I just ran into a series of science fiction books by Scott Westerfield, called Uglies, Pretties, and Specials. They are aimed at “young adult” readers, and deal deliberately with issues of medical and psychological enhancement.
In the first book, our hero Tally wants nothing more than to turn sixteen, the age at which everyone is given surgery to turn them from Ugly to Pretty. It’s a rather extensive renovation--alteration not just of facial features, but of bone structure, skin color, and muscle mass, so that everyone conforms to a norm of physical perfection. After the surgery the kids settle down to a life of intense, shallow partying that Tally can’t wait to be a part of.
Her plans are messed up by meeting Shay, a girl who doesn’t want the surgery. When Shay “escapes,” Tally is forced to follow her into the wild where people live as Uglies, in horrible conditions (building wooden houses! wearing non-synthetic clothes! eating meat! ick!) There Tally and Shay find out that the surgery is on more than just people’s bodies-- their minds and personalities are altered too--and that refusing the procedure is not really an option. Many exciting narrow escapes, aerial skateboard chases, and medical ethics discussions ensue. But in the end, both girls have the surgery, more or less unwillingly.
The second book takes on the ethics of consent, as both Tally and Shay have become essentially different people following the surgery. They are happy with their new lives, and do not remember their initial wish to remain “themselves.” Enticing them away from all those great parties and restoring them to their own personalities (via an experimental procedure, of course) poses lots more ethical dilemmas, along with way too many more aerial skateboard chases.
I haven’t read the third book yet. There is a long waiting list for it at the Andover public library. I may not wait for it. Since the books are aimed at a younger audience, there is a fair amount of cool slang, which became annoying. And the repeated necessity for riveting action eventually became wearing. But I think it’s encouraging that there is a lot of teen interest in books which are essentially about the cost of conforming to a physical and mental ideal.