Written evidence submitted by Changing Faces (MISS0030)

  1. Summary

One of the biggest issues affecting people’s wellbeing and mental health today is negative body image.

So imagine the pressure of living in today’s world of filters and Photoshop when you look different.

Despite the fact that one fifth of people in the UK self-identify as having a visible difference such as a mark, scar or condition[1], people with visible differences are still largely absent from mainstream culture, from film and TV to advertising and brand campaigns. This woeful lack of representation, combined with shocking daily levels of abuse and harassment, means people with a visible difference experience the harmful impact of poor body image; limiting their lives, aspirations and ability to achieve simply because of the way they look and how society reacts to their appearance. The charity Changing Faces work to change this situation, so anyone with a visible difference can live the life they want to lead.

  1. Introduction

One in five people in the UK today lives with a “visible difference[2]. They tell us that they are more vulnerable to loneliness, social anxiety and low self-esteem. They experience lowered expectations in school, problems getting work and stereotyping in the media. This has a devastating, and lasting, impact on their mental health - we know one in three people with a visible difference today feel depressed, sad or anxious because of how they look[3].

Changing Faces has 27 years’ experience as the UK’s only charity for everyone with a visible difference. This includes people born with visible differences such as birthmarks and cranio-facial conditions, or those acquired during life, including scarring from accidents, skin conditions like psoriasis, vitiligo and acne, facial and skin cancer, and after a stroke or a Bell’s palsy.

Changing Faces operates across the UK providing a range of expert psychosocial Wellbeing Services include 1:1 counselling, a helpline, peer support group, an online forum, a CBT self-help programme and self-help factsheets. In Scotland we deliver interactive Face Equality workshops about appearance-related bullying for schools and youth groups, whilst across the UK we provide classroom resources and materials to support education professionals teaching children with visible differences and introducing others to the topic of appearance and disfigurement.  We also offer Skin Camouflage consultations for those who want to try out skin camouflage products whilst receiving practical and emotional support. Last year, we were proud to support around 16,000 people with visible differences across the UK. They talk about the relief and dignity of finally being taken seriously and listened to, and the new confidence from having the skills to cope and thrive.

Alongside our services, we campaign for a society which values and respects people with visible differences, so they can live the lives they choose, free from bullying, staring, discrimination and exclusion. Changing Faces’ campaigns are co-created with our volunteer campaigners, youth action group and ambassadors, who share their lived experiences, as well as their demands for change and hopes for the future. This submission has been written using evidence from research reports and includes the voices of our campaigners and ambassadors, who have shared their views and experiences on the impact of poor body image, and what needs to change in the future.

  1. The impact of poor body image

According to Changing Faces’ #MyVisibleDifference Report, 2019, one fifth of people in the UK self-identify as having a visible difference such as a mark, scar or condition[4].

Having a visible difference can put people at greater risk of poor body image. Too many people with visible differences endure a daily cycle of comments, stares and appearance related abuse. Added to this, there is a lack of mental health support available to people who have a visible difference.

Disfigurement is included within the protected characteristic of disability. Many people with a disfigurement recognise this is a legal classification for their condition, but don’t self-identify as disabled. Some members of our community often prefer to use the descriptor ‘visible difference’ or identify their condition, or reason for having a mark or scar, e.g. Rhona, who was born with a cleft lip and palate. Throughout this response we will use the term, visible difference.

Changing Faces has identified contributing factors, including the impact of the behaviours of others and the challenge of representation, that people with visible differences face and can lead to poor body image.

Behaviour of others - in person and on social media

Appearance-related bullying is a problem for many young people, particularly those who have a visible difference. The majority of young people say they have experienced nasty or negative comments about the way they look (55%), with six in ten of these children receiving those comments from people in school[5]

Appearance-related bullying gets worse as young people move to secondary school – with more than six in ten teens experiencing negative or nasty comments relating to the way they look[6]

 

Young people often don’t understand the issues facing those with a visible difference, highlighting a real opportunity to educate and raise awareness. Only three in ten young people say they would like to be friends with somebody who has a visible difference[7]. Interventions in schools are clearly needed to help young people understand the impact of appearance-related bullying and what they can do to help.

The experiences of adults demonstrate that appearance related abuse doesn’t stop at school. Independent research of over 1,000 people with a visible difference found that seven in ten experience negative behaviours such as stares, abuse and bullying because of how they look[8]. This also shows that experiencing negative reactions, stares or comments unsurprisingly impacts self-confidence. Almost half of those who have experienced negative behaviours say they have lost confidence. Over a third say they now feel anxious when they go out and over a quarter say it has had a negative impact on their mental health[9].

When Tulsi, a Changing Faces ambassador, was ten years old, she was in a plane crash and sustained 2nd and 3rd degree burns to 45% of her face and body. For years she was bullied about how she looked, which affected her mental health.

“I endured bullying and staring. I associated my scars with being ugly and had no self-esteem. I would read about beautiful celebrities and want to be like them. I never felt beautiful,” she says.

Hannah, 26, a Changing Faces volunteer campaigner, was fourteen when she started to notice a patchwork of marks on her skin. It took 18 months to find out that the marks were caused by an autoimmune disorder called scleroderma, which affects the skin. This led to significant scarring on her back and torso. It used to make her feel “intensely self-conscious” and “ashamed”, which was made worse by the attitudes of others.

She says: “Once when I was on holiday, I wore a bikini. As I came out of the water, I was stared at by so many people, some of whom also made snide comments. I ran back to my towel, covered myself up and swore I’d never reveal my scars publicly again.

“My visible differences have had a huge impact on my self-confidence. I used to obsessively cover up and I was constantly afraid to reveal them to people. My scars made me ashamed and it had a huge impact on my general wellbeing.

Abuse and comments are also experienced online. Over 40% of people with a visible difference have had negative experiences online and one in ten say they are repeatedly harassed on social media[10].

Actor, presenter, and Changing Faces ambassador, Adam Pearson says the levels of abuse he receives is tough to deal with at times.

“I’ve been abused in the street but I also get a lot of hate online. Some people say to me ‘well just quit social media’ but that’s not a solution. Why should victims of abuse be removed from social media platforms – it only further ostracises them.

 

Women with a visible difference are more likely than their male counterparts to say that they have experienced someone posting negative comments about them, or someone posting negative comments about an image of them, on social media (28% vs. 20%). People with a visible difference aged 18 - 34 are more likely than their older counterparts to say that they have experienced someone posting negative comments about them, or someone posting negative comments about an image of them, on social media (39% 18-34 vs. 20% 35-54 vs. 9% 55+)[11].

Lack of positive representation

Every day we are bombarded with messages telling us we need to look a certain way. Adverts portray a very narrow view of beauty and we are under constant pressure to conform. This pressure can be difficult to deal with, whoever you are. But when you have a mark, scar or condition that means you look different, it is intensified.

Despite the fact that about a fifth of people in the UK self-identify as having a visible difference such as a mark, scar or condition, people with visible differences are still largely absent from mainstream advertising and brand campaigns. They tell us that they never see anyone who looks like them. Two-thirds of people do not think visible differences are represented well in adverts, whilst over half say that people with visible differences are regularly ignored by brands[12].

By creating campaigns that better represent society, including people who look different, we can challenge ideas of perfection, and help create a world free from prejudice and discrimination.

Changing Faces’ Pledge to Be Seen campaign calls on brands to commit to featuring people with a visible difference in their campaigns. Beauty brand, Avon was the first to sign up and has featured Changing Faces ambassadors as models across their advertising campaigns.

Catrin, 26, a burns survivor, Changing Faces ambassador and Avon model says: “When I was receiving treatments for my burns I would read magazines to pass the time and I never saw anyone who looked like me - so to be a part of a mainstream beauty campaign is so important. Hopefully these campaigns will open people’s eyes to the need for more diversity in the fashion and beauty industry and the impact this can have on people’s confidence and self-esteem.”

There is also a lack of positive representation of people with visible differences in film and on television. Films use scars and looking different as a short-hand for villainy or vulnerability far too often nearly every ‘baddie’ in the Bond film franchise has a scar or facial disfigurement, whilst Disney’s Lion King goes further, with the ‘evil’ character called ‘Scar’. On television there is a lack of characters who have visible differences, with disfigurement largely ignored.

It can be incredibly damaging to people with visible differences because they become associated with the negative stereotype. Teenager Marcus, who was born with a facial cleft and cleft palate, has been bullied and taunted with the names ‘scar face, two-face and Joker’. Around one in five children and young people say that people with a visible difference are regularly shown as ‘baddies’ in films and books (18%), they rarely feature in adverts (18%) and aren’t shown as positive role models (17%). 6% actually believe they’re scary[13].

Changing Faces campaign, #IAmNotYourVillain aims to tackle this use of tropes and stereotypes by highlighting the impact this has on the visible difference community. The British Film Institute has signed up to the campaign and committed to not having negative representations depicted through scars or facial difference in the films they fund. 

Recently we have seen some positive representation receive acclaim. The great reviews for actress Vicky Knight, a burns survivor, in the powerful and moving 2019 film, Dirty God, shows that things can change. And earlier this year the CBBC adaption of Malory Towers features an actor, Beth Bradfield, who has a visible difference. Beth’s character has a storyline that is not centred around her disfigurement. Beth’s father, Robin says: “I think it is very important for people with a scar, mark or condition that makes them look different to appear on television. The more role models there are, the more opportunities there will be for others to be inspired by them. Hopefully, seeing Beth on TV will help other young people with visible differences.”

Long term effects of poor body image

With most mental health problems starting at a young age, early intervention work with young people with a visible difference and their families is more important than ever.

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Changing Faces research[14] with children and young people found that concerns about appearance begin to trouble children from just 7 years old. The majority of children and young people say that the world they inhabit influences how they feel about their appearance. Family and friends are the most significant influencers (74%), followed by celebrities (64%) and social media (61%).

 

Our research found that just two out of five young people feel confident about their appearance.

 

These insecurities, about looking and feeling different, impact the day-to-day lives of children and young people. The majority admit that their appearance stops them doing certain things.

 

For one in six young people this means how they look stops them going out in public and going to school. This increases for teenage girls, with a fifth saying they avoid going out in public because of how they look.

 

For one in five young people, it means avoiding photos with friends and family and not trying new things.

 

For those young people with a visible difference, the impact of looking different can be even more difficult. “It’s not nice when you’re walking down the street and you feel shy to show your face” said one boy. “That’s a horrible, horrible feeling and that’s what I feel and I don’t want anyone else to feel that, or even me.”

 

Young people spoke about avoiding going out because they only feel confident at home. Some described coping by wearing camouflage make-up or hoodies before venturing outside.

 

Effective prevention can help avoid the considerable distress that mental ill-health can cause young people and ensure that they look to their future with hope, not fear.

 

Changing Faces research has found that experiencing hostility and abuse can have a long-lasting impact. Almost half (45%) of adults with visible differences who have experienced negative behaviours say they have lost confidence, over a third say they now feel anxious when they go out and over a quarter say it has had a negative impact on their mental health[15].

Gender plays a significant part when it comes to appearance, body confidence and mental health. Women with a visible difference are particularly likely to say they feel self-conscious or embarrassed about showing parts of their body (36%) and that they feel depressed, anxious or sad (33%). Women also feel more self-conscious going out in public (27%) and say that they feel embarrassed about the clothes they wear (26%)[16].

Changing Faces has also undertaken research with men who self-identify as having a visible difference which is due to be published later this year.

Men are less likely to access the support services provided by organisations like Changing Faces. The research found, two-thirds of men felt negative emotions, such as being embarrassed, worried or afraid, when they realised they looked different. Half of men think about their appearance once a day or more; one in six say they think about how they look constantly.

Michael, 31, a burns survivor, would notice stares from other people when he went out with his family when he was younger, and became very self-conscious. He says: “One time I was on a train with my mum and sister and I noticed that people were staring at me so I put my jacket over my head because I couldn’t stand it and I just wanted to disappear.”

Three-quarters of men with a visible difference say men are under pressure to meet macho male stereotypes and that men do not talk about their appearance. Three in five men with a visible difference say that it is harder for men than women to seek support about their appearance.

  1. Media

The effect on people’s body image when using social media

Social media can be a hugely valuable tool for connecting and providing peer support amongst people with a visible difference. Changing Faces campaigners anecdotally report how speaking out online has enabled them to connect with others who have shared experiences of living with a visible difference, with social media sometimes being the first, and only place, they have seen someone who looks like them. But it can also be a very difficult environment.

 

Over 40% of people with a visible difference have had negative experiences online and one in ten say they are repeatedly harassed on social media[17].

 

One of Changing Faces’ campaigners shared their experiences of using social media as a person with a visible difference as part of our submission to the Online Harms White Paper consultation:

 

“We often feel a lack of confidence about showing ourselves in photos online.

 

“Because when we're brave enough to post publicly, responses can run the gamut from supportive and uplifting, to "want to hide in a cave" awful.

 

“People with scarring, and amputees, including teenagers and people in support groups, have been exposed to fetishistic attention when they post photos.

 

“Photos have been stolen, and exploited to earn money from people who are encouraged to 'like, share and pray' for the exploited image.

 

I and many others have tried reporting harassment on these sites and apps, and it can feel very hit-or-miss.

 

We know that for many people with a visible difference the daily grind of online harm and negative comments can have a debilitating effect on their self-confidence, wellbeing, and anxiety levels.

In order to understand the challenges and barriers faced online by people with a visible difference – social media organisations need to commit to up-skilling reporting staff on appearance-related online harm and the experiences of people with a visible difference on their platforms.

We know that in addition to user generated content, advertisements and paid-for online content can also have an impact on people’s body image. The ASA’s gender stereotyping research in 2017 showed that advertising does contribute to a culture of idealised appearance, which can in turn lead to self-esteem issues, and body dissatisfaction.

Adverts and campaigns that have a negative impact on body image

The very act of not including people with visible differences in adverts and campaigns is harmful; creating a world where people do not see themselves represented or championed. Through our work with the ASA we are also aware of a number of adverts for cosmetic surgery that irresponsibly trivialise cosmetic surgery and imply that people could only behave in a certain way, or could only enjoy life and be happy with their bodies, if they underwent cosmetic surgery which would make them feel more confident and attractive.  Ads which claim or imply that people must, or that their lives would be improved if they did, undergo cosmetic surgery to alter their appearance could have a negative impact on body image, and are also likely to break the Committee of Advertising Practice rules.

Adverts and campaigns that stand out in promoting a positive body image

Beauty brand, Avon, is working in partnership with Changing Faces as part of its commitment to the charity’s #PledgeToBeSeen campaign and has pledged to increase the representation of women with visible differences across its advertising and marketing. They have recently launched a campaign to promote a new fragrance, Herstory, featuring five of Changing Faces ambassadors as the models.

Speaking about the campaign, Stephen Rendu, Marketing Director, Avon, says: “Avon understands that beauty can be very powerful and so it’s imperative that it’s inclusive too.

“We are very proud to be working with Changing Faces and their ambassadors to inspire women with visible differences to feel included and empowered.”

Changing Faces volunteers have also referenced the impact of the Dove skin care campaigns, showcasing a diverse range of women in their adverts, including featuring women and models with skin conditions such as vitiligo, one of whom is also a Changing Faces campaigner.

In addition to challenging the beauty industry to have more diverse representation, Changing Faces continues to work across sectors to encourage more organisations to consider how they demonstrate diversity and include people with visible differences in their brand campaigns and recruitment advertising. Recently Changing Faces worked with the Foreign & Commonwealth Office, presenting to them the impact of a lack of representation and delivering training around inclusive recruitment for those with visible differences. We have been pleased to see that a number of their recruitment materials, including a video posted across social media channels, now feature someone with a visible difference.

 

  1. Regulation

Proposals in the Online Harms White Paper that can protect people from potential harm caused by social media content in regard to body image

Proposals in the Online Harms White Paper have the potential to protect people from the harms caused by social media content in regard to body image, if Ofcom, the new regulator for social media organisations, commits itself to working closely with people with a visible difference and Changing Faces - placing people with a visible difference at the heart of the industry, understanding their experiences, and ensuring their safety online.

 

To maximise its impact and effectiveness, the new regulator must be user-driven throughout both its design and practices. This could involve people with a visible difference being brought in for co-production workshops when creating such processes as code of conduct.

Social media organisations should also commit to work closely with Changing Faces on engaging with our community; up-skilling users with a visible difference and improving reporting procedures for people with a visible difference who experience online appearance-related harm. They should commit to up-skilling reporting staff on explicit appearance-related online harms and the experiences of people with a visible difference on their platforms. And, continue to improve their reporting and harm detection procedures by consulting and working with Changing Faces and people with a visible difference.

 

Changing Faces has engaged with social media organisations in a variety of ways. This has included:

 

-          Twitter delivering bespoke training for Changing Faces’ campaigners.

-          Changing Faces training Twitter’s internal Trusts and Safety team on appearance-related issues.

-          Twitter ‘White listing’ Changing Faces on their platform (allowing for complaints made by Changing Faces to be ‘fast-tracked’).

-          Both Twitter and Facebook providing Changing Faces with free advertising on their platforms. This has allowed us to spread positive campaign messages, attempting to establish a compelling counter-narrative to the prevalence of online harm on social media.

-          Twitter and Facebook collaborating with Changing Faces to provide guidance to support people with a visible difference to better understand how to report online abuse.

 

We believe that continuing this existing collaboration is vital to ensure that online spaces are safe for people with a visible difference and maximise the impact of the Online Harms White Paper. We also support a system of ‘super complaints’ in principle. However, this must not detract from strengthening social media platforms’ own complaints processes and how they treat individual users. Similar processes have also previously proved successful on social media platforms. For example, Changing Faces is ‘white-listed’ on Twitter, meaning our complaints are fast-tracked by the platform. Where individuals are involved with an organisation that has access, a system like this can also provide additional confidence that they can remain safe. By having a ‘super-complaint’ some victims of online harm, may feel that they will receive a more human response.

 

Does the ASA protect the public from adverts that have a negative impact on body image?

The ASA has proactively engaged with Changing Faces research and the lived experiences of those with visible differences. During Face Equality Week 2019, the ASA issued additional guidance; recognising that depictions in advertising can potentially affect the way people think about their own and others appearance. The guidance reminded their members that the positive and accurate representation of people who look different in advertising is not only crucial to counteracting stigma, prejudice and discrimination in the future – it also helps ensure that such ads stay in line with the Ad Rules.

Changing Faces also released updated media guidelines to complement this guidance, with a focus on language usage when addressing visible difference in the media.

We welcome engagement with regulators and are also working with Ofcom, who have committed to our #PledgeToBeSeen campaign. We look forward to their public announcement and to working with them in support of their crucial regulatory role of ensuring diversity and inclusivity across the output of broadcasters, to ensure that what we watch on our screens reflects the make-up of society.

 

We know that early intervention is key, and that when we educate young people it makes a difference. Changing Faces believes that the Government should:

 

-          make training on issues of visible difference and appearance-related bullying mandatory for trainee and probationary teachers. Changing Faces’ Face Equality in Schools resources are currently being developed in partnership with University College London, Institute of Education, and will be published in 2021 to ensure appropriate resources are available.

 

-          ensure primary and secondary school pupils have the opportunity to learn about visible differences and disfigurements, and the associated impact of appearance-related bullying and abuse as part of the Relationships, Sex and Health Education Curriculum (England) RSHE, and the equivalent curriculums in Scotland, Wales and Northern Ireland; utilising the expertise of organisations including Changing Faces who can provide key-stage appropriate learning resources.

 

-          provide funding to specifically undertake research to assess the impact of social media usage and its impact on the lives of young people with visible differences; providing a clearer picture of the support and potential interventions needed by regulators to ensure this group can live the life they want online.

 

-          sign up to Changing Faces #PledgeToBeSeen commitments, so that all Government funded advertising campaigns, including public information campaigns and Civil Service recruitment advertising represent more people with visible differences.

 

 

June 2020


[1] Changing Faces #MyVisibleDifference Report (https://www.changingfaces.org.uk/wp-content/uploads/2019/05/CHANGING-FACES-Report-My-Visible-Difference.pdf) ComRes interviewed 1,037 people with a mark, scar or condition that makes them look different online between 7th and 16th March 2019. Data were weighted to be representative of those with a mark, scar or condition that makes them look different by age, gender and region. This weighting scheme was sourced from a nationally representative public omnibus survey run between the 22nd and 24th March 2019. ComRes is a member of the British Polling Council and abides by its rules.

[2] Changing Faces #MyVisibleDifference Report

[3] Changing Faces #MyVisibleDifference Report

[4] Changing Faces #MyVisibleDifference Report

[5] Changing Faces Looking Different Report, 2018. https://www.changingfaces.org.uk/wp-content/uploads/2018/05/2266_Changing_Faces_FaceEqualityDay_report_AW_single_page.pdf

[6] Changing Faces Looking Different Report

[7] Changing Faces Looking Different Report

[8] Changing Faces #VisibleHate campaign (https://www.changingfaces.org.uk/quarter-people-disfigurement-victim-hate-crime). Savanta ComRes interviewed 1,006 people with a mark, scar or condition that makes them look different online between 23 October and 11 November 2019. Data were weighted to be representative of those with a mark, scar or condition that makes them look different by age, gender and region. This weighting scheme was sourced from a nationally representative public omnibus survey run between the 22nd and 24th March 2019. Full data sets: https://comresglobal.com/polls/changing-faces-hate-crime-survey/

[9] Changing Faces #VisibleHate

[10] Changing Faces #VisibleHate campaign

[11] Changing Faces #VisibleHate campaign (https://comresglobal.com/polls/changing-faces-hate-crime-survey/)

[12] Changing Faces #MyVisibleDifference Report

[13] Changing Faces Looking Different Report, 2018. https://www.changingfaces.org.uk/wp-content/uploads/2018/05/2266_Changing_Faces_FaceEqualityDay_report_AW_single_page.pdf

 

[14] Changing Faces Looking Different Report, 2018. https://www.changingfaces.org.uk/wp-content/uploads/2018/05/2266_Changing_Faces_FaceEqualityDay_report_AW_single_page.pdf

 

[15] Changing Faces #VisibleHate Campaign

[16] Changing Faces #MyVisibleDifference Report

[17] Changing Faces #VisibleHate Campaign