Challenge Match: americandingbat vs TheWayISeeIt: "Enough Is Enough, Right?", page

Thank you TWISI, for the challenge to debate a topic of particular relevance to women. Thank you to all the denizens of the Fight Club Pub for encouraging us.
Thank you to our readers and judges – we hope to provide material of interest as well as information.

And most of all, thank you to Semperfortis for trusting two newcomers with potentially fraught material. We hope to do you proud.

Breast Augmentation Is Necessary For Female Empowerment

Breast augmentation refers to the surgical enhancement of breast size, shape, or evenness. Usually this involves the insertion of a saline-filled or silicone-filled silicone shell either behind the woman’s own breast tissue, or under the chest muscle. There are also studies being done with some success in using injections of a woman’s own body fat to reshape the breast.

It is one of the most common surgical procedures performed in both the United States and the United Kingdom, and the numbers of women opting to take this route show no signs of slowing. Over the fifteen-year period from 1992 to 2007 in fact, the number of women who had breast augmentation surgery increased more than tenfold, from roughly 32,000 to more than 347,000 cases in 2007. This leap occurred despite the bad publicity caused by the withdrawal from the market of most silicon-filled implants between 1992 and 2006 while the possibility of a connection to systemic disease was investigated. (1a)

There are two major categories of breast implant surgery that are generally distinguished: that performed purely for cosmetic reasons, and that performed as reconstructive surgery especially after mastectomy. In this debate I will primarily focus on the first, as it is the more controversial of the two, but I wish to forewarn the reader that I will not be treated them as completely separate issues, but rather as related questions about the paternalist practices of the medical industry.

Before we turn to the definition of empowerment, I would like to give a brief overview of the history of breast augmentation surgery, which may surprise some.

The first attempts to surgically enlarge a woman’s breasts occurred between 1890 and 1895 (it may be of interest to note that 1890 was also the year in which the National Woman Suffrage Association and the American Woman Suffrage Association merged to become the National American Woman Suffrage Association, headed by Elizabeth Cady Stanton). During the period from 1890 to 1920, surgeons injected paraffin into the bodies of patients to fill out areas deemed too small. This procedure often resulted in infection, or the paraffin forming lumps under the skin.

From the 1920s to the 1940s surgeons experimented with using fat tissue from the woman’s own body to augment the size of the breast. While relatively free of the dangers of paraffin injection, the trouble with this approach was that the fat tissue was rapidly reabsorbed by the body, leaving the breasts uneven.

In the 1940s and 1950s various substances were tried in pursuit of the perfect figure ¬– silicone was injected directly into the body, causing inflammation and infection; and synthetic sponges were implanted under the breast tissue, but quickly hardened and shrank.

In 1961 the great breakthrough in breast augmentation surgery was made by two surgeons from Texas who developed the first silicone pouch implants. In the fifty years since then the basic concept has remained the same and refinements have been made in the safety and design of implants. This process has not been without its growing pains:

Silicone breast implants have attracted a lot of controversy since they were first introduced in 1962. Back then, the FDA did not evaluate medical devices for safety.

During the 1980s, the popularity of silicone breast implants surged, but so did accounts of their supposed risks. Many people claimed there was a link between the silicone gel from ruptured implants and an increased risk of immunological disorders (like lupus and rheumatoid arthritis), fibromyalgia, and other conditions. Some women reported that their symptoms went away after the implants were removed. Some filed lawsuits against implant manufacturers.

(1b)

From 1992 to 2006, the FDA limited the use of silicone-filled implants to reconstructive surgery while these allegations were assessed. No connection was found, and silicone implants returned to the market in 2006 as FDA-approved medical devices.

Implants now are available in an array of sizes, shapes, and textures, in recognition that women have differing needs and desires in breast enhancement.

And all types of women seek breast enhancement. As demographic changes occur and women are active physically and professionally at ages which fifty years ago were considered old, they want to look and feel their best, without the stigma of sagging breasts. In addition, women have claimed the right to be mothers and active, vital, people. Many choose to have breast lifts and augmentation after nursing their children as an expression of this right.

On this note, I will turn to the second half of our debate topic: Female Empowerment. First, a definition of empowerment:

Empowerment is the process of enhancing the capacity of individuals or groups to make choices and to transform those choices into desired actions and outcomes. Central to this process are actions which both build individual and collective assets, and improve the efficiency and fairness of the organizational and institutional context which govern the use of these assets.

(2)

This definition is focused on the economic sphere, but can be easily adapted to our purposes. The first sentence is the true key to empowerment: it is a process, and it involves increasing the options available to a demographic and protecting their right to choose among those options.

Women’s bodies have long been a contested resource; from laws which defined a woman as her husband’s chattel, to the cultural phenomenon of women as a sexual commodity and men as purveyors of that commodity, to the often unacknowledged but nevertheless powerful sexism and paternalism apparent in how doctors have treated women.

It is not a coincidence that the key points in the history of breast augmentation coincide with key events in the history of women’s rights, nor that it parallels developments in a consumer culture increasingly focused on providing women options that are important to them, rather than those deemed important by men. While the first, second, and third generation feminists have taken their turns claiming their rights in the political, professional, and personal spheres, a related process has brought us from those first painful paraffin injections more than a hundred years ago, to the 347,000 American women who chose breast augmentation surgery as a means to take control of their body image last year.

We will have a chance in this debate to look at these issues in more detail, and to discuss the specific importance of the breast in the struggle toward female empowerment, but I would like to turn the floor over to my opponent to give her a chance to speak.

Breast Augmentation is Antithetical to Female Empowerment

As we being to explore this issue I believe it is important to get clear about what the term ‘Female Empowerment’ means in the traditional sense, which is, quite simply, that women are seeking ways to be empowered in a male dominated, patriarchal society. It is my position that breast augmentation is the subjugation of women to a beauty standard that is, by its very nature, patriarchal.

I will ask throughout this debate how ‘empowered’ can one be when one is basing their decisions and sense of self-worth by the standards of those who, by dint of their sex, are part of the force that oppress them. And will iterate that the commonality of a practice does not change its purpose -- which is to curry favor with, or gain advantage from, those who hold the keys of power.

While one can argue that women get types of plastic surgery to meet a beauty standard that is endorsed and promoted by other women, breast augmentation is surely not one of them.

To example, as my opponent pointed out, some women choose to lift their breasts after childbirth, or because they feel vigorous in later life and want to project a picture of youth. What kind of ‘youth’ does a breast lift seek to project in these instances?

A sexual youth which correlates to fertility, which is in turn the driving factor of male sexual attraction to the female:

Because female fecundity typically declines after the late twenties, youth is an important aspect of physical attractiveness[18]….. As men age, they also desire a larger age gap from their mates.

1:1 en.wikipedia.org...

And in the Western World where we see the vast prevalence of mammaplasty:

Large breasts have also been shown to be attractive to men in Western societies, with the explanation that larger breasts will more explicitly show the aging process, hence an "honest" indicator of fertility.

1:2 en.wikipedia.org...

This is certainly not a procedure done by a woman to demonstrate her “active vitality” to other women. This is a procedure that seeks to gain the favor, and the approval, of those they seek to attract; the men who hold the balance of power over them.

It is not a coincidence that the key points in the history of breast augmentation coincide with key events in the history of women’s rights, nor that it parallels developments in a consumer culture increasingly focused on providing women options that are important to them, rather than those deemed important by men.

I say it is not a coincidence but a juxtaposed, counter-point to the Women’s Movement; a call-and-response by Western World men who were threatened and in turn began to demand a hyper-sexualized version of a female as their beauty/sexual attractiveness standard.

Empowerment? I think not.

As to my opponent’s selective definition of the word ‘empowerment’ :

it is a process, and it involves increasing the options available to a demographic and protecting their right to choose among those options.

Increased options to please those who hold you in a form of bondage is not empowering, but a further form of enslavement. The creation of a beauty standard, by men for men, that calls for women to engage in a form of self-mutilation in order to better their opportunities in society, or have a sense of self-worth, is not an example of a female empowerment but its exact opposite.

First Response


On Female Empowerment


My opponent begins her opening by trying to clarify what “female empowerment” means in what she calls the “traditional sense.” Yet she begs the question, defining empowerment as “seeking ways to be empowered” when what needs defining is what it means to be empowered.

My first Socratic Question for my opponent:

SQ 1: Is “having an enhanced capacity to make choices and to transform those choices into desired actions and outcomes” a fair definition of “being empowered”? If not, what would you suggest?

She also adds the phrase “in a male dominated, patriarchal society.” This highlights why I specified that empowerment is a process – it is one which begins in such a society, but I think we all hope that it will result in society in which men and women have achieved equality.

My next Socratic Questions:

SQ 2: Do you agree that female empowerment is an ongoing process during which society transitions from male dominance to equality of the sexes at some future time?

SQ 3: Do you agree that the period from 1890 to the present has seen a great increase in female empowerment?


On Standards of Attraction

My opponent has made clear the link between natural selection, breast size, and male sexual preference: men are attracted to women with large breasts because large breasts provide a visible sign of age and thereby of fertility. I presume she does not mean that individual men think through this process on a conscious level – rather, a genetic preference for large-breasted women has proved to be a successful adaptation for human males.

An interesting argument could even be made that an effective way to counter this preference among men is to obscure natural differences in breast size, so that it will no longer be a genetic advantage for a man to attempt to find a large-breasted mate.

Instead, though, I would ask that we turn our attention to her reaction to the notion that mothers might have breast enhancement surgery to signal their continuing vitality – she seems to take offense at the idea that this signals ongoing sexual vitality. But surely that is in the interest of the women, rather of the men, at least genetically speaking?

I do not believe that the benefits of having large, firm breasts are only felt in the sphere of sexual interactions, and I will turn later to other implications, but it is very important to me to acknowledge that this is one important motivation for women to undergo breast augmentation, and that there is nothing wrong with this.

We have already seen that men – through no decision of their own, but through genetic predispositions – are attracted to women who appear youthful, and that breast size and shape are an important subconscious clue for men to a woman’s vitality. In other words, until we can change men’s genetic makeup, breast size will be a factor in sexual opportunities available to a woman, and sagging or flaccid breasts will signal to men that a woman is not a desirable mate.

This standard of beauty, which my opponent would have us believe was designed by men for men, was in fact designed by nature for reproduction of the species, over eons of human history in which reproduction was far from assured. We now live in a world where women live long past the age of childbearing, and desire to have an ongoing satisfying sexual life even if procreation is not the goal.


An Imperfect World

As I reiterated above, we are in the process of female empowerment; we have not reached the goal yet. A related and ongoing demographic change is occurring with respect to age – as people are living longer and longer, issues of age discrimination are arising, particularly in employment opportunities.

While it would be nice to live our lives as though we were genuinely not judged based on our sex, age, or appearance, this is not a practical solution for most people. Numerous studies have shown that attractive people are more likely to be hired than less attractive people, that older people are less likely to be hired than younger, and that women are less likely to be hired (or are likely to be funneled into lower-status positions) than men. Moreover, these prejudices are additive – an older woman may find it more difficult to get employment reflecting their abilities than an older man person or a younger woman. (1)

In this imperfect world, physical attractiveness is a professional as well as a sexual asset. And as we discussed in relation to the sexual sphere, a woman’s age is subconsciously projected based on her body and particularly on her breasts. An older woman whose breasts have lost their fullness and lift finds herself in the unenviable position of being judged both old and unattractive – combined with being female, this is a serious handicap in the professional world. What is more, it may be more difficult for her to find flattering clothes, since women’s clothes are generally cut for a youthful figure, and she may lack the confidence in her physical presence that is so important in an interview situation. In short, she may decide that the benefits of breast lift and augmentation will be well worth the sacrifice and risks. While it is not right that a woman be judged this way in the workplace, it does happen, and if striving to fit the preferred image will enable more women to reach positions of more power, it can only further female empowerment in the long run.


Self Esteem and Breast Augmentation

This is certainly not a procedure done by a woman to demonstrate her “active vitality” to other women. This is a procedure that seeks to gain the favor, and the approval, of those they seek to attract; the men who hold the balance of power over them.

My opponent sees this as a black and white issue – if women are not choosing breast augmentation to impress other women, they must be doing it to curry favor with men. I hope that my discussion of employment opportunities has suggested how complex these issues actually are.

Add to this complexity the intricacies of female self esteem and there is no way to argue that breast enhancement has but one motivation. Causes and effects are intertwined and spiraling – increased confidence in one’s body may increase one’s likelihood of finding a mate, or getting a promotion, either of which may in turn increase self esteem and confidence – it is a complicated and unique permutation of factors for every woman.

My opponent may choose at some point in this debate to argue that studies which show increased risk of suicide among women who have had breast augmentation surgery are evidence that it cannot benefit a woman’s self-esteem.

I ask that you not be seduced into the mechanistic interpretation. There have been no studies that suggest that women who commit suicide after breast augmentation did not suffer from low self-esteem and depression before the surgery.

Breast enhancement is not going to make someone who is miserable with themselves be not miserable with themselves, and I think that research into identifying before surgery women with unrealistic expectations is crucial. But this is not evidence that implants never increase self-esteem.

Figueroa-Haas bristles at the idea that it's frivolous for women to want to improve their body image. Body image, she says, is an important factor in a woman's self-esteem.

"A lot of people consider plastic surgery a procedure that doesn't need to be done. They say women should stay with their bodies and what God gave them and be satisfied. I don't agree," she says. "This procedure does change women's psychosocial issues. There are differences [in life satisfaction] between people with good and poor self-esteem."

…

After getting breast implants, women experienced every measure of sexuality more strongly, Figueroa-Haas found. After breast augmentation, women reported significant increases in arousal, sexual desire, sexual satisfaction, and lubrication.

Figueroa-Haas says women tend to be left out of the discussion when it comes to enhancing sexuality.

(2)

Perhaps we would prefer that women boost their self-esteem in more cerebral ways, or through athletics, or volunteer work. But what is right for some is not right for all, and many women do benefit psychologically from the choice to have augmentation surgery.


[edit on 11/16/2008 by semperfortis]

I made an error when posting my Opening Statement, posting an complete draft, and although my opponent graciously offered me the opportunity to redact, I decided to ‘play by the rules’.

Due to that I am late in offering my thanks to the Readers, Judges and my Opponent for the opportunity to explore this fascinating subject. I would also like to add an especially deep curtsy to Semperfortis for all of his time and effort in bringing this debate to pass.

FIRST REPSONSE

My opponent begins her opening by trying to clarify what “female empowerment” means in what she calls the “traditional sense.” Yet she begs the question, defining empowerment as “seeking ways to be empowered” when what needs defining is what it means to be empowered.

To avoid the tedious pitfalls of semantics, I will come right to the point and say that:

My opponent is apparently hoping to make her case around the philosophy that if it ‘feels good do it’ in her exampling of ‘self-esteem’, and then in turn trying to show those examples of ‘self-esteem’ as an example of Female Empowerment. By doing this she not only overlooks the larger case of Female Empowerment as a movement for the sex, but also ignores the mounting and consistent data that clearly shows a marked increase in deleterious effects for women who embrace this procedure.

First I would like to address the distinctions between self-esteem, as so defined by my opponent, and the primary aspect, or tenet, of empowerment which is self-worth.

Feeling Good about yourself is a transitional and impermanent state

As my opponent cited, it is possible that a woman could make a decision to augment her breasts to better fit into ‘youthful clothes’ and be more competitive in the patriarchal dictated work environment and in turn get promoted, or hired, for a job based on standards of youthful bias. In this moment she could even ‘feel good about herself’ and have her ‘self-esteem’ boosted by the results.

The same would hold true if she was at a party wearing a ‘hot dress’ that displayed her purchased cleavage to effect and attracted a lot of desired attention from a member of the opposite sex.

Her self-esteem may be boosted in either of those moments; but it is not going to help her in a time of psychological crisis that would be caused by by a man who was duped into believing she is more youthful than she actually is, spurning her when he realizes the truth of her diminished fertility/age. Nor will it aid her in the event of a missed deadline, or failure, for whatever reason, at her place of employment.

This is because the kind of self-esteem generated by her choice ceases to be functional, it ceases to be functional because it dos not speak to her true sense of self-worth

Self-worth is a normative state

A sense of self-worth is the knowledge of having a personal value that is not predicated on the transitional or impermanent. And I think we can all agree that a natural change of one’s physical appearance is a constant, and defining, factor of the Human Condition. To fear or mask the true reality of what is innate to an oneself not only does not allow for a sense of self-worth, but I would argue undermines it.

Now, if our woman had a sense of self-worth that was based in a truth of who she really is and value was placed on that truth, and that value was mirrored by a society that did not require her to engage in a form of self-mutilation to be more sexually desirable, or gain employment at the place where she is now in crisis, she would be able to fall back on that in her time of challenge. But she does not truly have that as a result of breast augmentation because she has embraced a deleterious personal belief system as to where her self-worth lies.

This is not empowerment in any form, but a sign of the subtle psychological tyranny of a power structure that women, as a sex, are seeking to break free from -- a patriarchal power structure that creates false definitions of where a woman’s value lies.

I ask that you not be seduced into the mechanistic interpretation. There have been no studies that suggest that women who commit suicide after breast augmentation did not suffer from low self-esteem and depression before the surgery.

Dear Readers and Judges, before we dismiss out of hand these studies you are so diligently being asked to disregard as ‘mechanistic’, let’s look at the most recent one from August, 2007:

The report in the Annals of Plastic Surgery’s August issue was the most recent to detect a higher suicide rate among women who had their breasts enlarged, providing a gloomy counterpoint to studies that showed women felt better about themselves after getting implants. (emphasis mine)

1:1

As you can see it is simply untrue that there have been no studies that look at the long term psychological effects of breast augmentation. To that end I would like to present another article that discusses this same study:

Swedish women who received cosmetic breast implants had suicide rates that were 3 times higher than other women; the risk appeared 10 years after surgery. Deaths due to drug and alcohol abuse also increased 3-fold in the women who received breast augmentation.

These findings are based on data from a cohort of Swedish women who received breast implants from 1965 to 1993 and were followed for an average of almost 19 years.

2:1
So we see it is not only increase of suicide but also alcohol and drug abuse as well. Now let’s consider:

Five other studies all showing increased risk of suicide

The researchers explain that 5 previous epidemiologic studies looked at mortality patterns among 5 cohorts of women in Sweden, Denmark, Finland, Canada, and the United States who received cosmetic breast implants. These studies all reported an approximately 2- to 3-fold higher rate of suicide in the women who received implants compared with other women.

The current study aimed to gain further insight into the relationship between implants and suicide by looking at a cohort of 3527 Swedish women who had previously been followed for a mean of 11.3 years, extending this follow-up to a mean of 18.7 years (range, 0.1 – 37.8 years).

The women, identified by a national registry of hospital discharges, had undergone cosmetic breast augmentation (mostly silicone gel implants) for the first time from 1965 to 1993. The women had a mean age of 32 at the time of surgery.

Overall, 175 women with implants died during follow-up, vs 133.4 expected deaths based on mortality rates of age-matched Swedish women. A total of 24 women with implants committed suicide, vs 8 expected deaths from suicide (standardized mortality ratio = 3; 95% CI, 1.9 – 4.5). The elevated rate of suicide was seen after 10 years. Suicides were higher in women who were aged 45 years and older at the time of breast augmentation. (emphasis mine)

2:2

It seems we have two choices to consider here when parsing this data and they are not mutually exclusive:

a) Women with mental health issues are more likely to embrace the ideology of breast augmentation as an answer to their problems or empowerment issues

b) The failure of breast augmentation to meet up to women’s expectations of empowerment is so disillusioning as to create tendencies to drug/alcohol abuse and suicidal despair

It is my position, and strong belief, that the reason for this is caused by cognitive dissonance.

Women who pursue this kind of surgery ‘believe’ they are going to have greater ‘self-esteem’ because they feel better about themselves and will be more functional, vibrant participants in a society that is dictating to them that they have less value in their natural state. Hence, psychological crisis and disappointment ensues.

Answers to SQ’s

SQ 2: Do you agree that female empowerment is an ongoing process during which society transitions from male dominance to equality of the sexes at some future time?

Yes.

SQ 3: Do you agree that the period from 1890 to the present has seen a great increase in female empowerment?

In most parts of the Western World, yes.

SQ 1: Is “having an enhanced capacity to make choices and to transform those choices into desired actions and outcomes” a fair definition of “being empowered”? If not, what would you suggest?

Not if “the enhanced capacity of choice” is the choice to embrace a potentially harmful and unnatural standard that is set by the powers you are seeking to be liberated from.

I suggest that empowerment would be better exampled and defined by the act of not accepting an edict that is designed to please the oppressor.

Second Response

Psychological Considerations

As you can see it is simply untrue that there have been no studies that look at the long term psychological effects of breast augmentation.

It seems we have two choices to consider here when parsing this data and they are not mutually exclusive:

a) Women with mental health issues are more likely to embrace the ideology of breast augmentation as an answer to their problems or empowerment issues

b) The failure of breast augmentation to meet up to women’s expectations of empowerment is so disillusioning as to create tendencies to drug/alcohol abuse and suicidal despair

Not only are the two possible explanations my opponent offers not mutually exclusive, I would argue that the one is the direct precedent of the other – as I alluded to when I noted in my last post that no reliable studies have been done to discern whether there is a predisposition to depression or suicide among women who have had breast implants.

Women with mental health problems often look to external or physical changes to fix what is essentially an emotional and spiritual issue – these women are liable to be disappointed. But we cannot blame the item they tried to “fix” themselves with for their despair.

How many women with self-esteem problems have ended up in unhappy relationships because they believe having someone will make them feel better? Would my opponent like to rule out relationships, which have a definite tendency to lead to disappointment, and sometimes even drug or alcohol abuse and suicidal despair?

There is an urgent need for women to be screened for psychological health before undergoing breast augmentation surgery. But among women who go into surgery with realistic goals and expectations, there is overwhelming patient satisfaction.

Dr. David B. Sarwer has written some of the most-referenced papers documenting the link between breast implantation and suicide, and is the Director of Clinical Services at the University of Pennsylvania School of Medicine Center for Weight and Eating Disorders. As a psychological expert he wrote an article titled “Psychological Considerations of Breast Implant Surgery” for the website breastimplantanswers.com which begins:

Women considering any form of cosmetic surgery, including breast implants, often wonder, "What does the desire to have surgery say about me?", "What does it say about my self-esteem and my perception of myself?" And, lastly, "What will other people think about me if I have surgery?" These questions and concerns are understandable, given the numerous myths and misperceptions about the people who consider and undergo cosmetic surgery.

In short, the research suggests that the large majority of women who consider and/or undergo cosmetic surgery are both physically and mentally healthy. They view surgery as an option to address specific appearance concerns and physical changes often caused by major life events, such as the birth of a child or significant weight loss. Contrary to popular belief, these women are not trying to achieve “perfection” or satisfy other individuals, and they don’t suffer from self-esteem or self-confidence issues (no more so than the general population).

(1)

In the abstract to a review paper also authored by Dr. Sarwer, we read:

Although the first study of this issue suggested that the rate of suicide among women with breast implants was greater than that of women who underwent other forms of cosmetic surgery, the largest and most recent investigation in this area found no difference in the rate of suicide between these two groups of women.

(2)

And finally, in a paper co-authored with Elizabeth Didie and published in the Journal of Women’s Health:

Conclusions: Overall, breast augmentation patients appeared to be motivated by their feelings about their breasts rather than direct or indirect influence from external sources, such as romantic partners or sociocultural representations of beauty. These findings provide new information on the motivations behind breast augmentation and dispute several stereotypes about the factors that influence the pursuit of this surgery. Emphasis mine

(3)

While the link between breast implants and suicide rates is of grave concern, and highlights the need for responsible screening of candidates, the evidence points to the fact that most women who choose breast augmentation do so for their own satisfaction, studies show that most women’s self-esteem does improve after various forms of plastic surgery including breast enlargement, and the vast majority of women report that they are happy with the results of their surgery. (2)


The Benefits of Being Physically Attractive

In response to the points I raised about how breast augmentation may increase how attractive a woman is considered, which in turn will increase her opportunities not only romantically but in many other areas of life in which (however unfair and unfortunate this is) attractive people are favored over the unattractive, my opponent says:

Her self-esteem may be boosted in either of those moments; but it is not going to help her in a time of psychological crisis that would be caused by by a man who was duped into believing she is more youthful than she actually is, spurning her when he realizes the truth of her diminished fertility/age. Nor will it aid her in the event of a missed deadline, or failure, for whatever reason, at her place of employment.

Perhaps it is worth emphasizing that the benefit of beauty will not operate on a conscious level in these situations; that men are biologically programmed to find firm, high breasts physically attractive. This does not imply that they actually want a mate who will provide offspring to them. There is no need for subterfuge, because while we choose our partners at a conscious level, based on many things including whether their plans for a family in the future are compatible with ours, we do not choose our immediate physical attractions.

Similarly, in the employment situation, there is a real bar on employment opportunities offered to the older or more unattractive person. Removing these hindrances by doing what one can to minimize these assessments (which again are unconscious) simply levels the playing field so that these women have equal access to jobs as equally qualified younger women.


Female Empowerment, Self Worth, Self Esteem

My opponent is apparently hoping to make her case around the philosophy that if it ‘feels good do it’ in her exampling of ‘self-esteem’, and then in turn trying to show those examples of ‘self-esteem’ as an example of Female Empowerment. By doing this she not only overlooks the larger case of Female Empowerment as a movement for the sex, but also ignores the mounting and consistent data that clearly shows a marked increase in deleterious effects for women who embrace this procedure.

First I would like to address the distinctions between self-esteem, as so defined by my opponent, and the primary aspect, or tenet, of empowerment which is self-worth.

I am baffled at where my opponent got the idea that I am arguing “if it feels good, do it” but I confess to having a more nuanced view of self esteem and self worth than she is asking us to consider.

Thus far in my argument I have made no distinction between what my opponent terms “self-esteem,” which is apparently a good feeling about oneself based on the transitional, and “self-worth,” which is apparently a good feeling about oneself based on the permanent. I am willing to accept this distinction, but would ask readers to be aware that it is not one I have made thus far.

I do not see self-esteem and self-worth as being in opposition to one another – where my opponent apparently believes that a woman who feels good about her appearance will not feel good about her abilities, I have made no such assumption. Indeed I think that self-esteem and self-worth reinforce each other, as each contributes to a woman’s confidence and comfort in herself.

I am considering Female Empowerment to be neither self-esteem nor self-worth (although both will benefit from the empowerment of women) but a sociological shift allowing women greater access to choices and to opportunities, and greater autonomy over their bodies and their lives.

And I think that includes the choice to make oneself sexually attractive to men, if one wishes to be sexually involved with men. Also the choice to participate in various behaviors that improve one’s opportunities in professional life, including altering one’s appearance.

Women have suffered for centuries from having men make decisions for them. Let’s not start trying to make decisions for each other now.

SECOND RESPONSE

Please allow me to begin where my opponent ends:

Women have suffered for centuries from having men make decisions for them. Let’s not start trying to make decisions for each other now.

And take the opportunity to remind her that the title of this debate is not: “Is Breast Augmentation a Choice That Should Be Denied Women”, but is indeed “ Breast Augmentation is Necessary for Female Empowerment”.

THE FEMININE BEAUTY STANDARD AS SUBORDINATION

Breast Augmentation is antithetical to Female Empowerment because it is a manipulated beauty standard used to demonstrate that women are subordinate to and weaker than men.

To further example this I ask that you consider that breast reduction is the fourth most popular plastic surgery that men undertake, outstripping hair replacement surgery almost 2-1. Link

Of course beauty standards for women have changed throughout history. We have, in the last century, seen the rib-breaking, crippling corset give way to the ‘boyish-look’ bound breasts of the 1920’s. Then after the Second World War -- and some would argue as a response to the brief era of women going into the workplace for the first time en masse -- the standard of the wasp-waisted, high-heeled buxom bombshell becomes the norm.

Today we see a slightly different version of ‘buxom as the beauty ideal’ in that the standard is now that large breasts should be accompanied by a body too thin to produce or sustain them in a natural state.




And while these beauty standards have changed overtime, they have never changed to anything other than that which is both a ‘complement’ and a ‘compliment’ men. Namely emphasizing women’s physical weakness to men and presenting a hyper-sexualized, fetishized version of the female form that calls for both protection and dominance.

AT WHAT COST THIS ‘SELF-ESTEEM’?

In response to the statement my opponent made in an earlier post:

… and if striving to fit the preferred image will enable more women to reach positions of more power, it can only further female empowerment in the long run.

I would like to excerpt from my opponents own link and call our attention to a statement written by the esteemed Dr. Sarwer that my opponent did not see fit to include in her argument:

It is unlikely that breast implants will have a significant impact on other areas of your life, such as your job or relationships.

1:1

This, I think, speaks directly to the larger point that my opponent is trying to base her case on. Namely, that women will benefit in the larger world – romantic partnerships, better employment opportunities etc. -- as the result of the ’unconscious’ psychological power of their enhanced bosoms. But there is simply no evidence that women are gaining in positions of power because they have breast augmentation. Regardless of their increased ‘self-esteem’

While the suggestion that psychological screening for breast augmentation candidates is a fine one, suicide is far from the only mortality issue that women who undergo breast augmentation face.

Death
A more recent NCI study found that women who had breast implants for at least 12 years were more likely to die from brain tumors, lung cancer, other respiratory diseases, and suicide compared with other plastic surgery patients.22 Augmentation patients were not more likely to smoke than other plastic surgery patients, so the difference in respiratory diseases did not appear to be due to smoking.

2:1

And there are a host of other issues that speak to a decline in the quality of life of women who undergo that augmentation procedure:

Cognitive Problems
Women with implants have raised concerns about memory loss, difficulties with concentration, and other cognitive problems. FDA's analysis of industry data found a significant increase in neurological symptoms, such as poor concentration, for women who had silicone implants for two years compared to their symptoms just prior to getting implants. These differences were maintained even when the women's ages were statistically controlled.

2:2

Cancers
A study by National Cancer Institute (NCI) scientists found a 21% overall increased risk of cancer for women who had implants for at least seven years, compared with women of the same age in the general population.21 The increase was primarily due to an increase in brain, respiratory tract, cervical, and vulvar cancers.

2:3

And then there is the financial costs, which are not simply limited to the expense of the initial procedure -- on average $5000-$10000 dollars. Women who have opted for the silicone implants can expect to spend $2000-$5000 every few years for MRI’s if they are following the FDA recommendations. 3

In another study 67% of women with all types of implants had rupture in at least one breast. Also, please note that 1/3 of the women study had previously undergone another costly procedure to have at least one implant replaced.
4

So what we are left with when we look beyond a woman’s initial increased ‘self-esteem’ after the breast augmentation? We find multiple studies showing increased mortality both by suicide and various cancers.

We see a loss of cognitive function associated with the procedure and a lifetime of expensive MRI’s with a great likelihood of potentially painful surgeries to maintain their augmented breasts.

So women who engage in this procedure, based on what that various studies indicate, are going to potentially be:

• Less Intelligent
  
• Have fewer financial resources
  
• Are far more likely is endure a lifetime of serious adverse health effects
  
• And have a far greater statistical increase of dying at an earlier age than those women who do not have the procedure.
  

Judges and Readers, I would put forth that if a personal choice to boost our ‘self-esteem’ leaves us potentially dumber, broke, dying or dead -- empowered we most certainly cannot be.

Third Response

Dumber, Broke, Dying or Dead

The picture for women with breast implants that my opponent paints is accurate in some ways, but it is also misleading. The article she cites claiming high rates of cancer after breast augmentation does not mention whether they are including women who have implants as reconstructive surgery after mastectomy for breast cancer – which could certainly be a factor increases the incidence of cancers later. Similarly, the article points to high rates of cervical and vulvar cancer – both of which are linked directly to the HPV virus. So an equally valid hypothesis to explain the linkage is that women who get breast implants are more likely to have been exposed to HPV – it is entirely possible that they would have had cancer even if they hadn’t undergone breast augmentation.

So we have a statistical links to suicide and to cancer, both of which very likely reflect preexisting conditions rather than having a direct link to breast implants.

As for cognitive problems after breast augmentation: the source my opponent used provides its source in its notes: an FDA PowerPoint presentation from 2002 assessing whether or not to approve Inamed Corporation’s silicone-filled breast implants for the general market. The result? They did not approve the implants used in the studies cited.

If that’s the best that an anti-implant site can do to link cognitive problems to implants, the evidence that choosing breast augmentation will leave us dumber seems dubious at best.

I will grant that both the procedure and the followup are expensive and will leave us significantly poorer. Surely it is the right of the empowered woman to choose how to spend her money.


Doctor Knows Best

Dr. LERNER: Well, I think the women's health movement contributed in many ways. The first and most important way was that they forced doctors, male doctors in particular, even women doctors, to listen to the patient. Again, the standard in the 1970s was for doctors to make the decisions. Occasional patients would object but most patients would simply do what the doctor said. And what women in breast cancer activism did for women with many diseases, for all women in fact, announced through women's journals--I'm sorry, women's magazines, for example, and newspaper articles, that it was OK to talk back to your doctor, it was OK to even go to the library and read up about your breast cancer. It was OK to talk to other women and, in fact, other women often knew as much or more about certain aspects of breast cancer than doctors did.

For example, doctors paid very little attention to the emotional aspects of breast cancer. I heard a story about a doctor who once said to a woman who was complaining about the fact that she'd lost her breast and emotionally devastating it was, said to her, 'Oh, come on. Go stuff an old stocking in your bra and get on with your life.' Now that was a particularly harsh way of dealing with this patient, but the attitude was not dissimilar of other doctors. Many people at that time felt, 'Look, isn't it most important that we save your life? Can't you deal with the loss of a breast?'

(1)

The above excerpt from a radio interview of Dr. Barron Lerner is revealing in so many ways. Before the feminist and women’s health movements of the 1970s, women with breast cancer signed a permission form allowing the doctor performing a biopsy on a suspicious lump in her breast to make the decision to remove the entire breast while she was still anaesthetized from the biopsy. In other words, women went into a biopsy not only not knowing whether or not they had cancer, but not knowing whether or not they would wake up with a breast missing! Reconstructive surgery was not routinely offered as it is now – little attention was paid to the emotional impact of a mastectomy. One wonders if the surgeons would have been quite so cavalier to a male patient who had just lost a testicle.

Another interesting episode in the history of cosmetic surgery and feminism is the story of Madame Suzanne Noel, who began her medical studies in 1905. (2) She became a famous cosmetic surgeon in Paris, earning the Legion of Honor award. She is also credited with inventing an important technique in breast reduction surgery. But she herself identified the start of her dedication to cosmetic surgery as having occurred during a facelift performed on a woman who could not find employment because she was too old – after surgery, the woman immediately found a position.

In addition to her surgical practice, Madame Noel campaigned for women’s suffrage, wearing a ribbon, marching, and even organizing a tax protest, convincing women not to pay taxes which they had no vote in deciding. By any standard, Madame Noel must be considered an empowered woman for the period in which she lived – and she saw no contradiction between using surgery to make women more beautiful and campaigning to make them more powerful.

A common theme to the stories of Mme Noel and the women’s health movement in the 1970s is that women’s concerns were heard where they had been ignored before. The woman on whom Mme Noel performed that life-transforming facelift came to the doctor with a problem, and rather than dismissing her problem or urging her to accept her lot, Mme Noel made it possible for her to find employment. Women activists in the 1970s finally spoke up and made their voices heard, telling doctors that it is not okay to dismiss the very real loss that occurs in a mastectomy, and tell a woman to stuff her bra if it bothers her. They proclaimed something that had never been proclaimed before: that even cancer survivors have the right to want to look good. They demanded reconstructive surgery and breast implants after mastectomy because they were asserting their right to their own bodies.


Breast Augmentation and Female Empowerment

My opponent has quite rightly pointed out that the subject of this debate is not whether breast implants should be legal, but whether breast augmentation is necessary to female empowerment. The reason I have spent so much time on the history of cosmetic and reconstructive breast surgery has been to demonstrate the intimate relationship between the history of this particular surgery and the process of female empowerment.

Breast augmentation is a form of female empowerment because it is an option that a woman can choose for herself, after weighing the advantages and disadvantages. And whether or not my opponent will come out and say it, increase in choice is a major part of empowerment.

Breast augmentation is also a necessary result of this process of female empowerment. As women gained a voice in their medical decisions, they demanded that doctors pay attention to the things that matter to them – and in the instance of breast cancer survivors, one of the important aspects that was being missed was attention to the need for reconstructive surgery. To a woman, her breasts are not solely sexual objects designed to attract men. As girls, we eagerly await the first signs of breasts: they are a symbol of womanhood. As mothers, we feed our children from our breasts: they are a symbol of nurture and unconditional love. And yes, they are a symbol of our sexuality and of our sexual desirability. Breasts are important to women, and empowered women demand that the medical profession do its best to address that.

Finally, breast augmentation has been a necessary enabler for female empowerment. As we stake claim to our bodies and our rights to make our own decisions, certain battlefields have emerged. One of those is the ethics and morality of breast implants. And a war cannot be won without a field to fight on. In just the last thirty years, women have driven the mainstreaming of breast augmentation, asserting that care for appearance does not make a woman shallow or sinful. In the process, they had the opportunity to demand that their complaints about silicone implants be listened to, and they convinced the FDA to remove them from the market for over a decade. During that decade, they demanded that the right to silicone implants be restored, and once the claims of harm were dismissed, it was.

In the fights over breast implants, women have been realizing their empowerment in a way and with a freedom that they have not been able to in areas of more direct concern to men. Because this is a women’s health issue, it has been crucial for the development of female empowerment with regard to medicine and to the right to make decisions about their own body.

THIRD RESPONSE

Let’s begin, once again, with getting our facts straight. My opponent would like to believe that:

The picture for women with breast implants that my opponent paints is accurate in some ways, but it is also misleading. The article she cites claiming high rates of cancer after breast augmentation does not mention whether they are including women who have implants as reconstructive surgery after mastectomy for breast cancer – which could certainly be a factor increases the incidence of cancers later.

The abstract from that study states:

Abstract:

Much attention has focused on disease risks among women receiving silicone breast implants, but there has been little evaluation of their mortality experience. We undertook a retrospective cohort study of 13,488 women receiving cosmetic implants and 3,936 patients with other types of plastic surgery at 18 plastic surgery practices. After an average of 13 years of follow-up, deficits in overall mortality were found as compared with the general population (U.S. rates) for both implant [255 deaths; standardized mortality ratio (SMR) = 0.69, 95% confidence interval (CI) = 0.6-0.8] and comparison subjects (125 deaths; SMR = 0.58, 95% CI = 0.5-0.7).

These findings indicate that patients seeking plastic surgery are in general healthier than their peers. Implant patients, however, experienced excess risks of death compared with the general population for brain cancer (SMR = 2.45) and suicide (SMR = 1.54). Internal analyses showed a higher overall mortality among the implant than among the comparison patients (relative risk = 1.27, 95% CI = 1.0-1.6). This overall excess reflected increases for respiratory tract (SMR = 3.03) and brain (SMR = 2.25) cancers and for suicide (SMR = 4.24).

(emphasis mine)
1

Based on the wording of the abstract I believe we can safely assume that women who had mastectomies were not part of the study.

When we consider my opponent’s hypothesis of:

Similarly, the article points to high rates of cervical and vulvar cancer – both of which are linked directly to the HPV virus. So an equally valid hypothesis to explain the linkage is that women who get breast implants are more likely to have been exposed to HPV – it is entirely possible that they would have had cancer even if they hadn’t undergone breast augmentation.

And since the study was carried out by the:

National Cancer Institute (NCI) scientists found a 21% overall increased risk of cancer for women who had implants for at least seven years, compared with women of the same age in the general population.

(emphasis mine)

If we use the logic of her hypothesis, we are left with women who are more sexually active in the act of unprotected sex being the more likely candidates for breast implants. Which in turn paints a psychological portrait of these women that does not reflect one of judicious choice or indicate a history of wise choices when choosing how to show themselves as empowered.

As to cognitive function, most of the scientific papers of studies that reveal these findings are required to be purchased. I will include a link to a study where we can see an abstract that shows in conclusion:

Furthermore, the diversity and distinction of silicone adjuvant breast disease may require the medical community to accept it as a new entity, encompassing a neurological and connective tissue disorder.

(emphasis mine)
2

And here is an article by Andrew W. Campbell, M.D. Medical Director Center for Immune, Environmental and Toxic Disorders where he cites a terrifying list of common complaints of 4000 women sampled. Among them:

cognitive function problems, such as attention deficit disorder, calculation difficulties, memory disturbance, spatial disorientation, frequently saying the wrong word

3

Upon further examination of the facts – and since my opponent and I concur on the financial costs - I believe my assessment that women who have augmented breasts are more likely to find themselves dumber, broke, dying or dead is sadly the case. And I believe quite clearly examples that breast augmentation is antithetical to female empowerment.

As to my opponents specious claim that the Women’s Movement is being exampled through the unfortunate choice of women to increase their breast size; Judges and Readers I find them so farfetched and overreaching that I am almost hesitant to address them lest I too get caught-up in their wrong-headedness.

The Women’s Activists of the 1970’s fought for a broad scope of women’s issues and the rights of women to seek breast augmentation was by no means at the top of their agenda, if on it at all.

THE BURNING BRA

The iconic association tied to the Women’s Movement of the 1970’s – the same time as the use of silicone implants begun to explode, becoming mainstream in America – was the ‘burning bra’. And while the story was manufactured by a female journalist in 1968 seeking to emphasize the Women’s Movement -- to showcase it as valid as the Vietnam protests -- the actual incident that spawned her journalistic exaggeration was:

As a small group of feminists prepared to launch their emerging women's liberation movement onto the national stage by protesting the 1968 Miss America pageant, they had no idea that the media was about to give them a new moniker: "bra burners." ….

Women threw bras, mops, girdles, pots and pans, and Playboy magazines — items they called "instruments of female torture" — into a big garbage can.

www.npr.org... " target="_blank" class="postlink" rel="nofollow">4

We can see from this incident, which is often cited as the beginning of the Women’s Movement of that era, that its foundation was to empower women by liberating them from the tyranny of male domination through the sexualization and “torture” of the female form.

It was not founded on freeing women from the paternal instincts of doctor’s, although as the women’s movement created a greater dialogue amongst women about the various issues they faced, confronting the male dominated medical establishment on a personal one-on-one basis when seeking treatment was certainly a topic of discussion. Women benefitted from the dialogue by empowering themselves to confront the medical establishment on every front, not just in the instance of breast augmentation or the treatment of breast cancer.

I will go so far as to say, that breast augmentation was antithetical to Women’s Movement of that era and that the rise of women getting implants in the 1970’s is not exampled by women who were activists or supporters of female liberation, but the women who sought to assuage men’s fears about their changing roles in society, consciously or not.

While the story of Mme Noel makes for interesting reading, and certainly examples an empowered woman, the tale of the woman who supposedly gained employment due to a facelift is conjecture at best, she may just as likely have gained employment after her procedure because she happened to apply for a job to which she was better suited.

And as we know the topic of debate is not: is plastic surgery required for female empowerment, but specifically breast augmentation. Which brings us to:

MASTECTOMIES AND IMPLANTS

It seems my opponent would now like to make her case that breast augmentation is necessary to female empowerment by taking the position that women who undergo mastectomies and choose to augment, or reconstruct, their breasts embody an empowered woman. I consider this is a perilous course, as there is ample evidence that mammograms are 55% less effective in finding tumors in women with implants.
5

This is bad news for all women with breast implants, but exceedingly bad news for women who are survivors of cancer, where constant screening is necessary for at least the first five years after cancer is detected in the breast, as the risk of cancer is never entirely eliminated by mastectomy.

I would argue that just because women have a ‘choice’, which is certainly part of empowerment, using that option to make an arguably poor choice, a choice that is based on societal standards that equate femininity with breast size, at a time when you are fighting for your life shows how powerful and pervasive the male dominated society we live in is and further illustrates why breast augmentation is antithetical to female empowerment.

Final Rebuttal

If we use the logic of her hypothesis, we are left with women who are more sexually active in the act of unprotected sex being the more likely candidates for breast implants.

Since HPV can be spread during protected as well as unprotected sex – the virus can be active on parts of the genitals not covered by a condom – this is not quite accurate. Any hypothesis on either my or my opponent’s part is simply a guess; studies would be needed to ascertain the true mechanisms, and those studies would also need to take into account how much more we know about HPV and cervical cancer now than we did even ten years ago.

As to cognitive function, most of the scientific papers of studies that reveal these findings are required to be purchased.

I will just note that the abstract my opponent cites in her last response suggesting that “silicone adjuvant breast disease” may be a novel disorder that may require recognition is dated 1999, before the FDA’s review of the literature on silicone implants prior to their reintroduction to the cosmetic market. Her other new source for evidence of cognitive effects is undated and seems to refer to self-reported but unsubstantiated claims – the cognitive disfunctions do not appear on the list of common findings on physical examination of the complainants.

The Women’s Activists of the 1970’s fought for a broad scope of women’s issues and the rights of women to seek breast augmentation was by no means at the top of their agenda, if on it at all.

My specific claim was actually that the Women’s Health Movement, which is an aspect of the more general feminist movement of the 1970s, demanded that the medical community listen to women’s concerns and feelings about their health and their bodies, empowered women by asserting their right to discuss and make decisions about their own health, and led among other things to the demand for research about and for sensitive treatment of breast cancer – including reconstructive surgery rather than radical mastectomy and “quit complaining and put a stocking in your bra” attitude.

Here is an excerpt from Carol Downer’s 1972 speech to the American Psychological Association entitled “Covert Sex Discrimination Against Women as Medical Patients:

In what has been described as "rape of the pelvis, " our uteri, and ovaries are removed often needlessly. Our breasts and all supporting muscular tissue are carved out brutally in radical mastectomy. Abortion and preventive birth control methods are denied us unless we are a certain age, or married or perhaps they are denied us completely. Hospital committees decide whether or not we can have our tubes tied. Unless our uterus has "done its duty, " we're often denied.

(1)

While breast implants may not have been at the forefront of the minds of many1970s feminists, and they very likely would have dismissed them as anti-feminist, as a woman I can’t help but feel that the right to participate in my own medical decisions has been a more deeply empowering experience than the right to go braless and not shave my armpits. And as a woman approaching middle age, with the prospect of requiring far more medical intervention in the next forty years than in the first thirty-seven, I thank the women’s health movement of the 1970s and 1980s for pressuring the medical establishment into including women in research studies, actively seeking out gentler and less physically destructive means of treating particularly female cancers, and insisting that women continue to be treated as having legitimate health concerns worthy of full attention even after their child-bearing years are over.

And the history of breast implants is in part the history of breast cancer treatment. While the focus of this debate is on cosmetic breast augmentation, the role of breast cancer activists in demanding humane treatment as well as effective treatment cannot be left out of the picture.

As a final note on breast implants in post-mastectomy reconstruction surgery, I will note that I found on my opponent’s anti-implant source two pieces of excellent news: that new methods of breast augmentation that do not involve implanting a foreign material have been introduced and are in testing and that there is evidence from a Japanese study that while mammograms are less effective in screening for breast cancer in women with implants, ultrasound may prove effective. (2)

No doubt further advances in medical science can be expected in the upcoming years, making breast augmentation ever less risky. All surgery, indeed all medical intervention, carries risk – it is the responsibility of the medical practitioner to make sure that the patient is fully aware of the risks involved, whether psychological, financial, or physical. It is the responsibility – and the right – of the patient to determine whether the benefits outweigh the risks.


Closing Statement

nec⋅es⋅sar⋅y
4. Logic.
a. (of a proposition) such that a denial of it involves a self-contradiction.
b. (of an inference or argument) such that its conclusion cannot be false if its supporting premises are true.
c. (of a condition) such that it must exist if a given event is to occur or a given thing is to exist. Compare sufficient (def. 2).

(3)

I have argued that the history of breast augmentation and the history of female empowerment have been intrinsically linked – that developments in breast augmentation surgery have been a natural and necessary result of the empowerment of women with respect to their own health and bodies.

Although I can’t assert with certainty that Mme. Noel performed breast augmentation, since her 1926 book on cosmetic surgery is not available online, there is no reason to assume that it was not one of the services she offered, along with facelifts, body sculpting, and breast reduction. That an obviously empowered woman would choose to devote her considerable surgical talents to helping other women through cosmetic surgery makes it clear that, to her, there is no opposition between female beauty and female empowerment. She reports that her interest in cosmetic surgery stemmed from the experience of giving another woman an opportunity to support herself, which had been denied to her before surgery. While we can’t go back in time to verify this claim, her belief stands on its own.

The changes in women’s health care since the steps taken in the 1970s have been vast. Although not fully implemented – there are of course still doctors who believe that they know what’s best for a female patient better than she does – the progress is tremendous. In the case of breast cancer survivors, we see clearly that the old, patriarchal, model was to treat women who were unlikely to continue their reproductive service as unreasonable for wishing to continue to be physically appealing.

I am reminded of the recent acid attacks by Taliban members in Afghanistan threatened by the empowerment of young women in that society. Nothing is more threatening to patriarchal systems than the assertion by women that they can be attractive and empowered.

Breast surgery – both cosmetic and after breast cancer – has also been a particularly important battleground for women’s empowerment in medicine because it allowed women to establish themselves as experts on their own needs in medicine. This experience has in turn allowed other advances in medicine that could not be attempted until women had a secure foothold. In particular, the 1990s saw the beginnings of the acknowledgement that heart disease presents very differently in men and women, and that failure to include women in medical studies had created a gap in quality of care for men and women. Since the turn of the 21st century, there has been increasing outcry over the tendency of the medical establishment to view all pre-menopausal women as “pre-pregnant”: to deny them treatments that might endanger a fetus, even if the woman is not sexually active; and to exclude them from medical studies on the basis that they might become pregnant. Since both of these are potentially threatening to men in a way that breast surgery is not, the experience women acquired in standing up to patriarchal medicine in the matter of breast cancer has been a vital help.

Women desire and demand safe, effective forms of breast augmentation, both post-surgery and for cosmetic reasons. The two cannot be separated, and it is disempowering to women to assert that breast implants are okay in reconstructive surgery but not in cosmetic surgery.

A woman whose breasts do not develop, or whose breasts are sized very differently, may feel just as deformed as a woman who has undergone mastectomy. My opponent’s example of cosmetic breast augmentation has been Pamela Anderson. I have been unable to present “before and after” photos of women who arguably have more reason to desire augmentation, because of site Terms and Conditions requirements forbidding images with nudity. But there are plenty of images of women available on the internet who are not choosing to go from a 34C to a 34F, but from no breasts to an A-cup, or from one A and one C to two Cs.

Because augmentation exists, denying women the option is inherently disempowering. Because augmentation has been an important battleground in progressive women’s health, it has contributed to female empowerment. Because empowered women have demanded access and improvement in the surgery, it is a result of female empowerment.

In all three senses – as necessary contribution, as necessary result, and as increased access to choice in self-determination, we have seen that:

Breast Augmentation is Necessary for Female Empowerment