When U.S. Senate majority leader Harry Reid proposed a five per cent levy on elective cosmetic surgeries and procedures to help fund the US$848-billion Senate health care bill last month, a Robin Hood-style logic appeared to be at work: let those who can afford Botox or facelifts subsidize low- to middle-income citizens currently without health care to the tune of US$6 billion over 10 years. What he didn’t foresee was that those very low- to middle-income Americans would take to the streets to protest the so-called “Bo-tax” as an infringement of a perceived enshrined right to smooth foreheads and surgically enhanced breasts.
“Washington leave our boobs alone” read a placard at a rally in New York’s Times Square organized by a Park Avenue cosmetic surgeon. “The tax directly affects me,” Irma Cadiz, a 33-year-old hairstylist saving for a US$7,000 tummy tuck, told the New York Daily News. “If I have a heart attack, will they tax that, too?” she asked, revealing how conflated elective cosmetic procedures have become with necessary medical intervention. Opposition to the Bo-tax from the American Medical Association further muddled the matter. As did its denunciation by the National Organization for Women (NOW), the largest feminist lobby in the U.S. NOW’s president Terry O’Neill argued the Bo-tax unfairly targeted women, who comprise 90 per cent of cosmetic surgery recipients—especially middle-aged women facing workplace discrimination who rely on sometimes risky cosmetic procedures to “freshen” their image.
NOW’s seemingly pro-Botox stance was greeted as a jolting about-face from its long-standing opposition to the pressure on women to conform to rigid beauty ideals. Back in 1968, two years after its founding, the group famously burned a trash can full of bras, girdles and cosmetics outside of the Miss America beauty pageant.
Now middle-aged itself, with founding member Gloria Steinem admitting to having had cosmetic eye surgery, NOW’s opposition to the Bo-tax suggested resignation with the ubiquity of cosmetic work and acceptance of its new artificial norms. Older women’s aged appearance was holding them back, O’Neill told the New York Times: “I know a lot of women whose earning power stalled out or kicked down as they entered into their 50s, unlike their male counterparts’, whose really went up.”
Sensing another Boston Tea Party brewing, legislators quickly backed away from the Bo-tax, replacing it with a less contentious 10 per cent levy on indoor tanning beds, a “Tan-tax” expected to net less than half the amount.
The Bo-tax backlash offers a telling glimpse of cosmetic surgery’s new socially and economically vulnerable face, territory explored by Laurie Essig, a sociology professor at Middlebury College, in her upcoming book American Plastic: Boob Jobs, Credit Cards and Our Quest for Perfection. In it, she quotes industry statistics that reveal one-third of cosmetic surgery is performed on those earning less than $30,000 a year, while some 70 per cent is done on those who make less than US$60,000. The working poor’s access to facelifts is abetted by what Essig calls the “predatory” lending practices of “medical credit” at 30 per cent interest. Many of those Essig interviewed were working class—female police officers, secretaries—and most were in jobs where one’s appearance once didn’t matter. A magazine editor who had her first facelift in her 60s told Essig: “You’ll get one; you’re too ambitious not to get one.’ ” Real estate agents complained to her: “No one wants to buy a house from someone who looks tired.” There’s pressure to look a certain way, she says. And the way middle-aged women look is coded: “ ‘I’m tired, I’m overwhelmed, I’m angry.’ ”
The flight to cosmetic surgery is a reaction to social and economic insecurity, says Essig: “People got that they were facing downward economic mobility and that their kids were going to be worse off, so they responded with forms of [debt-fuelled] consumption—[taking out] a subprime mortgage or a high-interest college loan or a medical loan for a boob job, thinking, ‘If I do this, there’ll be some reward.’ ”
But, as she points out, statistically speaking that’s a myth. Daniel Hamermesh, an economics professor at the University of Texas at Austin who has conducted the most-cited studies of the correlates between beauty and income, concludes that while better-looking people tend to earn more, attempting to improve attractiveness, be it with new clothing, cosmetics or surgical intervention, has little impact on earnings.
Women who go under the knife make an extra five cents per dollar, he says, research backed up by Soohyung Lee, a economics professor at the University of Maryland. “It’s a terrible investment,” says Hamermesh, who points out that people can tell the difference between natural and artificial beauty, a fact sometimes lost in the presumption that all cosmetic surgery is appearance-enhancing. Also overlooked is the fact that the reason employers prefer employees who look young is because they are young: cheaper to hire and easier to dispense with.
O’Neill, eager to distance herself from the Bo-tax, declined Maclean’s request for an interview. In a statement, she called it “a distraction from the larger issues NOW has been working on in health care reform.” But it’s too late for that: U.S. health care isn’t the only system in dire need of fixing if cosmetic surgery is the new female social and economic safety net.