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The Opinions
Have We Reached Peak Botox?
00:27:17
Tressie McMillan Cottom, Jessica Grose and Meher Ahmad on why plastic surgery and fillers no longer feel like a secret — or a stigma.
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Podcast Host/Announcer
This is the Opinions, a show that brings you a mix of voices from New York Times Opinion. You've heard the news. Here's what to make of it.
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Meher Ahmad
I'm Meher Ahmad. I'm an editor for the New York Times Opinion, and I'm joined today by columnist Tressie McMillan Cottam and opinion writer Jess Gross. So good to see both of you. Did you have a good holiday season? I'm curious how you rung in the new year.
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Tressie McMillan Cottom
I did have a good holiday season. I think like many people, it was both a long one and not long enough. I returned and I wasn't sure why I had chosen to return, but had a particularly good Christmas this year and a wonderful New Year's Eve on a beach in Florida this year.
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Meher Ahmad
Oh, that sounds nice.
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Tressie McMillan Cottom
Oh yeah, much warmer. Much nicer than here.
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Meher Ahmad
Jess, what did you get up to?
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Jess Gross
I went to San Francisco for five days, which was also delightful to see family. And then I was actually ready to get back into it yesterday and I had a productive day. And then my older daughter came home from school at 10am this morning with a fever. So, you know, I got 24 hours of peak production.
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Meher Ahmad
Classic, classic, best laid plans. Well, I went to Istanbul on holiday mostly to do sightseeing and hang out with my family. But the reason why I bring it up is because I had always known that the city had kind of become this destination for hair transplant procedures. When I used to travel there for work often, or even just like passing through the airport, I would often see men with these bandages on their head recovering from getting hair transplants. But on this trip was my first. After about 10 years of not being in Turkey, I realized just how much of a plastic surgery destination Turkey has become. Walking down the streets in Istanbul, I'd see people with casts on their noses or bruises on their faces, and a lot of them were actually tourists from the United States who were there just to get those procedures. So it made me realize just how mainstreamed these body modification procedures have become. There are over 34.9 million cosmetic procedures performed globally, and that's a 40% increase from four years ago. And the more plastic surgery people are getting done, the more it kind of seems like they're talking about it openly, too. As if the taboo around admitting that you've had work done is kind of disappearing. I started getting Botox when I was.
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Jess Gross
26, in my forehead and in my crow's feet.
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Meher Ahmad
I have my nose done, my lips done. I have chin lipo, I have chin filler. I have Botox in my face. I have Botox in my traps. If you want injections anywhere, if you guys want to get fillers anywhere, like.
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Tressie McMillan Cottom
Just go for it.
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Meher Ahmad
Life is too short, too, to not.
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Tressie McMillan Cottom
Be happy with yourself.
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Meher Ahmad
So I wanted to talk to both of you today about whether the Overton window of what is considered socially acceptable with plastic surgery has shifted and what that shift means for our society. So, Tressi, Jess, when did the two of you start clocking this shift towards more and more body modification?
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Jess Gross
So I wrote this piece for the News side in 2021 about the rise of plastic surgery analysis videos. So these are third parties analyzing how much plastic surgery a celebr may or may not have done. They don't have any inside information. This is just their suspicion. And when I talked to plastic surgeons and sociologists around this, they said the real turning point was reality TV and specifically the Kardashians. So that was a major moment where I think Kim admitted to having Botox, you know, maybe 15 years ago. And social media just really ramped it up. Right. So at some point, it becomes not only a badge of sort of honor, but also to say, I can afford to do this. The plastic surgeons I spoke to then said before, people would sneak in, they wouldn't tell their family what they were doing. And now most of his patients who are on the younger side ask to post, you know, their own journey of it. And that has been a huge shift over the past 10 years. But, you know, in the 70s, 80s, 90s, you'd have a little bit of joking around it. You know, I always think about Dolly Parton, takes a lot of money to look this cheap. And Joan Rivers, who would joke about her plastic surgery. So there was sort of smattering here and there, but it was more sort of for laughs. But this era I would cite starting with the rise of reality tv.
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Meher Ahmad
And Tressi, what about you? When did you start seeing this shift towards this rise in body modification?
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Tressie McMillan Cottom
Yeah, so there's a difference between when it became democratized for me and the people of my peer Group. There's a race dimension here. There's a class dimension here. African Americans until 15 or so years ago were not as likely to get plastic surgery, for example, as were their white peers. And then there was also this huge social class dimension where plastic surgery and other aspirational body modifications were considered something of an upper middle class, if not a wealthy leisure activity like Jess. One of the tipping points there is reality tv. I set the beginning of that, though, a little bit earlier than even the Kardashians, although I think the Kardashians absolutely democratized the idea of who should get plastic surgery and accept expanded our cultural awareness of what types of plastic surgeries were available. But if anybody remembers what I would maybe call Reality Television 1.0, the entire genre of reality television becomes popularized through shows that were makeover shows. So my first awareness that plastic surgery was something that, quote, unquote, regular people did was through television shows like the Swan, which was all about plucking an everyday American out of anonymity and exposing them to the glamorous world of making themselves over through plastic surgery and other extreme body modifications. At that time, though, with Reality Television 1.0, it was still very aspirational. It was still almost like a Beverly Hillbillies kind of approach to plastic surgery, which was to take this sort of hillbilly and drop them into the world of the rich and the famous, by which we meant Hollywood. But the race dimension I find really interesting because so much of what we do in body modifications is about sort of making ourselves look like what we think is sort of a middle America, which in the United States of America would mean white, Anglo, Saxon, Protestant, a WASPy sort of understanding of the body. That for me, happened with the Real Housewives of Atlanta, which was absolutely targeted at an African American female viewer, but where they talked about plastic surgery in a sort of culturally responsive way, if there's such a thing, which was, yes, you can get a nose job, but in a way that does not eradicate maybe the African American ness of your features, for example. And so this conversation starts become way more nuanced as reality television becomes more pegged to different kinds of minority groups.
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Jess Gross
I mean, I also think I'm Jewish. And the idea of Jewish girls getting nose jobs, that's been around, you know, since the 50s, 60s, since nose jobs existed. But again, not something you would probably brag about, though. Something that was joked about, that was thought of as a thing that some people needed to do. And my mother always framed it as this is terrible. And, you know, we don't do this, but you may feel pressure to do this. So I think there's sort of a lot of different cultural elements into who's getting plastic surgery and why and to look like what?
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Meher Ahmad
Tressy, you're mentioning the kind of democratization of it, you know, that I find to be super fascinating because it isn't just that plastic surgery, like nose jobs and things like that are becoming more widespread spread, but there's also this more ubiquity of treatments like fillers and Botox, sort of like minimally invasive non surgical ones that are a couple hundred dollars. And so if you're have this aspirational kind of goal to change your face or body, like that's accessible to you instead of like a, you know, multi thousand dollar procedure. But it's made me realize that a lot of these types of faces kind of like a cat, like high cheekbones, you know, yanked back eyebrows, that sort of face, like even 10 years ago, 15 years ago, I associate with like an upper class society person. And now that type of face is something that you see everywhere in the middle class and the lower middle class. Do you see that as like a fad or is that kind of something that will morph into something else as more time goes past?
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Tressie McMillan Cottom
I mean, there's no way around the reality of I think two things, right? Technology, which makes these things easier and cheaper so they become more accessible, right? I'm like you, I woke up one day and there is a place to get fillers. And almost every strip mall in America, irrespective of the buying power of the community around the strip mall, right? Strip malls where I come from are highly class, right? You have the high end grocery store with the high end drugstore and then the high end shopping and on down the ladder, these sort of like retail outlets, however, for like accessible body modifications, really just tear down those walls. You know, I can see them in a working class community and you can see them in a wealthy enclave. Some of that is about technology. It is more available. There's also this piece that they are more affordable. Now it doesn't mean I think we have more money to spend on body modifications, but I think there are more avenues to finance access to these tools. So I notice how many of these body modifications, especially when you start talking about, you know, the wild wild west of cosmic suitables, you know, this, this hybrid of cosmetics and pharmaceuticals where a lot of these things like fillers exist, is that a lot of people are financing them. So you have this whole market of people doing A buy now, pay later scenario, which makes them more accessible and makes them feel more affordable. So I think technology, the ability to finance or pay for them, are just, you know, these two macro changes in how Americans live every day. But there's also the aspect that we have an expectation that we are supposed to be able to change the way that we look. There was this interesting moment in the early days of social media where the idea of democratizing beauty was somehow considered radical, that everybody should have access to all of the tools to make over their body however they want. And I think a lot of that narrative was about the technologies that allowed us to, like, face tune ourselves, which created this new sense of what was possible for us in our own homes, on our own phones. You used to have to go to a medical doctor who would tell you this is what's possible. But now you've got an app that can say what would happen if you lightened your skin and raised your eyebrows? What if you got a little nip and a tuck? And I think the democratization of the tools to play with how we see ourselves made us believe that, oh, well, if I can imagine myself this way, I should be able to access it. And we almost start to think of beauty modification as a right, as like a consumer right. Everybody should have access to this. Some of that was coming out of, like, queer communities, but I think it got taken up by a broader section of society to say that everybody should be able to afford to like the way that they look.
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Meher Ahmad
I was in the subway and I saw an ad campaign for Facetune that was like, you can just edit your face. It was like, this is the free way to do it. Yeah, yeah, yeah.
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Jess Gross
I mean, one, one thing, Tressy, mentioning the democratization of things like filler and Botox, I have seen in the past two to three years a move to put those down and say, oh, no, what you really need is a deep plane facelift. You're just playing around.
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Tressie McMillan Cottom
Yeah, you're just putting off a facelift. Or it's going to be so much harder to do your facelift later because you're going to be full of so much filler. I don't know about your social media algorithm, Jess, but mine clearly knows what age I am. And so I'm getting these things like, oh, have you been getting fillers? You might be ruining your chance at a facelift. You better hold off. And I, yeah, I find it all fascinating.
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Jess Gross
And a facelift is so much more financially out of reach for most people. I mean, there was Just a great article in New York magazine that went into deep plane facelifts. And at the high end, there are hundreds of thousands of dollars. So there is this sort of ratcheting up of what is aspirational. When, you know, the masses can get filler, then, oh, well, that's declassive. We don't want that anymore. You need to have the next thing that is, of course, more expensive, more invasive, or you just not measuring up.
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Meher Ahmad
Right. Well, it's also interesting because I find that same exact thing that you're saying just bleeds into the actual aesthetics at play. I think of Kylie Jenner, for example, who was at one point the epitome of Instagram. Face like the patron saint of lip fillers in 2016.
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Tressie McMillan Cottom
Yeah, I don't even recognize her. Yeah.
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Meher Ahmad
But now, you know, she's removed a lot of them. Looks a lot more natural. I think for sure she still had some intervention done. I'm being one of the videos, Jess, that you were just talking about, but for me, I find that really fascinating because it feels as though the more mainstream big lips, you know, filled up cheeks, you know, whatever the procedures are that in order for the elite to kind of be at a different level aesthetically, they also look different. And now I think the. The new kind of like, tippy edge of what the aesthetic is, is less plumped up and more sort of like, subtle, which is more difficult to achieve and more expensive. Right.
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Tressie McMillan Cottom
Yeah. This is the catch 22 of democratization. Bodies are a status symbol. And so as a status good or a status symbol becomes more accessible, you need something to become the status good, the signal that you are wealthy, that you are highly educated, that you are elite. The power and the money, however, to shape what is considered accessible and what is considered elite, that is never going to be democratized. I also think it's worth pointing out that when these standards, these aesthetic goals are associated with different types of people, they have different types of status. The Kardashians are a great example of this. A lot of the other aesthetic features that they popularized during their rise to, you know, global cultural dominance were ones that were associated with black people, with Latino women, with poor and working class people. They popularized them by saying, oh, look, you can have big lips, but not be associated with the racial group that naturally has big lips. But once those things become more accessible, then you have to change the beauty standard. And in this moment, I find it really interesting to think about the rejection of things like bbls and lip fillers and what they are saying about the groups of people that those things are naturally associated with.
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Meher Ahmad
Say more about that. You mean as though, like, there's more of a kind of shift away from body shapes that are associated with women of color, for instance.
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Tressie McMillan Cottom
Yeah. I think there's a reason why you take up an exaggerated BBL profile, for example, or overfilled lips. If we wanna talk about Kylie Jenner, for example, during a time of Obama's America, when diversity has an extreme amount of capital and black women are highly visible in popular culture. And then there would be a really good reason to abandon those things when the cultural moment has passed and now everybody, you know, mar a lago face and a makeover into Trump's aesthetic ideal, which is not the same as the Real Housewives of Atlanta. And so this is why I question the extent to which the Kardashians are playing with beauty trends and how much they are just playing with our ideas about the people that are associated. Associated with those beauty trends.
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Meher Ahmad
Yeah. And for those listeners who don't know a BBL is a Brazilian butt lift. It's a way.
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Tressie McMillan Cottom
Yeah, thank you for that. I'm so deep. I didn't know I was so deep that I was just using the shorthand. Yeah. The Brazilian.
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Meher Ahmad
Well, I find that word has entered the mainstream lexicon, for sure. Bbl. Well, so, I mean, part of this is also we've been discussing procedures and avatars that are mostly women. But, you know, this kind of trend, and we're seeing it affect men, too. Right. Like in places like Turkey, the procedure you see most visibly is hair transplants. And now there's also an increasing number of men getting facelifts as well. So I'm curious whether you, you know, Jess, like, do you see there being a difference in these types of procedures when they're done by men? Like, how does the kind of gender of it all factor in ultimately?
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Jess Gross
No, I mean. And it's about conforming to an ideal. Right. And looking younger. A lot of these procedures are just to look younger, and I think increasingly are held to stricter standards than they used to be. Again, it depends on culture, class, all of this. But all of us, if we want our ideas to be heard, increasingly have to visually put ourselves out there along with our ideas. If you own a business, if you, you know, are trying to get further in your career in multiple different places now you have. Your looks matter more, I would say, than they used to. They're not everything. You can certainly not conform and still be successful. But I think that there is this pressure or at Least this perception. And once you are putting yourself out there like that, there's just such more potential for self consciousness. So whether or not it actually does help you to have hair instead of not having hair. Although one of the most heartwarming things that went around the Internet the past month was the bald subreddit. Did you see this?
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Meher Ahmad
Oh, no, I missed that.
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Jess Gross
It was all these men accepting their baldness and cutting off their hair. They just like, yeah, they cut off their weird mullets or their, you know, comb overs and they look great. They look so much better. So, you know, there's still some resistance in corners of the Internet, but I think it is people having to put themselves out there more and getting criticized by strangers. And that affects you. It doesn't matter who you are, that affects everybody.
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Tressie McMillan Cottom
Right? The great pivot to video came for all of us. And the tyranny of having tens of thousands of tiny angry bosses in commenters, social media posters to tell you that you do not look good enough came for all of us, Jess. Men and women.
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Meher Ahmad
And you know, to that point, I know a lot of people used to talk about during the pandemic, like staring at your own face on zoom and how many plastic surgery procedures that spurred. So a lot of it seems like it has to do with just kind of seeing images of your own face.
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Tressie McMillan Cottom
I don't believe that were meant to see ourselves as much as we do now. I really do think that the technology in so many ways has outpaced our social development. The COVID experiment was an example of this happening. The dysmorphia of seeing ourselves when we are totally normal. This is how normal human beings look. This is how normal human beings emote. But there is something about seeing that refracted through your own eyes. I just don't think was supposed to happen happen.
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Meher Ahmad
It's interesting. You know, speaking of housewives, there's like a trend that usually season one housewife to season two, almost always season two, they get so many procedures done because you've watched an entire season of yourself and seeing yourself on television, nothing will prompt you to get plastic surgery more than that.
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Tressie McMillan Cottom
And they all then start to look alike. So one of the things that scholars have pointed out that I really find fascinating is the homogenization of our aesthetic ideals, right? They all start to choose the same procedures, which then limits you to a certain set of possible features. And what I find fascinating from season one to later is how much they will all start to look alike.
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Meher Ahmad
That's so true. The airport in Beirut is called Rafiq Hariri International. And whenever I'm there, I always say, rafi Khariri International Nose. Because every woman has the same nose. It's like, I know you're not related. It's interesting, too, because I think, especially with it being something that is so accepted now and something that feels like we all know somebody who's had something done if we haven't done it ourselves. Sometimes I lose sight of the fact that these are very painful and risky procedures. I think seeing people walking around Istanbul with bruises and bandages on their face really hammered home the degree to which it's like, beauty is pain. We know this. It's an old adage, but it's quite dramatic to get some of these procedures done. And it gave me a little bit of pause because I think I certainly fit in the camp. I think of everyone should do what they want to, and if it's your right and you want to pursue it, that you should. But on the flip side, that sort of this normalization and also, like, homogeneity of, like, what is beauty? And what the new beauty standards are, is putting pressure on people to put themselves in positions where they're experiencing a lot of pain and discomfort to achieve this look that, you know, for me, growing up as a teenager, I didn't think that I would ever consider plastic surgery because I could achieve what I wanted to with makeup. And that's all that was offered to me as a teenager. Right. That's what was promoted then. So I'm curious, like, what. What the two of you see as being the end game of this. Like, is this. Are we heading in the right direction by making this completely ubiquitous to everybody, or should we reign in what kind of beauty standards are being reinforced by that look especially?
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Jess Gross
Well, there's no way to rein it in. Like, we have no control over any of this. But I will say, when I think about whether these procedures are actually going to make people happier or feel more secure in themselves, I have a lot of doubt that for many people, they will, because you have to keep having them. It's not like you just get them once and then, oh, it's done. You also age. And as you get every day, I am reminded that I get further and further away from the beauty ideal. Right. I think sometimes people confuse happiness with the relief of conformity and the relief of other people treating you better because you look a certain way. So I worry about that from sort of a mental health perspective without, you know, being infantilizing. You only have one body, and you should get to do with it what you want. But I think in general, more people feeling pressure to get elective surgery is not great.
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Tressie McMillan Cottom
Yeah, yeah. It doesn't seem like a positive social indicator to me either. I just think it's something really perverse that there are parts of this country where it is easier to get maybe filler and a nose job than it is to see a doctor about your diabetes. Right. There is something really perverse about that system. And I have to believe that good quality healthcare would do far more for making us feel better about ourselves than the democratization and full accessibility of plastic surgery.
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Meher Ahmad
Yeah, yeah, yeah.
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Jess Gross
When I say, you know, are you doing this for conformity and it's not actually going to make yourself feel better. I'm not trying to say that from a place of superiority, like, there's many things that I don't like about myself and probably would change if when I was younger, for sure, it took time and maturity to embrace the way that I look without having to change it for what? Who is this for?
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Tressie McMillan Cottom
Yeah.
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Jess Gross
And ultimately it wasn't for me.
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Meher Ahmad
It's interesting. There's one kind of paradox to all of this, which is that as these procedures have made this kind of smooth, glossy, plump, airbrushed face the norm, that like a wrinkled face almost stands out in a beautiful way sometimes. And I think about people like Pamela Anderson who stopped wearing makeup on the red carpet and, you know, certain actresses, especially in countries like France, where people are not as like, fillered up as they are in the United States, that there's like a. Almost like a rare beauty to just kind of someone who has. Is aging with an untouched face in this environment where we see that kind of other type of face everywhere.
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Jess Gross
I think my reaction to it too, as Tressy mentioned earlier, we're in a period of rising conservatism and gender essentialism, however you want to put it, and. And my sort of punk spirit is like, I'm just gonna be ugly.
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Tressie McMillan Cottom
Yeah.
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Jess Gross
I'm not a wrongful to them. I'm gonna be ugly. I love it. Everyone can think I'm ugly. It's great.
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Tressie McMillan Cottom
Old and ugly, wrinkled. It'll feel. I'm with you, Jess. There are so many fantastic books, by the way, about ugliness as resistance, about resisting the call to use beauty as your social identity. And I'm like you, Jess. I am about it. I read just about everything that comes out in that area of research because I. Even before age started to come for me, I just thought there's something really perverse about trying to demand of me that I perform to a beauty standard that I cannot control. Now, this might be my resistance to authority. I have a ton of authority issues, well documented. But I just don't like this idea that I am supposed to conform to something over which I have absolutely no control. And so there is something too, I think, refusal. Just, you don't have to make it part of your identity saying, oh, you know, I reject fillers or I reject makeup. But I think there's something to just quietly refusing the demand that you perform to a standard that you do not control. And as I, you know, age into that dark night, I think that's gonna be my position. I'm just. I just refuse.
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Meher Ahmad
Well, I really appreciate you both joining me for this conversation. It's been super interesting. And, yeah, just wanted to say thanks.
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Tressie McMillan Cottom
Thank you.
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Jess Gross
Thanks so much.
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Podcast Host/Announcer
If you like this show, follow it on Spotify, Apple, or wherever you get your podcast. The Opinions is produced by Derek Arthur Vishaka Darba, Kristina Samulewski and Gillian Weinberger. It's edited by Kari Pitkin and Alison Bruzek. Engineering, mixing and original music by Isaac Jones, sonia Herrero, Pat McCusker, Carol Sabaro and Afim Shapiro. Additional music by Aman Sahota. The Fact Check team is Kate Sinclair, Mary Marge Locker and Michelle Harris. Audience strategy by Shannon Busta and Christina Samulewski. The director of Times Opinion Audio is Annie Rose Strasser.