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The Boom in Plastic Surgery

Alienated Bodies

by DAVID ROSEN

In 1952, George Jorgensen, a 26 year-old former private in the U.S. Army traveled to Denmark to undergo a gender reassignment procedure, what was then known as a “sex change” operation.  Upon her return to New York as Christine Jorgensen, she gained a famous headline in the Daily News: Ex-GI Becomes Beauty.  Jorgensen’s sex change operation was one of the 20th century technology’s greatest achievements.

Jorgensen’s transformation from a man into a woman was a truly forbidden accomplishment, an act that reconfigured one of the most basic of human conditions, gender identity.  Today, it is but one more accepted “medical” procedure, sex reassignment surgery (SRS).  SRS covers both male-to-female (MTF) and female-to-male (FTM) procedures.

In a 2008 study, “The Incidence and Prevalence of SRS among US Residents,” Mary Ann Horton estimates: “If the US run rate [for 2001] is 1166 surgeries/year (MTF+FTM) and the population of adult US residents was 281,421,906 in 2000, the incidence of SRS per year among adult US residents is about 1:241,000 (about 1:187,000 MTF and 1:333,000 FTM.) That is, about .0004% of the population has SRS each year.”  (No current data on SRS appears available.)

In 2012, Donald Trump, who owns the Miss Universe and Miss USA pageants, changed the organizations’ official rules so that a 23 year-old contestant, Jenna Talackova, could compete in the Miss Universe Canada contest.  Talackova, who’d lived as a female since the age of 4 years and had undergone sex reassignment in ‘08, was initially disqualified from the contest because she was born a male.  Trump changed the rules of what is normal.

Gender reassignment is but one significant technological accomplishment involving sexuality.  The introduction of “the Pill,” the oral contraction, in 1960 prefigured the modern sexual revolution.  Still other advances include artificial insemination, particularly in vitro fertilization research (i.e., “test tube babies”), and the “morning after pill” (i.e., levonorgestrel, Plan B or ulipristal, Ella).  Drugs ostensibly designed to address male “erectile dysfunction” (ED) like Viagra and Levitra have become mass-market products. Sexual prosthetics, particularly genital reconstruction for war-damaged male soldiers, represents one shameful marvel of the U.S.’s 21st century military-industrial-medical complex.

Something has surely changed in the last half-century with regard to sexuality and gender.  Homosexuality is no longer a pathology and gay marriage is legal in a dozen or so states; porn is a $13 billion business, commercial sex estimated at $18 billion and sex toys sales are about $15 billion annually.  Sex is an industry.

Technology revolutionizes our lives, our flesh and our sense of natural existence.  Yet, it is constituted within a market economy.  So the new freedoms technology brings as expressed in, for example, sexual reassignment can be manipulated and recuperated, becoming a form of repression.  Nothing expresses this more than cosmetic surgery.

* * *

As suggested by pop TV shows like “Extreme Makeover,” “Nip/Tuck” and the Kardashians, aesthetic surgery is back big time.  Mass-media promotion of plastic surgery has led to its mass consumer acceptance.  And the market is huge and growing.  One estimate pegs the plastic surgery industry at $14 billion in annual revenue.

Today, consumers prefer less invasive treatments like Botox injections, dermal resurfacing and microdermabrasion.  Most rewarding, a significant proportion of these procedures — as distinguished from medically-necessary reconstructive surgery — are elective, paid as out-of-pocket expenditures by predominantly female customers.

Popular acceptance of cosmetic surgery was spurred by changes in Food & Drug Administration (FDA) policy.  In 1998, following years of complaints about implant ruptures and charges that the devices lead to problems ranging from autoimmune diseases to cancer, it lifted its ban on the use of silicone breast implants. (The resulting litigation forced Dow Corning Corp., then the leading implant supplier, into bankruptcy.)

The industry’s trade association, ASPS, reports in its annual survey, “National Plastic Surgery Statistics,” divides the industry separate categories — minimally-invasive cosmetic procedures and medically-necessary reconstructive surgeries.  Approximately 13 million cosmetic procedures were performed in 2012, a nearly three-fold increase from the 5.5 million procedures in 2000.  This escalation was driven by the seven-fold jump in Botox procedures, to 6.1 million in 2012 from 787,000 in 2000.  During the same periods, 2012 and 2000, medical-necessary surgical procedures increased to 1.9 million from 1.6 million, respectively.

In 2012, there were 91,655 breast cancer reconstructive surgeries and 68,416 breast reduction procedures.  And they are not cheap, costing between $5,500 to $12,000, including $1,600 for the actual silicone implants.  This is about double the cost of saline versions. In addition, there were: liposuctions (202,128), nose reshapings (242,684), eyelid surgeries (204,015), facelifts (126,320), tummy tucks (106,626) and buttock lifts & implants (3,756).

While Botox injections skyrocketed nearly 8-fold over the last decade, other minimally-invasive procedures also increased significantly.  In 2012, these procedures included: laser skin chemical peels (1,133,821), microdermabrasions (973,556), laser hair removals (1,118,821), sclerotherapies (i.e., elimination of spider veins, 358,152) and cellulite treatments (33,123).

Reconstructive surgical procedures, which improve function and appearance, remained relatively stable. The top five reconstructive procedures in 2012 were: tumor removals (3.9 million), laceration repairs (344,000), scar revisions (181,000), hand surgeries (172,000) and breast reductions (114,000).  Finally, the number of vaginal rejuvenation procedures (i.e., vaginoplasty) and labiaplasty or labia/lip reduction) increased more then 7-fold between 2012 and 2005, to 3,521 from 793.

Not surprising, little data is available on hymen reconstruction procedures in the U.S.  Medically, the procedure is known as hymenorraphy, hymenoplasty, hymen replacement and “virginity repair” and is used to address religious concerns (i.e., a female’s virginity) and sex abuse (e.g., child rape).  It is performed in India and other countries; in the U.K., the National Health System paid for 116 such procedures between 2005 and 2009.

* * *

The natural world is whole.  The destruction of the environment takes place simultaneously with the plunder of the human body.  One rarely asked question is whether body modification, the non-medically-necessary cosmetic procedures performed by the “medical-aesthetic” industry, is a form of environmental plunder?  Does it further the ecological crisis by turning each person’s living body into a marketable commodity?

Alienation is the great deception of capitalism.  In the 19th century, as Marx showed, it redefined the primary economic relation, the selling of one’s labor power as a commodity.  In the 20th century, as Benjamin, Marcuse, Foucault and others showed, it came to define social relations, the disconnectedness one felt toward one’s self and others.  In the 21st century, alienation defines the separation one experiences from the natural world – including from one’s own natural being, one’s physical body.

Elizabeth Kolbert, author of The Sixth Extinction, chronicles current examples of the ecological catastrophe playing out across the globe today.  Others raise alarming questions as to the long-term consequences of factory farming, especially in terms of the use of genetically modified seeds or the horrendous conditions of the livestock farm sector.  Still others detail the consequences of global warming and the pollution of the air and water.

Alienation, especially among ordinary people in the 1st — or over-developed urban — world, fashions the natural world as separate from the individual’s living being.  Nature now exists as something foreign, a constellation of things separate from one’s true or inner-self, one’s “soul” or conscious being, one’s very body.  Alienation renders each individual’s body — and the natural world in which s/he lives – as something other, not a subject but an object of existence.  Only when people of the 1st world recognize their own physical self-destruction as part as the larger environmental crisis will we be able to halt the plunder of living nature.

David Rosen can be reached at drosennyc@verizon.net; check out www.DavidRosenWrites.com