Jean McHale on children, cosmetic surgery and perfectionism

In this post Jean McHale responds to an article in the Sunday Times entitled “Fill me In”, which reports on the rise of teenagers seeking access to cosmetic procedures. Jean is Professor of Health Care Law at Birmingham Law School, and Co-Investigator of the Beauty Demands project. 

On the 26th July 2015 the Sunday Times carried an article in their “Style” section titled "Fill me In" reporting on the rise of teenagers seeking access to lip fillers, botox and to more invasive cosmetic surgical procedures. The article highlighted the influence of media representations of appearance being particularly influential in this context. A notable example was that of the American Kylie Jenner. Pictures were shown illustrating the difference in her facial appearance through lip enhancement between the ages of 13 and 17. The rise in demand and access to such procedures by teenagers represents a worrying trend.

I have explored this in a recent paper I have written “Children, cosmetic surgery and perfectionism: a case for legal regulation” published in P. Ferguson and G. Laurie (eds) Inspiring a Medico-Legal Revolution: Essays in Honour of Sheelagh McLean Ashgate (2015). Concerns over access by those under the age of legal majority to to such procedures have led in the state of Queensland, Australia to statutory prohibitions on cosmetic procedures concerning minors. Some procedures are sanctioned for therapeutic medical purposes but the aim is effectively to put restraints in place and to make clinicians stop, think and be prepared to justify that procedures are within the law before going ahead. It is notable that at least one factor in the drive for change in Australia was clinicians themselves concerned about the rise of the “body beautiful” and “beach” culture and the impact of this upon adolescents in particular. As yet we have not had such a wide debate concerning the regulation of cosmetic procedures concerning those under the age of 18, of legal majority in the UK but I suggest that given the trend here towards increased demand for such procedures now is the time for professions and government to review such issues here also. This can be seen as part of either a broader regulatory system for cosmetic procedures with perhaps the introduction of a regulator similar in structure to bodies such as the Human Tissue Authority or Human Fertilisation and Embryology Authority. A specific statutory prohibition could be enacted without the need for an overarching new regulator as the Queensland example illustrates, however a broader regulatory approach accompanied with specific prohibitions may be preferable to address many of the safety concerns in this area. Public policy considerations not least the vulnerability of children and adolescents, questions of safety and the legitimacy of undertaking such procedures on persons whose bodies are not fully developed, questions of professional medical ethics and the need for professional policing here are just some of the issues underpinning this area. We urgently need policy makers to engage with the question of cosmetic procedures, children and adolescents and seriously consider the question of legal prohibition and indeed more comprehensive regulation in this area.


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