Written submission by Dr T Katz (MISS0015)

I am an NHS GP with a particular interest in women’s health, LGB and T health issues, and mental health issues.

Poor body image is so widespread in my practice as to be an almost universal phenomenon however particular groups are far more vulnerable to its effects.

There are multiple underlying factors impacted on body image, and women, people from the Trans community, disabled people, and people from the BAME groups are far more effected by this.

From a very young age girls have been judged on appearance rather than intellect or manual prowess.

This is reinforced from the moment of birth where babies are dressed in gendered colours and clothing and their bodies handled differently by adults. Baby girls are breast fed for shorter periods than baby boys and comments on girls’ appearance and dress are made from a young age.

Boys are encouraged to engage in more physical activities whereas young girls are still encouraged to be less boisterous and to cover themselves or sit with crossed legs and somehow make themselves less visible.

Religious groups reinforce a policy of bodily shame in young girls and women, where menstruation is seen as dirty and women’s genitalia are regarded as unhygienic needing to be cleansed.

This is reinforced at home and in schools where menstrual shaming is experienced by girls regardless of ethnic background.

Religious groups insisting that women cover their bodies or hair, also instils a sense of shame, or the idea of the women’s body as a source of danger when exposed.

The idea that what a woman wears matters in terms of whether she is vulnerable to attack by men also provokes a sense of shame that someone a woman is at fault if she is assaulted: a further attack on her sense of her body.

With the huge influence of social media the visual image /appearance is seen as a paramount aspect of identity, to the extent that young girls will often digitally manipulate their images in social media in order to conform to a particular ideal of beauty. Digital manipulation and also physical manipulation or surgical intervention to change one’s body is encouraged. This includes the relatively harmless practice of removal of bodily hair, to severe forms of plastic surgery to enhance a particular bodily feature.

The sudden increase in young girls requesting surgical interventions to change their bodies extends to the ore recent trend of transitioning to the male body shape for usually Lesbian girls who don’t conform to the feminine gender stereotype. This is encouraged by vociferous social media groups appealing to young vulnerable children affirming that their bodies are wrong in some way.

Recent government interventions regarding self identifying as the opposite sex has creating even more confusion amongst young girls and boys who may rightly be challenging the current gender role stereotypes prevalent, but when they do so, they are encouraged to change their body shape rather than challenge societies norms of gender. This has created even more confusion amongst young girls and boys especially those who may be identifying as gay. They are told that they are in the “wrong body”, and that this needs to be altered by chemical and surgical interventions.

Young girls have often been criticised about their appearance not conforming to societies norms of feminine attributes or actions. This has a profound effect on one’s body image and the desire to alter it.

Also recent evidence that Rape cases are not being taken seriously, and victims are made to feel as if vilified, and conviction rates for Rape are very low, this has a profound impact on women sense of themselves and their bodies, as somehow to blame for assaults against them.

Eating disorders and more severe forms of body dysmorphia, are more prevalent in girls and more recently young men as well.

The ideal presented in advertising images usually sexualizes women and young girls whilst exaggerating physical and mental prowess in men. Clothing, specifically underwear is designed to accentuate sexualized physical features rather than being for comfort in women.

The cult of thinness also acts to humiliate those with bodies that are not childlike sizes.

Racist ideas are also pervasive leading BAME groups to be vulnerable to body dysmorphia when the pervasive images of beauty do not reflect themselves. The marketing of skin lightening creams which damage the skin, is still an issue.

The issue of the so-called ideal body profoundly affects those with disabilities as well, where various bodily differences are seen as socially unacceptable.

Multiple inputs ranging from parental disapproval to general societal disapproval and the pervasive influence of social media on body image play a role in perpetuating various forms of body dysmorphia. This has a profound effect on young people’s mental health and desires to self-harm in various ways, including requests for plastic surgery from a young age, or the desire to transition to a different body habitus from the one that one was born into.

I think the government and ASA could play a really important role in discouraging sexualised and demeaning adverts aimed at women, or using women as sex objects attached to product advertising. Gender specific advertising is also damaging, implying stereotyped roles and appearances as ideal. A campaign aimed at including a more diverse body habits from the different communities could play an important role in marketing and broadening the nature of images of the supposed ideal body in advertising may help.

May 2020