The so-called “Bo-Tax” — a provision in the Senate Health Care bill that would impose a 5 percent tax on elective cosmetic surgery — “sounded like a refreshingly good idea to me,” writes Judith Warner at the New York Times’ Opinionator blog, “until I read that Terry O’Neill, the president of the National Organization for Women, is against it.” With all due respect to both O’Neill and Warner, I’ve read the feminist arguments against the tax, and I’m still really not moved to fight for my sisters’ right to go under the knife.
I can understand the logic, to a point. ABC News reports that “86 percent of cosmetic surgery patients are working women between the ages of 35 and 50, with an average income of $55,000 a year.” There’s no question that this is essentially a tax on women, some of whom feel that plastic surgery is necessary to keep them competitive in the job market — not just on rich, superficial stereotypes. Writes Warner, “The economy is terrible. Middle-aged women, many of whom reduced their working hours, limiting their earning power and ambition, when they had kids or, later, found themselves having to care for their parents, are in a particularly vulnerable spot these days, as they’re increasingly called upon to supplement or take over the lion’s share of family money-making. And any number of studies have shown that people with better (read: younger) looks have a better chance of getting a good job. Particularly women.” Thus, both O’Neill and Gloria Steinem told Warner that this would amount to an unfair tax on women who are only doing what they need to do to survive in a sexist, ageist workforce.
A few things about that. First, having cosmetic surgery does not necessarily make you look younger; often enough, it just makes you look like you’ve had cosmetic surgery. So, not only are studies showing younger-looking people have an advantage on the job market a red herring here — unless there are studies showing that eyelifts, facelifts, Botox, etc., improve women’s ability to get hired, we still have no idea which procedures, if any, could cynically be considered a smart investment and which would only be a further financial drain on an unemployed woman — but given society’s general disdain for cosmetic procedures, they might actually sabotage a woman’s chances. If she shows up to an interview with half her face frozen from Botox or a permanently surprised expression, for instance, a (sexist, ageist) interviewer might be dazzled by the glow of youth, or might just write her off as vain and ridiculous. There’s no way of knowing in advance which way it will go.
Second, let’s be clear: We’re not talking about women as a class here, we’re talking about white women. In 2007, “Hispanics had 9 percent of the procedures, followed by African-Americans (6 percent), Asians (5 percent) and other non-Caucasians (2 percent).” White people, then? Seventy-eight percent. Women who aren’t white don’t have the option of paying a doctor to minimize their chances of employment discrimination; racism will still exist no matter how young-looking and symmetrical they are, just as sexism and ageism still exist even if 55-year-old women manage to pass for 40. And while capitulation to bigoted standards (where possible) might be a useful short-term survival strategy for some — as a bottle-blond who rarely leaves the house without mascara, I am certainly not judging individuals who choose that route — there is a big difference between acknowledging that reality and promoting such capitulation as a feminist cause. Rallying behind women who feel forced into cosmetic surgery only reinforces the standards that drive them to that point; Botox and eyelifts may help some of our struggling sisters get jobs, but what of those who can’t afford such interventions, those who will still be discriminated against because of their skin color or disabilities or sexual orientation? Helping white women maybe improve their economic circumstances by becoming a bit more conventionally attractive is really not the kind of goal I want to see feminist leaders fighting for.
Besides which, once again, we have no idea if it actually will improve the economic circumstances even of a select group of privileged women. As Laurie Essig recently wrote in True/Slant, “cosmetic surgery is now primarily consumed not by the rich, but by the working and lower-middle classes, sometimes even by the poor. According to the American Society for Aesthetic Plastic Surgery (ASAPS), about 1/3 of cosmetic surgery is consumed by people who make less than $30,000 a year. About 70% of it is consumed by people who make less than $60,000 a year.” So the tax would indeed add an even greater burden to struggling women who choose plastic surgery as an investment in their careers, but I’m still not convinced that means I should be bothered by it. Essig goes on to say, “What these women don’t understand — what few of us understand — is debt. You sign on the dotted line for your boob job at $8000 but you don’t realize you’ll end up paying almost twice that much if you can’t put any money down. Easy for Hollywood starlets to plunk their cash down for new boobs, but for the rest of us, taking on debt for a better body is risky business.” How long will it take a woman to work off all that debt at the new job she got with her new face? And will a tax on cosmetic procedures necessarily mean that the same people are saddled with more of a financial burden, or might it mean that fewer women decide it’s in their economic best interest to take on a pile of credit card debt in the hope of finding a job that will lead to greater long-term security? Because if it’s the latter, I’m really not sure this tax is a bad thing.
That doesn’t necessarily mean it’s a good thing, either, mind you. Essig offers a number of solutions I like better: “If the government wants to control cosmetic surgery, then the answer is to re-regulate the banking industry so these medical credit loans don’t exist. And the other answer is to tax the obscene amounts of wealth being made by the likes of GE, who is selling medical credit to people who cannot afford it. Or the cosmetic surgeons income as part of an overall progressive income tax on the top earners.” But I think it’s safe to say we shouldn’t hold our breath for any of those plans — which is related to yet another reason why I can’t see access to affordable plastic surgery as a feminist issue.
If you can be judged by the company you keep, then it’s worth noting that Terry O’Neill and Gloria Steinem have thrown their lot in with the likes of Allergan Inc. and Medicis Pharmaceutical Corp., whom the Wall Street Journal reports “are mounting lobbying and public-relations campaigns against the proposed levy.” Allergan owns Botox, among other things, and Medicis produces competing products like Restalayne. Representatives from The American Academy of Cosmetic Surgery and The American Society of Plastic Surgeons are also all over the news, trying to spin this as an assault on women’s rights rather than their own wallets. “You’re taxing a disorganized group that has no one of its own representing it,” one doctor told The New York Times. “There’s no American Society of Plastic Surgery Patients… You’re not going to have a million-man Botox march.” But fortunately for the poor, unheard masses, you really don’t need on-the-ground activism when you’ve already got Big Pharma in your corner. Women who hope to maintain access to plastic surgery will do just fine without any organized leadership or the support of prominent feminists, as long as the people who profit most from sexist beauty standards are leading the charge against this tax. Heaven knows they have more political power than middle-aged women do. In fact, it’s almost like that’s the core fucking problem here or something!
And then there’s this: Women die from the pursuit of youth and beauty through surgery. This week, an Argentine model. In 2007, Donda West. In 2004, Olivia Goldsmith. In 1996, Adrienne Brown. Two months ago in Miami, and who knows how many other times, a woman who had no public profile. Statistically, the risk of death may be minimal, but it can’t be ignored in a conversation about feminism and cosmetic surgery. Is the ability to potentially maim and kill ourselves to look younger and prettier really something we want to fight for?
Look, I have no beef with any woman, up to and including Gloria Steinem, choosing to have work done for her own reasons; as a feminist, I believe in bodily autonomy without exception. And I can absolutely understand choosing to maximize whatever privilege you have in an effort to secure your own future; it’s not pretty, so to speak, but I’m neither naive nor noble enough to demand that people quit doing that. And I don’t have high hopes that this tax will make a dent in the cost of more urgent healthcare concerns, so I really don’t care if it stays in or not. But it’s still galling to see feminist leaders spewing the exact same lines as far more powerful people and organizations who depend on sexist, ageist, racist beauty standards for their very livelihoods, essentially to defend the right of white women who can afford it (even if they really can’t) to make themselves appear more acceptable to sexist, ageist, racist employers. I like a good contrarian argument as much as the next overanalytical feminist, but no. Just no. Access to affordable cosmetic surgery is not a feminist issue. What drives women to risk not only their financial stability but their lives, because being seen as plain or old or ugly in this society can be just that devastating to their self-esteem and career prospects, is the feminist issue here.
Kate Harding is the co-author of "Lessons From the Fatosphere: Quit Dieting and Declare a Truce With Your Body" and has been a regular contributor to Salon's Broadsheet.More Kate Harding.