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to marriage and maternity: the highest percentage of its population being married44 and the earliest median age for marriage (24.0 for women and 26.2 for men). 45 Utah has the highest fertility rate 46 and stands among the highest in breastfeeding rates.47 Perhaps it is no surprise that, according to one researcher, 48 many Utah mothers respond to cultural pressure to undergo the Mommy Makeover, which local doctors advertise as a solution to young mothers’ bodies “trashed” by motherhood. Additionally, despite having the largest average household size in the nation,49 Utah has some of the fastest-growing incomes in the country, 50 leaving families with more discretionary income than ever before. Authors: Dr. Susan R. Madsen (Orin R. Woodbury Professor of Leadership & Ethics, Utah Valley University), Janika Dillon (Research Fellow, Utah Women & Leadership Project), and Robbyn T. Scribner (Research Fellow, Utah Women & Leadership Project). For questions or information: uwlp@usu.edu or www.utwomen.org There are many possible explanations for the plastic surgery boom in Utah. Some attribute social media, the increase in pornography consumption, or the influx of southern Californian body-obsessed culture. Others blame competition for a desirable spouse in a state that puts a high priority on marriage, 51 a key concern for Mormon women specifically since self-identified Mormon women outnumber Mormon men in Utah by a ratio of 3:2.52 An in-depth research study on cosmetic surgery among Mormon women explored this possibility and found a common belief among many participants (the vast majority of whom live in Utah) that physical beauty was a key means of securing status as a Mormon woman, particularly as marriage and motherhood are often prioritized above educational or career achievement. Study participants saw elective cosmetic surgery as an acceptable means of achieving and maintaining that standard of beauty.53 The pressure on women who see so many others getting surgery can also be significant; a recent Time article began by telling the reader, “You’re going to have to [undergo a cosmetic procedure] . . . because every other woman is.”54 Some even assert that in certain circumstances, the choice not to have surgery could actually be a disadvantage. 55 Whether these pressures are real or merely perceived, they seem to be having an impact on Utah women’s decisions to undergo cosmetic surgery. Efforts to Support Positive Body Image Various groups are working both nationally and locally to help girls and women combat poor body image and selfobjectification, which can, in turn, contribute to such outcomes as disordered eating, depression, and plans for elective cosmetic surgery.56 In 2004, the Dove brand initiated a self-esteem project to improve women’s body image. This project includes videos and other media, as well as the pledge to showcase a diverse group of real women (not models) in all their marketing campaigns.57 Locally, Drs. Lexie Kite and Lindsay Kite, body image researchers, founded the nonprofit Beauty Redefined to promote positive body image via a website, presentations to girls and women across the United States, and online body-image resilience programs. 58 Lexie Kite has said, “We know women are capable of much more than being looked at, and once they believe that message, they can move on to accomplishing so many happy and worthwhile pursuits.”59 Though the LDS Church (a prominent voice in Utah culture) has no official opinion on cosmetic surgery, leaders of the Church have spoken out against it.60 Addi-tionally, as one study showed that women with lower levels of education are more likely to consider plastic surgery,61 continued efforts to encourage women to attend college and complete their degrees 62 are needed. Finally, the Utah Women & Leadership Project (UWLP) (in partnership with YESCO and Justin Hackworth Photography) recently started a “Women Shaping Utah” campaign with billboards along I-15 showing strong women leaders who are making a difference in their communities. This is an effort to counteract the messages of the numerous cosmetic surgery billboards that imply a woman’s worth lies in her physical appearance. Conclusion Clearly, elective cosmetic surgery is a complicated issue upon which many disagree. Furthermore, Utah is among the top states in the nation for these procedures, yet with only a handful of studies addressing this topic, it is difficult to pinpoint the exact numbers, influences, and outcomes of cosmetic surgery among Utah women. Yet much can be done to encourage women’s educational efforts, confidence, and overall health and well-being, which can consequently help girls and women combat negative body image and focus on traits beyond physical appearance. Doing so will strengthen the positive impact of women in communities and the state as a whole. 1 Namie, J. (2013). ‘In the world, but not of the world’: The paradox of plastic surgery among Latter-day Saint women in Utah. The Journal of the Utah Academy of Sciences, Arts, & Letters, 90, 225–248. 2 Ruiz, R. (2007, November 29). America’s vainest cities. Forbes. Retrieved from http://www.forbes.com/2007/11/29/plastic-healthsurgery-forbeslife-cx_rr_1129health.html 3 Gallup. (2016). State of
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