Children Who Want to Hide Their Faces: Bigger Concerns than Mask Dependence

Fashionable Masks and “Face Underwear”

Recent headlines have been questioning if Japanese people will ever quit wearing masks. Western countries have steadily shifted away from mask wearing, but Japan shows no signs of change.

In May 2022, the Japanese government announced that it was no longer necessary to wear masks outdoors, partly to reduce the risk of heat stroke, if maintaining a distance of 2 meters or more from others. It was the second hottest summer on record, but the majority of people continued to wear masks.

According to a survey conducted in August, roughly 70% of respondents said they still mask up outside. Interestingly, some indicated that their choice was based not on health concerns, but due to personal appearance: Their goal was to avoid the need to wear makeup or to shave. Over 37% of people said they wanted to keep wearing masks after the pandemic ended, including over 50% of girls aged 16–19.

As a fresh wave of climbing COVID-19 infections coincides with the year-end influenza season, it seems likely that many people will continue to mask up.

Many Japanese people talk of “fashion masks,” an indication that some regularly wear masks for reasons unrelated to hygiene. Recently, the term kao pantsu (face underwear) has even entered the lexicon, suggesting an equivalent shame in removing a mask in someone’s presence to removing underwear.

But the phenomenon of mask dependence, or feeling nervous without a mask, existed before the pandemic. It is common among people with interpersonal insecurities. After nearly three years of constant mask-wearing, it is possible that the phenomenon is growing, and some specialists are concerned about possible impacts on children’s development.

The School Situation

The Ministry of Education, Culture, Sports, Science and Technology (MEXT), and the Ministry of Health, Labor, and Welfare have released guidelines concerning mask-wearing in schools. For example, masks are not required during physical education, but should be worn for choral singing. During lunch, students should not sit with their desks faced together, to avoid possible COVID-19 transmission from respiratory droplets. They are asked to not speak in a loud voice, and to wear masks when chatting after lunch. One wonders how accepting children are of these expectations.

On my request, a friend who teaches at a public school in Kyoto surveyed students from mid-September to mid-October. Of the 54 students surveyed (from third through ninth grades), approximately a third indicated they would not remove their masks even if requirements were relaxed with the ending of the pandemic.

Students said they dislike wearing masks due to finding it hard to breathe, feeling hot, being unable to know if someone is really smiling, and being chided by the teacher for being hard to hear. But reasons given for not removing their masks included being accustomed to wearing them, fear of invoking parental anger, not wanting to pass their germs to others, or embarrassment about their own appearance.

“Having been conditioned into mask-wearing at home and school, they fear reprisal for removing them,” says the teacher. “There are children who are so used to wearing masks that they will endure breathing discomfort, or even if their ears hurt. They are so accustomed to it.” The teacher was concerned that children have become less perceptive of people’s facial expressions.

“While some girls in junior high said they wanted to keep wearing masks even after advancing to high school, there was a noted tendency among older students to assert that removing masks should become the norm. I’m also concerned about the impact three years of wearing masks has had on first and second graders, who were not included in the survey.”

The Importance of Providing a Choice

According to the child psychiatrist Yamaguchi Arisa, some children she encounters fear that if they remove their masks, they will be called ugly or might disappoint people. Others are so anxious that they refuse to eat school lunch.

She claims that it is not necessarily psychologically safe to force children to remove their masks simply due to concern about mask-dependence. “We need to realize that there are some children who feel safe in the classroom because they have masks. If they are arbitrarily told to take their masks off, it’s possible they’ll feel unease and stop coming to school.”

Child psychiatrist Yamaguchi Arisa, a clinical mental health researcher at the National Center for Child Health and Development, is also a member of the preparatory office for the Children and Families Agency under the Cabinet Secretariat. She is affiliated with the Center for Child Abuse Prevention, and counsels part-time for her local child guidance office and at a temporary shelter facility.

Yamaguchi warns: “If we suddenly force children to take off their masks, some children may suffer the same degree of psychological damage as they did when we suddenly ordered them to start wearing them three years ago.”

The priority, she says, should be to ensure that children are emotionally prepared for change, rather than focusing on the abnormality of wearing a mask when it is no longer needed, or questioning whether we have even needed them over the past three years.

“We must clearly explain to children, in age-appropriate language, situations where it is no longer necessary to wear a mask to prevent infection, and then seek their opinions and discuss them. If we try to force all children to take their masks off, children who until now felt at ease may become conflicted and suffer as a consequence. In terms of psychological health, it is far more beneficial to respect the feelings of children than to prevent mask-dependence. As we move forward, it is important that, as a society, we provide children with a choice”

As the government begins to promote removal of masks at school, it is also important to provide support to teachers, notes Yamaguchi.

“Even though some children may happily take off their masks, others may feel unable to attend school. There will certainly be some children who feel troubled. There is also the possibility that children who continue to wear masks will face discrimination or bullying. How are teachers supposed to prepare to handle this? We must train them, and provide support when they experience exhaustion.”

Concern over Demerit Disparity

What health side-effects might children suffer from wearing masks? According to Yamaguchi, at present, most Western experts believe there are no major negative impacts, such as obstruction of children’s breathing or impediments to social or psychological development.

Personally, her biggest concern is the disparity of impact.

“For example, for families with a sufficient level of communication, children still enjoy interaction with a full range of expression, even if it’s necessary to wear masks outside the home. But if their family situation is difficult, and lacks interaction between family members, children may suffer greater demerits from mask-wearing. Also, if the family struggles financially, the parents may be more stressed. If they work long hours and come home late, the children may not have much opportunity for mask-free communication.”

Factors are not restricted to the home. The disparity in demerit is also greater among children according to the strength of relationships with friends and teachers at school or within their local community. “I believe that’s something we need to pay closer attention to.”

Learning from the Pandemic

From April 2020 to December 2021, Yamaguchi and her fellow researchers at the National Center for Child Health and Development conducted seven online surveys targeting children from the first to twelfth grades.

“We generally believe that children experience greater stress as they grow older, and are more likely to engage in self-harm. The surveys we conducted certainly confirmed this tendency, but importantly, we learned that many younger children also showed signs of stress and a significant number were attempting self-harm.”

Yamaguchi notes that many surveys conducted because of the pandemic have shed light on the stress that children are facing. “With children approaching adolescence, I believe we need to take a firm preventive approach when such abnormalities first become apparent, before they reach the level when they are considered a disorder.”

According to a nationwide survey conducted by MEXT, refusal by elementary school children to attend school reached an all-time peak of 244,940 children in 2021. It indicates that the distance between people has increased as the pandemic has prolonged, and potentially, there are children facing their uncertainties and troubles with no support. The number of known incidents of bullying at all levels of school was also at an all-time high.

But in spite of the negative impacts, Yamaguchi says we should ask what we have learned from the pandemic.

“We’ve managed to secure learning opportunities for children, in some cases increasing the options, through measures including online classes, staggered attendance, and smaller class sizes. For example, even students who don’t go to school could take online classes and join in school life. Staggered attendance gave an alternative to students who can’t wake up early.”

Not everything needs to go back to the way it was, argues Yamaguchi. “I hope we can evaluate what we changed during the pandemic that could be retained in some form to benefit children. This is an ideal opportunity to reform the school environment, listening carefully to children on topics like mask-wearing as well as other issues, and respecting their individuality and freedom of choice.”

(Originally written in Japanese by Kimie Itakura of Nippon.com. Banner photo © Pixta.)