The cutting up that girls do secretly in their bedrooms, the nipple piercing that is performed in high street studios, breast implant surgery, sex reassignment surgery, are connected. They are all forms of self-mutilation, and increasingly the cutting is carried out by proxies for a profit. They are responses to low social status, sexual and physical abuse or severe emotional distress created by a male dominant society which does not accept women’s varied body shapes or condemns homosexuality.

The forms of injury provided by these studios and independent operators ranged from bellybutton piercings to the extremes of spearing straight through the torso as carried out by the Californian ex-advertising executive Fakir Musafar. The practices stemmed from two main sources, punk fashion and gay male sadomasochism.
Gay male fashion designers placed pierced models on their catwalks, and helped to inscribe a practice that had symbolised gayness, onto the bodies of conventional young women and some young men.

The practices of mutilation that are being carried out on the bodies of women, girls and vulnerable categories of men in the early 21st Century are savage and increasing in their brutality. Underlying the demand for these practices is the despair of those with low social status, particularly women and gay men. The harms of misogyny, sexual and physical abuse and gay-hating, create the ability of those who self-mutilate to disassociate emotionally from their bodies, and to blame their bodies for their distress.