218 Throughout the 1980s: The figure of more than 2 million Americans was up from 590,550 in 1986 (a rise of 24 percent from 1984). See Standard and Poor’s Industry Surveys (New York: Standard and Poor’s Corp., 1988) and Martin Walker, “Beauty World Goes Peanuts,” The Guardian (London), September 20, 1989. But since over 80 percent of eyelifts, facelifts, and nose operations are on female patients, as are virtually all breast surgery and liposuction operations, the true female-male ratio must be higher than 87 percent—meaning that cosmetic surgery is only properly understood as a processing of femaleness. See, for figures, Joanna Gibbon, “A Nose by Any Other Shape,” The Independent (London), January 19, 1989.
218 Violence, once begun: Angela Browne, When Battered Women Kill (New York: Free Press, 1987) p. 106.
220 The Emperor Constantine: Sarah Pomeroy, Goddesses, Whores, Wives and Slaves: Women in Classical Antiquity (New York: Shocken Books, 1975), p. 160.
220 Sontag: Susan Sontag, Illness as Metaphor (New York: Schocken Books, 1988).
221 Misbegotten man: Barbara Ehrenreich and Deirdre English, Complaints and Disorders: The Sexual Politics of Sickness (Old Westbury, N.Y.: The Feminist Press, 1973); “Repulsive and useless hybrid,” ibid., p. 28.
221 Michelet: Quoted in Peter Gay, The Bourgeois Experience, Volume II: The Tender Passion (New York: Oxford University Press, 1986), p. 82.
221 Separate sphere: See Sarah Stage, Female Complaints: Lydia Pinkham and the Business of Women’s Medicine (New York: W. W. Norton, 1979), p. 68.
222 1870–1920: Elaine Showalter, The Female Malady: Women, Madness and English Culture, 1830–1980 (New York: Pantheon Books, 1985), p. 18. See also Mary Livermore’s “Recommendatory Letter” and “On Female Invalidism” by Dr. Mary Putnam Jacobi, in Nancy F. Cott, ed., Root of Bitterness: Documents of the Social History of American Women (New York: Dutton, 1972), pp. 292, 304.
222 Women were the primary patients: Showalter, op. cit., p. 56.
222 Victorian medicine: Ehrenreich and English, op. cit., p. 60.
224 Catherine Clément: “Enclave Esclave,” in Elaine Marks and Isabelle de Courtivron, eds., New French Feminisms: An Anthology (New York: Schocken Books, 1981), p. 59.
224 Calm . . . face: Showalter, op. cit.
225 Menopause: John Conolly, “Construction,” cited in Showalter, op. cit., p. 59.
225 Modernity: Stage, op. cit., p. 75.
225 Engels: Cited in Ann Oakley, Housewife: High Value/Low Cost (London: Penguin Books, 1987), pp. 46–47.
225 Scientific interest: See Peter Gay, The Bourgeois Experience, Volume II: The Tender Passion (New York: Oxford University Press, 1986).
226 Questions of safety arose: Vivien Walsh, “Contraception: The Growth of a Technology,” The Brighton Women and Science Group, Alice Through the Microscope: The Power of Science over Women’s Lives (London: Virago Press, 1980), p. 202.
226 Recasting freedom . . . as disease: See Carlotta Karlson Jacobson and Catherine Ettlings, How to Be Wrinkle Free (New York: Putnam, 1987): “Wrinkles . . . may not be life threatening in the purest sense, but the stress and anxiety they produce can alter (if not threaten) the quality of life.” The authors describe skin “shock treatments meant to ‘shock’ [skin] back into beautiful shape.” According to the authors, Steven Genender injects a toxin into the facial muscle so it will not express emotion; others sever facial muscles, leaving the face impassive.
226 Paleolithic fertility figures: Eugenia Chandris, The Venus Syndrome (London: Chatto & Windus, 1985).
227 Balin: “Despite Risks, Plastic Surgery Thrives,” The New York Times, June 29, 1988.
227 Dr. Tostesen: “Harvard and Japanese Cosmetics Makers Join in Skin Research,” The New York Times, August 4, 1989. The University of Pennsylvania has also accepted donations from cosmetics manufacturers for a $200,000 chair in “beauty and well-being” research.
229 Disabled people: Daniel Goleman, “Dislike of Own Body Found Common Among Women,” The New York Times, March 19, 1985.
229 Bay Area: “Staying Forever Young,” San Francisco Chronicle, October 12, 1988.
229 Rose Cipollone: “Coffin Nails,” The New York Times, June 15, 1988.
229 Liquid fasts: Carla Rohlfing, “Do the New Liquid Diets Really Work?,” Reader’s Digest, June 1989; see also “The Losing Formula,” Newsweek, April 30, 1990.
229 Cancer detection more difficult: In a study involving twenty breast-cancer patients with implants, researchers found that none of the tumors had been detected early with X rays, and the cancer had spread to the lymph nodes of thirteen by the time the disease was detected: Michele Goodwin, “Silicone Breast Implants,” The New Haven Advocate, March 13, 1989. The Public Citizen Health Research Group made the charge to implant manufacturers Dow Corning Corp., citing the manufacturers’ own research that 23 percent of female laboratory rats implanted with silicone developed cancer. The Group also points out that implants have been followed only for ten or twelve years, not long enough for the cancers to develop. The literature of the American Society of Plastic and Reconstructive Surgery denies any risk.
229 Mental illness: Stanley Grand, “The Body and Its Boundaries: A Psychoanalytic View of Cognitive Process Disturbances in Schizophrenia,” International Review of Psychoanalysis, vol. 9 (1982), p. 327.
229 Stress: Daniel Goleman, “Researchers Find That Optimism Helps the Body’s Defense System” “Science Times,” The New York Times, April 20, 1989.
230 Schizophrenia: Daniel Brown, Harvard Medical School, quoted in Daniel Goleman, “Science Times,” The New York Times, March 15, 1985.
230 Manufacturing mental illness: Eating disorders are mutating into self-mutilation, creating a new wave of young women who cut themselves up. “A growing number of ‘self-lacerating’ young women . . . One bulimic binged and vomited until she felt so out of control that she ‘grabbed a knife and stuck it into [her] stomach.’” [Maggy Ross, “Shocking Habit,” Company, September 1988]. Three “attractive young women” who feel “physically repulsive” and “evil inside” regularly cut a pattern of up to sixty diagonal slashes on their forearms, feeling numb and detached. “I couldn’t stand being so judged,” said one [Michele Hanson, “An End to the Hurting,” Elle, October 1988].
231 A million dollars: Gerald McKnight, The Skin Game: The International Beauty Business Brutally Exposed (London: Sidgwick and Jackson, 1989).
232 Surgery profits: Standard and Poor’s Industry Surveys, 1988.
233 As a businessman: Ehrenreich and English, op. cit., p. 26.
235 Fetal experimentation, human organs: See The New York Times, August 1, 1988. See also Wendy Varley, “A Process of Elimination,” The Guardian, November 28, 1989, and Aileen Ballantyne, “The Embryo and the Law,” The Guardian, September 8, 1989.
“There are, in a civilized society, some things that money can’t buy”: Ruling on Baby M. Case. In re Baby M., 537 A2d 1227 (N.J.) 1988; In re Baby M., 225 N.J. Super. 267 (S. Ct., N.J., 1988) 73.
236 Robert Jay Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide (New York: Basic Books, 1986).
237 Experimentation: “Use me to ‘experiment’”: Quoted in Maria Kay, “Plastic Makes Perfect,” She, July 1988.
237 Stomach stapling experiments: Paul Ernsberger, “The Unkindest Cut of All: The Dangers of Weight-Loss Surgery,” Radiance, Summer 1988.
237 Nuremberg: The Code of Ethics of Human Experimentation was laid down on August 19, 1947, at the Nuremberg Military Tribunal. [See David A. Frankele, “Human Experimentation: Codes of Ethics,” in Amnon Karmi, ed., Medical Experimentation (Ramat Gan, Israel: Turtledove Publishing, 1978).] The Berlin Medical School adapted a formulation (by Thomas Percival, 1803), a version of which was later adapted by the American Medical Association, that forbids “risk of any man’s life . . . by vain experimentation, or doubtful means” and condemns debasing oneself by employing one’s art “for . . . immoral purposes.”
In September 1948, the General Assembly of t
he World Medical Association adopted the Declaration of Geneva: “A doctor shall not in any circumstances do, authorize to be done or condone anything that would weaken the physical or mental resistance of a human being, except for the prevention and treatment of disease.”
The Nuremberg Code was “meant to reinstate ‘existing general principles of human experimentation accepted by all civilized nations.’” German courts after Nuremburg “have considered every medical operation or other treatment invading the human body technically to be assault and battery, which in general needs to be justified by the patient’s informed consent.” [A. Karmi, “Legal Problems,” in Medical Experimentation.]
Without “free choice,” the procedure is criminal: “It is generally agreed that scientific experiments cannot be undertaken without the free consent of the person subjected to them after having been duly informed.” [Gerfried F. Scher, quoted in Karmi, op. cit., p. 100.] Moreover, “the decision to participate in a scientific clinical trial must be perfectly free and uninfluenced by any sort of dependency.” [Ibid., p. 101]
Cosmetic surgery violates current codes of medical ethics as well: As the chief U.S. medical adviser at the war trials adapted the code:
“The voluntary consent of the human subject is absolutely essential. This means that the person involved should have the legal capacity to give consent, should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge of the subject matter involved as to enable him to make an understanding and enlightened decision. The duty and responsibility for ascertaining the quality of the consent rests with the experimenter (minors cannot be considered to consent). . . . The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved in the experiment.” Regarding fraud, deceit, etc.: The State Court of Michigan ruled that the “inherently coercive atmosphere” surrounding one medical experiment made “truly informed consent impossible.” Regarding minors’ maturity to consent: Cosmetic surgeons have targeted teenage girls as a new market; they operate on them with parental consent in spite of their status as minors.
Regarding nontherapeutic experiments: “The risks to be run must be in reasonable proportion to the possible benefits. If the experiment entails actual risk to the subject’s life, his consent is invalid even if he has been informed of this. . . . The same holds true where there is an actual risk of heavy and lasting damage to the patient’s health.” [Italics added]
For the patient’s own benefit, the experimental nature of new treatments must be disclosed: “His general consent to the treatment without knowing its experimental character is not sufficient.” The law governing medical practice in the United States depends on the concepts of Standards of Care to distinguish between those medical and surgical procedures generally accepted by the medical professions and those that are not. According to Martin L. Norton: “We should . . . regard anything done to a patient, which is not for his direct therapeutic benefit or contributory to the diagnosis of his disease, as constituting an experiment.” [Ibid., pp. 107–109]
237 1 in 30,000 possibility of death: Joanna Gibbon, Independent Guide to Cosmetic Surgery (The Independent, 1989), pamphlet, p. 7.
According to the Guide, silicone implants for breast augmentation “leach to other parts of the body, and the long-term effects are unknown,” and there is a 10 to 40 percent chance that the scar tissue will harden into “a cricket ball,” necessitating “a further operation to split the scar capsule.” [Ibid., p. 8.] McKnight, op. cit., asserts that the chances are 70 percent that the implants will harden. Dr. Peter Davis at St. Thomas Hospital in England asserts that “Mortality . . . is reported to be up by 10 percent in America.” [McKnight, op. cit., pp. 114, 120.] “If [U.S.] doctors were to admit to a 10 percent failure rate, which is normal in our experience out of every thousand facelifts, they’d lose their practice. Take the breast prosthesis we’ve been inserting for years here—it has a 70 percent complication rate. Yet there are people in America quoting 1 percent. One of us has to be telling the truth.”
237 Liposuction deaths: Wenda B. O’Reilly, The Beautiful Body Book: A Guide to Effortless Weight Loss. (New York: Bantam, 1989).
237 Liposuction . . . count of eleven: Robin Marantz Henig, “The High Cost of Thinness,” The New York Times Magazine, February 28, 1988.
238 As many as 70 percent: See McKnight, op. cit. When I asked the spokeswoman for the ASPRS what the likelihood of “capular contraction,” in her words, might be, she replied, “It’s impossible to say. Some surgeons have ten percent and some have ninety percent.” “Aren’t there any studies with complication rates?” “No. Every woman’s different. It’s not fair to a woman to tell her she can’t have the operation because there might be these numbers.”
238 Addicts: See Maria Kay, “Plastic Makes Perfect,” She, July 1988: “It’s quite painful afterwards, because your jaw feels dislocated . . . you have to go on a liquid diet . . . food particles cause infection if they catch in the stitches, but you can’t chew anyway. You can’t smile, your face aches. My face swelled up like a hamster’s and I had terrible yellow bruising and trauma.” Chemical peeling “makes you go brown and crispy, then a scab forms and drops off.” See also “Scalpel Slaves Just Can’t Quit!,” Newsweek, January 11, 1988.
239 Double standard: See “Government to Ban Baldness, Sex Drugs,” Danbury (Conn.) News Times, July 8, 1989.
240 Fraud: Paul Ernsberger, “Fraudulent Weight-Loss Programs: How Hazardous?,” Radiance, Fall 1985, p. 6; “Investigating Claims Made by Diet Programs,” The New York Times, September 25, 1990.
240 In Britain: The British Medical Association has issued a statement deploring direct access of patients to cosmetic surgery clinics, but the General Medical Council can do nothing about it.
240 90 percent unregulated: Cable News Network, April 19, 1989; also Claude Solnick, “A Nip, a Tuck, and a Lift,” New York Perspectives, January 11–18, 1991, pp. 12–13.
240 Congressional hearings: See Federal Trade Commission Report, Unqualified Doctors Performing Cosmetic Surgery: Policies and Enforcement Activities of the Federal Trade Commission, Parts I, II, and III, Serial no. 101–7.
241 Weir: Jeremy Weir, “Breast Frenzy,” Self, April 1989.
242 Nipple death: Penny Chorlton, Cover-up: Taking the Lid Off the Cosmetics Industry (Wellingborough, U.K.: Grapevine, 1988), p. 244. See also the literature of the American Society of Plastic and Reconstructive Surgeons.
243 Genital mutilation: Gloria Steinem, “The International Crime of Genital Mutilation,” in Outrageous Acts and Everyday Rebellions (New York: Holt, Rinehart & Winston, 1983), pp. 292–300.
243 Footbinding: Andrea Dworkin, Woman Hating (New York: Dutton, 1974), pp. 95–116.
244 Dr. Symington-Brown: Sarah Stage, Female Complaints: Lydia Pinkham and the Business of Women’s Medicine (New York: W. W. Norton, 1981), p. 77.
245 Weldon: Fay Weldon, The Life and Loves of a She-Devil (London: Coronet Books, 1983): “One day, we vaguely know, a knight in shining armour will gallop by, and see through to the beauty of the soul, and gather the damsel up and set a crown on her head, and she will be queen. But there is no beauty in my soul . . . so I must make my own, and since I cannot change the world, I will change myself” (p. 56). Weldon wrote a pro-surgery article for New Woman, November 1989.
245 Ovariotomies: Stage, op. cit.; also Ehrenreich and English, op. cit., p. 35.
250 Electroshock: Newsweek, July 23, 1956, reports that a behavior-modification program used electric shock when subjects ate their favorite foods; cited in Seid, op. cit., p. 171.
250 Electric shock: Showalter, op. cit., p. 217, citing Sylvia Plath, The Journals of Sylvia Plath, Ted Hughes and Frances McCullough, eds. (New York: Dial Press, 1982), p. 318.
254 Harm: Suzanne Levitt, “Rethinking Harm: A Femi
nist Perspective,” Yale Law School, unpublished doctoral thesis, 1989.
255 Right to life: Andrea Dworkin, op. cit., p. 140.
255 Rich: Adrienne Rich, Of Woman Born: Motherhood as Experience and Institution (London: Virago Press, 1977).
255 Dissociate: Lynda Birke et al., “Technology in the Lying-In Room,” in Alice Through the Microscope, op. cit., p. 172.
256 Trivialization: See Lewis M. Feder and Jane Maclean Craig, About Face (New York: Warner Books, 1989): “Just as a seamstress can reshape a garment by taking necessary ‘nips and tucks,’ so the cosmetic surgeon can alter the contours of the facial skin” [p. 161].
258 Health at work: Occupational Safety and Health Act of 1970, United States Code, Title 29, Sections 651–658.
260 Facelifts: “What a shock!,” quoted in Jeanne Brown, “How Much Younger My Short Haircut Made Me Look!,” Lear’s, July/August 1988. See also Saville Jackson, “Fat Suction—Trying It for Thighs,” Vogue, October 1988: “The insides of my thighs are black. I am aghast but the surgeon seems quite pleased.”
There are several “feminist” readings of cosmetic surgery: Surgeon Michele Copeland, in “Let’s Not Discourage the Pursuit of Beauty,” The New York Times, September 29, 1988, urges women to “burn their bras” with breast surgery. Carolyn J. Cline, M.D., in “The Best Revenge: Who’s Afraid of Plastic Surgery?,” Lear’s, July/August 1988, urges women to have facelifts with the exhortation, “Voilà! You’ve been led to freedom.”
260 Moral insanity: The term is attributed to asylum innovator John Conolly, cited in Showalter, op. cit., p. 48. See also Phyllis Chesler, Ph.D., Women and Madness (Garden City, N.Y.: Doubleday, 1972).
261 Stomach stapling: See Paul Ernsberger, “The Unkindest Cut of All,” op. cit.
261 200,000 pounds of fat: Harper’s Index, Harper’s, January 1989.
263 Neimark: Jill Neimark, “Slaves of the Scalpel,” Mademoiselle, November 1988, pp. 194–195.
265 Lifton: Robert Jay Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide (New York: Basic Books, 1986), p. 31.