estudos feministas/ études féministes
janeiro/ junho 2006 -janvier / juin 2006

Body modification as self-mutilation by proxy

Sheila Jeffreys


This article explores some of the themes of Sheila Jeffreys' 2005 book Beauty and Misogyny. It suggest that practices such as commercial body piercing, breast implant surgery, transsexual surgery and sadomasochism should all be seen as forms of self-mutilation by proxy. Self-mutilation is carried out by socially despised groups such as young women and gay men, usually in private. When this practice is carried out by proxies such as studio cutters, surgeons, or sadists, for their profit or pleasure it should not be seen as fashionable, as choice, or transgressive but the result of abuse or despair.

The cutting up that girls do secretly in their bedrooms, the nipple piercing that is performed in high street studios, breast implant surgery, sex reassignment surgery, are connected. They are all forms of self-mutilation, and increasingly the cutting is carried out by proxies for a profit. They are responses to low social status, sexual and physical abuse or severe emotional distress created by a male dominant society which does not accept women’s varied body shapes or condemns homosexuality.

Self-mutilation is overwhelmingly the behaviour of girls and young women. Its most common form is cutting of the forearm with razors, or other sharp implements, though other areas of the body can be injured. It is a common behaviour. An estimated 2 million young women in the US regularly self-mutilate. Girls and women who have no outlet for the rage and pain they experience from male violence and abuse and from the other injuries of a male dominant culture, attack their own bodies. Often they are emotionally disassociated from their bodies, having learnt this technique to survive abuse. Self-mutilation breaches the barriers they have created and allows them to ‘feel’. The frequency of self-mutilation by young women fits into a context of increasing mental and physical health problems in teenage girls.

I call the practices in which women, and some men, request others to cut up their bodies, as in cosmetic surgery, transsexual surgery, amputee identity disorder (pursuit of limb amputation) and other forms of sadomasochism, self-mutilation by proxy. The proxy, such as the surgeon, the piercer in a piercing studio, the sadist, takes the role that in self-mutilation is more normally taken by the mutilator themselves, and in private. The proxy gains financial benefit, sexual excitement, or both, from carrying out the mutilation.

In the 1990s self-injury perpetrated by proxies became fashionable through the piercing, cutting and tattooing industry. The private self-mutilation born of despair and self-directed rage at abuse and oppression was exploited by piercing entrepreneurs. Piercing studios were set up in cities throughout the western world offering various forms of self-injury to make a profit for the perpetrators. The forms of injury provided by these studios and independent operators ranged from bellybutton piercings to the extremes of spearing straight through the torso as carried out by the Californian ex-advertising executive Fakir Musafar. The practices stemmed from two main sources, punk fashion and gay male sadomasochism.

Gay male fashion designers placed pierced models on their catwalks, and helped to inscribe a practice that had symbolized gayness, onto the bodies of conventional young women and some young men. The practices were enveloped in new age philosophy, said to be “tribal” in their reflection of the practices of African and other non-western peoples, and carried out by “modern primitives”

The majority of those acquiring piercings and tattooings were simply being fashionable rather than deliberately pursuing pain and the mortification of the flesh. Cutting, piercing and tattooing have quickly become commonplace and socially acceptable amongst constituencies of young women and gay men, even though they are recent additions to the repertoire of beauty practices. But some young people who are already self-mutilating in private are attracted to more than just multiple piercings. They graduate to the extreme forms of what are now called ‘body modification’. Internet websites encourage practices such as tongue splitting, suspension from hooks in shoulder muscles, and castration. They show photos with fresh blood and are creating self-harming networks. Male pornophiles can pay to access the photos for the satisfaction of seeing girls being cut up.

One extreme product of this movement is the development of ‘body integrity identity disorder’ (previously called amputee identity disorder). Some of the psychiatrists and surgeons who have been involved in the creation of an industry of sex reassignment surgery are now working together to get BIID recognized in the US diagnostic and statistical manual. If they achieve this then in the future they may legally cut off the limbs of those who say that they have always felt uncomfortable with their body shape. A Scottish surgeon has already cut legs off two healthy men. The Internet is enabling  those experimenting with amputating parts of their bodies, such as fingers, and seeking to lose one or more limbs to grow in numbers and support each other’s self-harming behaviour.

All of the practices of piercing, tattooing and cutting can cause severe physical harm and even medical emergencies. About 10-15% of piercings get infected. The majority of problems are caused by staphylococcus aureus and streptococcus. Infection with pseudomonas can be dangerous because it can liquefy ear cartilage. Other problems include candidal infections of the navel, and moist areas such as genitalia and the nose. Infections can arise from trauma-induced tears. Some people form keloids or scar tissue and diabetic patients should not have piercings. Piercing has been known to cause a range of other infections including tuberculosis, tetanus, hepatitis, and toxic shock syndrome. The practice of branding hurts a great deal. Tongue piercing can create particular problems such as swallowing or inhaling the stud, the formation of cysts, scarring, damage to nerves and veins, neuromas and damage to teeth. The splitting of tongues can lead to loss of the ability to speak.

The most common form of severe self-mutilation by proxy is cosmetic surgery and this practice overwhelmingly affects women. Many of the forms of harm promoted to women by television shows and the adverts of surgeons derive directly from the pornographication of western culture. Breast enlargement originated in the prostitution by the western armies of occupation of Japanese women after World War II, who were seen as being the wrong shape for men’s excitement. In the west it developed from the so-called sexual revolution in the 1960s in which men’s practice of buying women in prostitution was destigmatized. The sex industry expanded swiftly in the US through pornography and stripping and the large breasts the male buyers demanded were created at first by silicone injections which caused even more severe harms to health than implants.

More recently labiaplasty, the removal of women’s labia to make their genitals fit the pornographic ideal, has become a profitable area for surgeons. Prostituted women in pornography were the first to have their genitalia modified, and the first in western culture to remove genital hair so that men could stare directly at the exposed genitals. Now, of course, the hair removal, called Brazilian waxing, is practiced in what are called beauty salons.

Other forms of invasive and risky surgery are also becoming much more common. Liposuction, in which fat on the tummy or thighs is liquefied and sucked out through a tube, is a temporary solution that some women seek to their failure to live up to the dictates of a male dominant culture. Silicone is put into lips and cheeks, buttocks (in South America in particular) receive implants, faces are cut up and rearranged.

The routinisation of seriously invasive cosmetic surgery is evident in the discussion fora and message boards that the industry has set up in recent years to gain clients and encourage women to pay for their services. The message boards are sections of the websites of cosmetic surgery clinics and referral services. Women’s agonized requests for help or reassurance reveal the damage that is being inflicted. Problems that women discuss include swelling, bruising, pain, numbness, itching, smell, unwanted lumps, dents, and constipation.

There are deaths too. Major surgery requires anaesthesia and always involves some risk. Olivia Goldsmith, the US author of the novel on which the movie First Wives Club was based, suffered a heart attack from a bad reaction to the anaesthetic during a routine cosmetic surgery procedure to tighten skin on her neck. This unregulated abuse by surgeons who should do no harm does not arouse the outrage that it should because there is a societal acceptance that women should suffer to be beautiful. The seriously invasive surgery involved in breast implantation, for instance, might be considered savage if it was carried out at a body modification convention. When it is done by surgeons in the name of relieving the supposedly ordinary distress of women about their appearance it can be seen as unremarkable. Also there is huge profit in it. The cosmetic surgery industry in the US was estimated in 2003 to be worth 8 billion dollars a year.

The practices of mutilation that are being carried out on the bodies of women, girls and vulnerable categories of men in the early twentieth century are savage and increasing in their brutality. Underlying the demand for these practices is the despair of those with low social status, particularly women and gay men. The harms of misogyny, sexual and physical abuse and gayhating, create the ability of those who self-mutilate to disassociate emotionally from their bodies, and to blame their bodies for their distress. The cosmetic surgeons, piercers and cutters, sadists, those who watch cutting and SM performances on the Internet or in practice for sexual thrills, and those who create academic careers out of making the cutting up seem glamorous or avant garde, are parasitic on these harms and help to perpetuate them.


Sheila Jeffreys is an Associate Professor in the Department of Political Science at the University of Melbourne. Her most recent book addresses these themes in detail: Beauty and Misogyny: Harmful Cultural Practices in the West. Routledge, 2005. She has been a lesbian feminist activist since 1973 mostly on issues such as pornography and prostitution. She moved to Melbourne, Australia from London in 1991 where she teaches sexual politics and international feminist politics in the Department of Political Science at the University of Melbourne. She is the author of 6 books on the history and politics of sexuality.


estudos feministas/ études féministes
janeiro/ junho 2006 -janvier / juin 2006