“You Look Like A Boy”: Gendered Representations of Hair Loss in Books for Pediatric Cancer Patients

Hair plays an integral role in identity construction for children as well as adults. Hair carries a significant social and cultural importance relative to normalcy, physical outward appearance of health, and positive self-identity. The importance of hair extends to processes of social negotiation outside of the arena of health and medicine. The process of cancer treatment and chemotherapy often causes hair loss, or chemotherapy-induced alopecia,¹ which can complicate identity construction and threaten an individual’s ability to associate with social groups of which they previously felt a part. Some children’s books are designed to help young pediatric cancer patients understand and grapple with the impact of cancer on their bodies and lives, and most specifically chemotherapy-induced alopecia. This essay explores how books currently targeting children with cancer do more than tell a story. Through the text and illustrations, the books consistently identify hair loss for girls as damaging to social identity and social status. On the other hand, the books depict hair loss for boys as providing an opportunity for identity exploration and discovery as opposed to a severe social disadvantage. Thus, these books maintain gender ideology that upholds a form of hegemonic or ideal femininity that encourages girls and women to measure their self-worth by their appearance. Contrastingly, ideal masculinity is constructed as related to courageousness and strength as opposed to dependent on outward appearances.

Cancer, Hair Loss, and Gendered Beauty

Hair possesses meaning beyond its biological, organic properties. In Rapunzel’s Daughters, Weitz asserts, “Our hair is one of the primary ways we tell others who we are and by which others evaluate us, for it implicitly conveys messages about our gender, age, politics, social class, and more” (xiii). Hair as a physical marker establishes connections with other social groups, whether intentional or not. Individuals who identify as female have a more complicated relationship with their hair than individuals who identify as male due to numerous outside pressures originating from family, peers, media, and other sources, concludes Weitz. Weitz’s research shows that these sources of pressure instruct girls and women to “center [their] self-worth on [their] looks” as opposed to other qualities, whether they be internal or external, for which men and boys are more likely to enjoy praise and accolades for (33). As a result, she writes, “controlling our [referring to women and girls] hair helps us control our lives,” and loss of control over our hair (through aging, illness, disability, religious commitments, imprisonment, or anything else) can make us feel we’ve lost control over our lives” (xvii). Thus, the apparent failure to maintain “normal” hair means that the same element that previously established effective, working connections with peers, family, community, and even femininity also severs those ties. Therefore, gender is implicated. A disjunction occurs, and a part of a girl’s or woman’s identity goes missing when she loses her hair.

Hair signals individual identity, of which gender plays an integral role. The social construction of gender incorporates arbitrary ideas about “appropriate” hair for sexed bodies.² Lorber argues that gender signs and signals, one of which is hair, are so pervasive that they cannot usually be identified until they are either missing or not immediately apparent. So it may not be immediately obvious that it is “normal” for girls and women to have hair that looks different from that of men and boys until someone surpasses these boundaries. Lorber explains that when a gender marker is missing, or even ambiguous, “Then we are uncomfortable until we have successfully placed the other person in a gender status; otherwise, we feel socially dislocated” (64). In terms of gender, people can associate or disassociate with hair ideals of femininity and masculinity. “Ideal” gender association can be achieved at least partially with the “right” hair style. Hair serves as a gender marker, and since a person’s gender is incorporated into his or her identity, hair loss threatens to disassociate an individual from socially expected gender expression. As Weitz notes, loss of control over hair could result...