Body modifications & mental health

Lesson 1

You are enough, exactly as you are

Social media, ads and filters show bodies that have been posed, edited and lit to look flawless. Real bodies come in every shape, size and color, and they keep changing throughout life.

You are perfect exactly as you are. Don’t let anyone, online or off, convince you otherwise.

• Notice how you feel after scrolling, and unfollow accounts that leave you feeling worse about yourself.
• Focus on what your body does, not only on how it looks.
• Speak to yourself kindly, the way you would to a friend.

Lesson 2

When the struggle runs deeper

Sometimes worry about how you look becomes something more serious. Both of these are real conditions, and both are treatable:

• Body dysmorphic disorder is a constant focus on flaws in your appearance that other people can’t see, or that look minor to them, along with habits like checking mirrors, grooming, hiding a feature or comparing yourself with others. It affects about 1 in 50 people. Counseling and sometimes medicine help. Cosmetic procedures usually don’t.
• Eating disorders can affect people of any body size. Warning signs include eating only a few “safe” foods, exercising too much, hiding your body in baggy clothes, pulling away from friends and family, secret binge eating, and often feeling cold, dizzy or faint.

Lesson 3

Getting the whole picture

Strong distress about your body, including distress about your gender, can have more than one cause. Depression, anxiety, trauma, autism and other conditions can shape how a person feels about their body, and each deserves care in its own right.

That’s why major reviews of care for young people, including England’s Cass Review, call for a full assessment that also looks at mental health and autism before decisions are made.

• Ask for a full assessment from licensed professionals who look at your whole life and health.
• Make sure everything gets care. Help for depression, anxiety or trauma can change how everything else feels.
• Hear more than one view, including the ones that challenge you.

Lesson 4

Some changes can’t be undone

• Tattoos: in Washington, it’s illegal to tattoo anyone under 18, even with a parent’s permission. Removal is difficult, expensive and only partly works, and skin keeps changing after 18.
• Cosmetic surgery: the American Society of Plastic Surgeons says teens should be physically and emotionally mature, have realistic expectations and want the change over a long time, and it advises against surgery during treatment for depression or other mental illness. The FDA approves breast implants for enlargement only from age 18 for saline or 22 for silicone.
• Medical treatments for gender dysphoria: some can permanently change your body, and some can affect your ability to have children later. Reviews for England’s Cass Review found too little good evidence to show whether puberty blockers help, and the United Kingdom has banned them for under-18s with gender dysphoria outside of research. In 2026, the American Society of Plastic Surgeons recommended waiting until at least age 19 for gender-related surgery.

Experts disagree about what’s best for young people. The American Academy of Pediatrics supports gender-affirming care and is reviewing the evidence, and a 2025 U.S. Department of Health and Human Services review found no international agreement on best practice.

Lesson 5

Minimizing regret

How often do people regret changes like these? Honestly, no one knows for sure. Most studies of gender-related treatment have found regret or stopping treatment in about 1 to 10 out of 100 people, and one large study of U.S. military health records found that about 3 in 10 stopped hormones within 4 years, though stopping isn’t always regret. In 2025, the Department of Health and Human Services concluded that “the true rate of regret is not known.” Some people who change their bodies are glad they did, and some regret it.

• Give it time. Feelings during transformative seasons of life can change.
• Get a full assessment and a second opinion.
• Know exactly what’s permanent before you start anything, including what it could mean for having children later.
• Make sure the choice is yours, not the result of pressure from anyone, online or off.

No one can make this decision but you, and time is your friend.

Check yourself

Myth or fact?

Questions people ask

Asked and answered.