is an award-winning author, (Nia & The Numbers Game, A Teenager’s Guide to Education Relationships & Sex) speaker, family physician, and mentor dedicated to inspiring resilience, growth, and possibility. Through her writing and public engagement, she encourages people to live with purpose and courage. Explore books, merchandise, and more at the DrKela.com
