Teenage girls who are diagnosed with scoliosis have to deal with a potentially serious physical condition at a time when most girls are already concerned with their appearance and their bodies.

In addition to forming a coherent body image, girls are in the process of developing a sense of personal identity, dealing with emerging sexuality and the stress of intimate relationships, and beginning the process of separating from their families.

Adolescence is a stage of development that begins around the age of eleven and lasts until around the age of eighteen. Adolescents develop physically, sexually, and psychologically. They grow to near their adult size and develop secondary sex characteristics such as pubic hair and underarm hair. Girls develop breasts and wider hips. For both boys and girls, adolescence is a vulnerable period in the development of self-image and self-esteem.

Self-image describes how people think about themselves: What do I look like? What kind of person am I? What is important to me?

Self-esteem describes how people judge themselves: Can I accomplish things? Am I happy with who I am?

These questions are especially important to adolescents because they are learning to think about themselves as individuals. Adolescents also compare themselves to their peers in order to see similarities and differences. Friends look to each other to understand what is normal, and then struggle to fit in, at the same time that they are seeking an individual identity. It is difficult to both fit in and be an individual.

Girls at this age often focus great emotional and mental energy on concerns about their weight, shape, hair, skin, and total appearance, and are often extremely self-conscious. In addition to self-criticism, adolescents are often criticized by their peers.

Since I was experiencing terrible peer pressure at my high school & rejected the stupidity of adolescence, I wasn't all that unhappy to know I would be out of school for most of my senior year because of my scoliosis. I did not encourage any visits from my friends during my long convalescence, although they occasionally came (maybe once a month?) Part of the reason was that I'd usually refuse to put on bedclothes prior to anybody coming because it was very difficult to keep them in order with my cast pulling on them while turning. But my mother wanted me to "look good" when they came! I basically never talked to my friends about my scoliosis. It was something to endure until I could get better & forget about it.

All this worrying and pressure can be overwhelming for adolescents. It helps if they have supportive friends, family members, and other adults such as teachers to help them talk about how they feel during this difficult time. Adolescents whose parents express approval and acceptance of them have a better chance of developing positive self-esteem than adolescents whose parents constantly criticizing them.

Why is positive self-esteem so important for girls with scoliosis?
In a survey of 36, 706 students between the ages of 12 and 13, of which 685 had scoliosis, it was found that scoliosis during adolescence is a risk for suicidal thought, alcohol consumption, and worries about body development. (Payne, Ogilvie, Resnick, Kane, Transfeldt, and Blum, 1997)

Although scoliosis puts girls at risk, positive self-esteem reduces that risk. Girls with a strong self-image are on a more solid emotional ground from which they can better adapt to the new aspects of their life such as constant medical evalution, dealing with a brace, and feeling like a normal girl their age.

EXPERIENCING SCOLIOSIS AS A WOMAN OR GIRL

In response to a survey posted on the Scoliosis Mailing List (for more information, see the Resource list), women and girls answered the following question:
"Do you feel that the expectations that you perceived being associated with being female made it easier or more difficult to deal with your scoliosis?"

I think it's easier because I'm not expected to be strong. When I announce my inability to help with lifting things, it's not expected automatically that I can help anyway. It makes it easier for me to let other people help me with physical tasks, although I hate it and am too independent about it. I think being a male would make it worse. Also, I think it is easier for me to deal with the vulnerability in having medical treatment. It isn't easy, but I think it would be worse for a male.

Do I think the lack of research stems from scoliosis being mainly a "women's condition?" Yes, I think it definitely contributes.

I think it depends upon a doctor. If the doctor is male than generally he thinks you know much less than the average business man. Due to the fact that I have been on this list, I have come up with a variety of my own opinions, but became much more knowledgeable in the long run!!

I feel that since I have had difficulty standing and walking-for the past 3+ yrs- I have been adversely affected by being "female". I am unable to wear form-fitting clothes because of my lumbar support, and because I have gained weight; I am unable to walk "sexy"- I'm lucky to get from A to B many times; not able to stand for more than 10 minutes, I can't be in social gatherings to mingle/party; I am unable to work out, which kept me 20 lbs lighter and looking much younger than my age.

Let's face it, doctors are usually autocratic anyway, & spinal surgeons are probably the worst of the profession. They like to intimidate people, and as a woman, one feels even more vulnerable to their tirades. So it's difficult for a female to get treatment from a scoliosis specialist because she has to face all of this egotism in doctors who don't like to be questioned or challenged.

This is complex. As a female, looks are important and to have a condition that appears as a deformity is very hard to cope with. Fortunately when I was an adolescent my scoliosis was not so bad. I didn't even know I had it in night school, just that one hip was higher than the other. But you do feel pressure to look your best and it's harder and harder as your curves advance. At some point, pain becomes your main issue. If you can just get rid of the pain. I think women in our society have to deal with life changes more openly than men. We go through getting our periods then menopause. These are defining life changes marked by very physical events. While I am sure men's life changes are as critical to them, ours seem to be marked with very tangible physical changes. And yet women spend millions every year on make-up; the fashion world still revolves around women. I think women are under more pressure to *look good*. Not that men don't want to look their best, but when was the last time you saw a male beauty pageant? I don't know that being female made it any easier.