Body
As cosmetic interventions have become more pervasive and, in some cases, younger, theologians, philosophers and bioethicists are urging that the ethical conversation catch up to the practice. The debate has played out across faith traditions and in medical-ethics discussions, with many experts focusing on whether cosmetic decisions reflect genuine agency or pressures amplified by social media and cultural beauty ideals.
In Los Angeles, 25-year-old Shula Jassell said she has periodically considered injectable fillers to change the size of her chin, but she has paused after weighing the practical and emotional implications of ongoing procedures. She said the effects last about a year and that surgery also scares her, as she tries to reconcile self-love with the prospect of repeated interventions.
Jassell’s internal deliberation reflects a broader tension experts describe as increasingly common: injectables such as Botox, cosmetic plastic surgery, and even weight-loss drugs such as Ozempic can all become part of a pursuit of beauty, youth and conformity. Natalie Carnes, a feminist theologian at Duke Divinity School, said the ethical conversation needs to widen so it does not put the burden squarely on women while “not taking away their moral agency.” She also said, “Beauty is something that’s good. And beauty is something that is good to pursue,” but that Botox and Ozempic and face-lifts “they’re all ways of really narrowing the cultural ideals of beauty.”
Even as experts call for more sustained discussion, they say major religions have offered relatively limited official guidance or prohibitions about cosmetic procedures. In March, the Vatican released a document on Christian anthropology that decried what it called the “cult of the body.” The document said that once modified, “the body becomes a body-object,” and described a relationship in which the person is no longer his or her body but “owns” a body.
Medical experts also point to gaps in how the ethics of cosmetic care is taught, even as demand grows. Dr. C. Bob Basu, president of the American Society of Plastic Surgeons, said demand for cosmetic surgery in the United States has increased across age demographics and ethnic backgrounds. Basu said that “Forty years ago, perhaps people would think, ‘Cosmetic surgery is for the superrich or the celebrity elite. It’s not for regular folk.’ That’s not the case anymore,” and he said more young people are pursuing interventions, including “baby Botox” to prevent wrinkles and face-and-neck-lifts in the late 30s or early 40s.
Arthur Caplan, founding head of the Division of Medical Ethics at New York University Grossman School of Medicine, said bioethics training often does not prioritize plastic surgery. “If you’re getting into bioethics and you rotate to learn about medicine, you go to the ICU, you go to places where the palliative care is for dying people, you’re looking at transplants. Nobody rotates to plastic surgery,” Caplan said, adding that surgeons may therefore set their own boundaries about what they will and won’t do.
Religious leaders and clinicians described a range of views within their faith communities, often rooted in how scriptures and doctrines are applied to questions of modesty and vanity. Dr. Jerry Chidester, of The Church of Jesus Christ of Latter-day Saints, said there is a broad spectrum of attitudes inside the church, contrasting stricter interpretations with the culture around Salt Lake City, where he is based, and where he said studies suggest many surgeons perform procedures per capita. When patients weigh whether to undergo surgery, Chidester said he tells them to focus on their own reasons, saying, “I’m like, ‘Look, if you want to do this or not, it’s up to you,’” and that it is “literally your body.”
Other faith-informed approaches also emphasize distress and guidance rather than blanket prohibition. Dr. Sheila Nazarian, a Jewish board-certified plastic surgeon, said that if cosmetic work is bringing distress, “then it’s OK,” and she said her patients are typically “pretty well adjusted, happy, successful, intelligent people” who still want help with “one little thing that they’d just rather not think about anymore.” Dr. Michael Obeng, a Christian board-certified surgeon in Beverly Hills, said acceptance has shifted over nearly 20 years, and he described people showing their surgeries “as a badge of honor.” He said he sees limited tension between his faith and his work and that he began rethinking certain procedures at a “crossroads” in 2018 when he considered his willingness to perform gender transition surgeries. He said he sought advice from pastors and religious leaders and then limited his practice to some gender-related procedures such as breast augmentation, stopping short of genital gender-affirming surgeries that he said are harder to reverse.
Beyond questions of faith and training, experts say the ethical debate often turns on whether cosmetic decisions can be treated as purely personal. Ivory Kellogg, an actor in Los Angeles, said she feels the pressure that many women face to make changes at certain ages, while also wanting women to be able to choose, saying, “At the same time, I do want women to feel like they’re allowed to do whatever they want. Like if you want to have a face-lift, that’s your prerogative.” Abigail Saguy, a sociologist at the University of California, Los Angeles, said it is important to consider how choices are constrained by social pressures and that “This is a social issue. It is a collective problem,” even though it is “continually treated as an individual issue.”
Some experts also focus on how health resources are allocated as cosmetic uses expand beyond medical need. Dr. Aasim Padela, who studies bioethics and Islamic thought at the Medical College of Wisconsin, said the medical profession should be about restoring or preventing loss of health. He said that “Certain types of procedures, body modifications, interventions — whatever you want to call them — may not meet those goals or even be aimed at those goals,” arguing for broader conversation about how prioritizing cosmetic surgery can affect the profession and how resources are distributed in society.
Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP