Written evidence submitted by The Children’s Society (MISS0010)

1. Introduction

1.1 The Children’s Society is a leading national charity committed to improving the lives of thousands of children and young people every year. We work across the country with some of the most disadvantaged children and young people through our specialist services. We place their voices at the centre of the work we do.

1.2 We have been researching children’s subjective well-being since 2005. Each year we publish the findings from this research in our Good Childhood Report. Alongside our national research, we also carry out local well-being assessments in local areas with children and young people. Through this work, we have a range of accounts from children and young people about their experience in relation to appearance, body image and their well-being.

1.3 We welcome this inquiry from the Women and Equalities Committee into body image. Our research has demonstrated the links between children’s well-being and the pressures they feel around their appearance. This response will therefore focus on the findings from our well-being research programme in relation to young people’s appearance. This response will not address all parts of the terms of reference, instead focusing on the lines of enquiry most relevant to our work. These lines of enquiry include the impact of body image and regulation.

1.4 Throughout the response we have included direct quotes from children and young people. We have chosen not to edit or censor the words of young people in order to provide a true reflection of how they perceive these issues.

1.5 The response will set out key recommendations to help address the issues and effects of poor body image. Recommendations include:

• The Government should commit to introducing comprehensive, national measurement of children and young people’s well-being that provides localised insight into children’s well-being across all local authority areas.
• We recommend that dedicated public health funding is provided to fund open access early help emotional well-being services to ensure that all young people can have timely access to support when they are struggling.
• In delivering the new RSE and Health Education Curriculum schools should be supported to explicitly address body image concerns and gender stereotypes.
• Local authorities and CCGs, working through community services, or Mental Health Support Teams should all have a local offer or targeted support for young people struggling with body image concerns.

The impact of poor body image

2.1 The Good Childhood Report 2019 found that nearly 1 in 10 children are unhappy with their appearance.[1] From this research, we know that there is a relationship between age, gender, and happiness with appearance.

2.2 Differences between girls’ and boys’ happiness with their body and appearance have been a recurring theme of our research. The research highlights that, over time, boys are significantly happier with their appearance than girls. Unpublished analysis of data from the Understanding Society survey for 2016/17 shows that, at ages 10-15, almost 1 in 7 (14%) girls compared to 1 in 13 boys (8%) in the UK were unhappy with their appearance.[2]

2.3 The gap between boys and girls happiness with their appearance has narrowed in recent years, however. We estimate that as many as 1 in 12 boys worry about the way they look.[3]

Figure 1: Trend in children’s happiness with their appearance by gender, UK, 2009-10 to 2016-17 (Girls = green line, Boys = orange line)

2.4 Findings from our local well-being consultations indicate that as young people get older, they become less happy with the way they look. This is particularly the case for girls where unhappiness with appearance becomes more pronounced at secondary school.

3. The impact of gender stereotypes

3.1 Findings from our research indicate that gender stereotypes impact on children’s well-being and how they feel about the way they look.  Our Good Childhood Report 2018 explored whether children’s experience of gender stereotypes and of negative or sexualised comments about their appearance is related to their subjective well-being.[4] We found that girls who said that appearance-related comments and behaviours at school were widespread had much lower happiness with their appearance and life as a whole than boys.

3.2 We also explored gender norms to find out whether children who feel under pressure to conform to traditional gender stereotypes had lower subjective well-being. We asked children which of a list of six attributes, for example being good looking, caring, funny, tough, having good clothes and working hard at school – they thought their friends would say was most important in a girl and in a boy. Children’s responses were in line with traditional gender stereotypes. Being good looking was the top answer for both boys and girls, and children were more likely to highlight this as more important for girls.

3.3 Qualitative research with young people speaks to these findings and suggests that young people have clear ideas about what it means to be a boy or girl. Many young people report feeling under significant pressures to adhere to a specific image based upon traditional and stereotypical ideas. For example, girls often talk about the pressures that they face to look attractive, but within tightly defined boundaries.

‘I feel judged all the time based on what I wear. It’s like girls are expected to fulfil certain ridiculous expectations and no one knows what to wear anymore.’
Girl, Secondary school age

‘Girls get told to look a certain way and if you don’t you get told you are ugly, fat and flat chested and that makes you not feel good enough for anyone.’ Girl, Secondary school age

‘Most of the time girls are expected to be really girly and wear lots of make-up instead of being able to play sports and be themselves.’ Girl, Secondary school age

3.4 Media also plays a role in reinforcing gender stereotypes and issues around body image. Secondary age girls often make the link between the portrayal of girls and women in the media and the way they feel about themselves. Teenage girls also comment on the expectations others have upon them, particularly boys, which many identity as being unrealistic and shaped by images in the media.

‘The girls feel pressured by the boys that they should look a particular way and that leads girls into depression or low self-esteem and makes girls feel ugly or worthless.’
Girl, Secondary school age

‘Girls are less happy with their appearance (compared to boys) because how the media portray how girls are supposed to look.’ Girl, Secondary school age

3.5 In our local well-being assessments we have found that girls often cope with open comments about their appearance which often go unchallenged and consequently girls adjust their behaviour to avoid them. It was felt that girls who do not conform to a particular standard or appearance are judged harshly and openly.  Some girls also reported feeling less safe in their local area as a result of unwanted attention from men and boys in relation to their appearance. The comments and behaviour that some girls contend with regarding their appearance influences how they feel about themselves.

‘We’re expected to be perfect, like Barbie dolls or something, and if we don’t then we get bullied.’ Girl, Secondary school age

‘Adults are dismissive of boys inappropriate behaviour as they think it’s ok for boys to be like that because they are dominant.’ Girl Secondary school age

3.6 Although our research indicates that girls are less happy with their appearance than boys, we are now starting to see the gap in happiness with appearance between boys and girls narrowing. Going forward, it is important that the trend in boys’ happiness with appearance is closely monitored. Boys too feel the pressure of conforming to societal pressures about how they should look.

‘If people don’t follow the norm then they won’t fit in and people might take the mick out of them.’ Boy

3.7 Boys refer to a specific form of masculinity when describing what attitudes and behaviours they should be adhering to. This often centred on demonstrating and showcasing their physical strength and dominance.  

‘You have to act cool to fit in at first then once your good friends you kind of form groups and different people have different groups based on how they act and appearance.’ Boy

[Boys are expected…] “To be strong, physically and mentally” Boy

‘Boys have to be a hard nut, not back down/able to fight for yourself. Be strong.’ Boy

Regulation - RSE and the whole school approach

3.8 Education is crucial in promoting positive and healthy body image. Positively, Relationship and Sex Education and Health education will become a mandatory part of the school curriculum from September 2020. Schools should not only use this curriculum as an opportunity to promote healthy body image, but to also introduce debates about gender in school in new ways. Schools should also encourage students to examine their attitudes and engage in the wider societal debates about women and men. This is particularly important given the impact that gender stereotypes have on young people’s well-being.

3.9 What is more, promoting positive body image must go wider than integration into the curriculum and should be part of the Whole School Approach to mental health and well-being. A Whole School Approach is strongly advocated by the Department for Education and is key component of work surrounding mental health.  Schools should work with students to consider the role of ‘appearance’ in school culture and how to ensure it is positive, rather than damaging to well-being.  Reviewing relevant policies that relate to appearance, such as school uniform policies, will also be key in fostering an ethos that challenges gender stereotypes rather than enforcing them.

Recommendations

• In delivering the new RSE and Health Education Curriculum schools should be supported to explicitly address body image concerns and gender stereotypes.
• As the Department for Education continues to articulate, provide guidance, and best practice support around the “whole school approach” it should ensure that body image and gender stereotypes are strongly embedded within any models it promotes – especially to secondary schools.
   

4.     The impact of social media

4.1 There has been widespread concern about the impact of growing use of social media and related technology on children and young people’s well-being.  Our Good Childhood 2017 explored whether social media usage could help to explain gender differences in subjective well-being in general, and happiness with appearance in particular. Our analysis found that high intensity social media usage did appear to be more important for girls’ happiness with appearance (and for life as a whole) than for boys.[5]

4.2 Our joint inquiry into cyberbullying with Alex Chalk MP and YoungMinds also found a connection between intensive social media use and mental ill health. Thirty eight percent of young people who took part in the research reported that social media has a negative impact on how they feel about themselves. This was exacerbated for girls, with 46% of girls stating that social media had a negative impact on their self-esteem.[6] It should be noted that this was not a representative sample, but it is clearly a significant concern to young people.

4.3 Young people we speak to as part of local well-being assessments, in particular girls, often make links between the portrayal of people on social and the way they feel about themselves – the so called  ‘comparison culture.’

‘Social media portrays people in a “perfect” way. It rarely shows people’s imperfections which causes young teens like myself to compare ourselves to an impossible life/appearance. I think it damages people’s self esteem and make them question their self worth.’ Girl, Secondary school age

‘I think that social media has a very bad influence on young people these days. People think that they have to look a certain way and act a certain way. I feel that Instagram has had the worst result on teenagers as people compare themselves to social influencers because they think they have the “perfect body + life”. This mentally affects teenagers as they think they are not good enough.’ Girl, Secondary school age

Regulation - social media and online harms white paper

4.4 Both the Online Harms White Paper and Age Appropriate Design Code are positive steps in protecting children and young people from online harms and will go some way in protecting young people from harmful content in regard to body image. We support proposals for greater transparency, trusts and accountability across online platforms as outlined in the Online Harms White Paper.

4.5 A key component of the White Paper is promoting education and awareness raising about online safety. The government need to do more to better equip young people with the preventative and proactive skills to protect themselves online.  The government should also work in partnership with social media companies and other online platforms to develop and test programmes aimed at empowering children and young people to intervene or report when witnessing online harms.  

4.6 From our inquiry into cyberbullying, young people told us that social media companies should do more to promote good mental health on their platforms. To tackle the effects of online harms, social media companies should do more to signpost to helplines, support websites or advertising mental health services.

Recommendations

• Social media companies should prioritise the promotion of children and young people’s mental health and well-being across their platforms.
• The government should work in partnership with social media companies to produce an educational resource to empower children and young people to intervene and report online harms.

5. Body image and mental health

5.1 As the evidence in our Good Childhood Report’s highlights, young people’s unhappiness with their appearance has an impact on their well-being. Our research has linked low well-being to mental ill-health, experiences of multiple disadvantage and ill health. Other studies have linked low well-being with poor academic attainment.

5.2 Poor body image can be a risk factor for poor mental health. Whilst mental health and well-being are the not the same, our research has found that low subjective well-being and mental health conditions like anxiety and depression are linked. Our Good Childhood Report 2018 identified that of young people surveyed who had low happiness with life, almost half (47%) also had high depressive symptoms – and vice versa.[7] The analysis also found that girls were more than twice as likely as boys to self-harm. 

5.3 What is more, analysis conducted in the Good Childhood Report 2016, found that happiness with appearance is most strongly associated with emotional conditions and this association is stronger for girls than for boys.[8]

Regulation - Increasing the availability of mental health support

5.3 Mental health and well-being support within schools is vital in addressing body image issues. The Green Paper produced by the Department for Education and the Department of Health and Social Care, Transforming Children and Young People’s Mental Health Provision, outlined ambitious new plans for delivery mental health support in schools. Commitments include a Designated Senior Lead Role lead within all schools for mental health, and Mental Health Support Teams working with clusters of schools to support those with low to moderate needs. These are welcome and positive steps and will increase a schools capacity to provide support on body image issues. Yet, the implementation of these proposals is slow with only fifth of the country benefitting 2022/23. This means that a vast number of children and young people will miss out on this increased support in school.

5.4 We believe that mental health support needs to readily available to children and young people within community settings, an aspect that has been seemingly missing in the Government reform agenda so far. Many young people might not feel able to ask for help at school and may prefer support in the community that they can access on their own terms with increased privacy.

5.5 We see that there is a role for increased provision of open access emotional health services within communities. The Children’s Society runs a range of open access, drop-in mental health hubs for children and young people across the Midlands, for example. These hubs aim to prevent the escalation of emotional health difficulties with timely support, whilst reducing the number of avoidable referrals to specialist mental health services. The drop-in nature of the hubs means there are no waiting lists so young people are able to access the support on offer whenever they feel ready. The support on offer is flexible from providing resources, a variety of groups/workshops and peer support networks to guided self-help, and brief interventions.

5.6 Within these services, we see a high number of young people dropping in with body image, self-esteem or self-confidence issues. Across these services in the year 2019/20, of the young people we supported, 13% reported body image, self-esteem or self-confidence issues.

Recommendations

• We recommend that dedicated public health funding is provided to fund open access early help emotional well-being services to ensure that all young people can have timely access to support when they are struggling.
• Local authorities and CCGs, working through community services, or Mental Health Support Teams should all have a local offer or targeted support for young people struggling with body image concerns.
   

6.      Creating policy surrounding body image and social media

National measurement of children’s well-being

6.1 Well-being can be an important tool to gather insights from children and young people about how they feel about different aspects of their lives in order to support positive change. However, we are concerned that the data currently collected about children’s well-being is not of high enough quality to properly inform decision and policy making.

6.2 Whilst well-being is increasingly used when designing policies aimed at adults, it is relatively under-used when designing policies for children and young people. Data on the well-being of adults has been collected since 2011 by the Office for National Statistics (ONS) National Well-being Measurement Programme. The ONS collect this data quarterly as part of the annual population survey, with a sample size of 150,000 adults.

6.3 As a result, much more is known about what can be done to improve adult’s life satisfaction than that of children. Children are the focus of much national and local policy making and spending, yet no comprehensive data exists about their lives to inform decision-making. The evidence outlined in this submission highlights the wealth of information that can be gathered by collecting data on children’s well-being, giving insight about how children feel about different areas of their life, such as appearance.

6.4 Measuring well-being has many benefits: it provides an evidence base, allows for the identification of new trends and pressures on well-being, provides a mechanism to target support to the most in need and allows for progress to be tracked so we can understand if the changes we make are resulting in improvements.

6.5 Without a reliable and comprehensive mechanism to collect well-being data we are unlikely to make significant progress in designing and implementing improved policies for children and young people, and addressing issues that impact their well-being.

Recommendation:

• The Government should commit to introducing comprehensive, national measurement of children and young people’s well-being that provides localised insight into children’s well-being across all local authority areas.

May 2020

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