by David Hagenbuch - professor of marketing at Messiah University -
author of Honorable Influence - founder of Mindful Marketing -
author of Mindful Marketing: Business Ethics that Stick
author of Honorable Influence - founder of Mindful Marketing -
author of Mindful Marketing: Business Ethics that Stick
Perhaps no toy is more iconic than Mattel’s Barbie. From its humble beginnings 66 years ago at the American Toy Fair to a 2023 blockbuster movie, an ever-expanding variety of dolls and accessories have delighted millions of children, as well as some adults wanting to relive their childhoods. Throughout their existence, Barbie products have been consistently on brand – cheery and upbeat. So why would the renowned toymaker want to give its signature product a life-altering disease?
Over the years, Barbie has held well over 100 different jobs that have literally ranged from A to Z, e.g., astronaut (1965) to zoologist (2021). In between, Barbie also been an Olympic skier (1975), a rock star (1986), a business executive (1992), a film producer (2005), and a martial artist (2017), to name a few other occupations.
However, there’s a big difference between a profession that people choose and a disease that chooses them. Moreover, individuals often undertake years of schooling or other specialized training to prepare for their career, which then becomes a major source of self-esteem, as well as a primary personal identifier when introducing themselves to others. No one says, “Hi, I’m Chris, I’m incontinent.”
It's true that there are many people who rightly take pride in being cancer survivors or in recovering from other major health challenges, like heart attacks. However, I’ve also heard some say that they don’t want a disease to be what defines them. They want to be recognized and remembered for other things.
By marketing a Barbie with type 1 diabetes, is Mattel teaching kids to make the disease what defines them?
To the company’s credit, over many years it has gained considerable experience making dolls with unique physical attributes and related challenges. As might be expected, some of the toys have been better received than others.
Mattel first introduced a Barbie with a disability in 1997: Share-A-Smile Becky, who came with a pink wheelchair. However, the initial success that saw 6,000 dolls sold within the first two weeks was short-lived, as users found that Becky’s wheelchair was largely incompatible with the Barbie Dreamhouse.
In 2000, Mattel marketed a Barbie with vitiligo, a skin condition in which a lack of pigmentation gives a person an uneven, spotty complexion, and another doll with no hair, designed to represent any of the many reasons a child may experience hair loss.
In 2012, The company made Ella, a bald friend of Barbie, distributing a limited number of the dolls directly to hospitals. Two years later, the toymaker produced more Ellas in response to a petition from the mother of a cancer patient.
Mattel released Barbies with different body types in 2016, e.g., tall, curvy, and petite – a significant departure from the doll’s perpetually svelte physique. Unlike other Barbies with unique physical attributes, these dolls’ distinct traits weren’t directly related to diseases or disabilities. Instead, they indirectly supported positive mental health by diverging from society’s homogenized and often unrealistic standards of beauty.
In 2022, Mattel introduced an expanded line of dolls with disabilities, this time consulting experts to ensure even more accurate representation of the conditions. The collection included a Barbie with a prosthetic leg, another with a behind-the-ear-hearing aid, and a Ken doll with vitiligo. AmeriDisability, which seeks to represent America’s disability community, lauded the introduction as “groundbreaking.”
Similarly, in 2023, ahead of the release of its first Barbie with Down syndrome, Mattel worked with the National Down Syndrome Society to ensures the doll’s accurate representation of the genetic condition.
Over the years, Barbie has held well over 100 different jobs that have literally ranged from A to Z, e.g., astronaut (1965) to zoologist (2021). In between, Barbie also been an Olympic skier (1975), a rock star (1986), a business executive (1992), a film producer (2005), and a martial artist (2017), to name a few other occupations.
However, there’s a big difference between a profession that people choose and a disease that chooses them. Moreover, individuals often undertake years of schooling or other specialized training to prepare for their career, which then becomes a major source of self-esteem, as well as a primary personal identifier when introducing themselves to others. No one says, “Hi, I’m Chris, I’m incontinent.”
It's true that there are many people who rightly take pride in being cancer survivors or in recovering from other major health challenges, like heart attacks. However, I’ve also heard some say that they don’t want a disease to be what defines them. They want to be recognized and remembered for other things.
By marketing a Barbie with type 1 diabetes, is Mattel teaching kids to make the disease what defines them?
To the company’s credit, over many years it has gained considerable experience making dolls with unique physical attributes and related challenges. As might be expected, some of the toys have been better received than others.
Mattel first introduced a Barbie with a disability in 1997: Share-A-Smile Becky, who came with a pink wheelchair. However, the initial success that saw 6,000 dolls sold within the first two weeks was short-lived, as users found that Becky’s wheelchair was largely incompatible with the Barbie Dreamhouse.
In 2000, Mattel marketed a Barbie with vitiligo, a skin condition in which a lack of pigmentation gives a person an uneven, spotty complexion, and another doll with no hair, designed to represent any of the many reasons a child may experience hair loss.
In 2012, The company made Ella, a bald friend of Barbie, distributing a limited number of the dolls directly to hospitals. Two years later, the toymaker produced more Ellas in response to a petition from the mother of a cancer patient.
Mattel released Barbies with different body types in 2016, e.g., tall, curvy, and petite – a significant departure from the doll’s perpetually svelte physique. Unlike other Barbies with unique physical attributes, these dolls’ distinct traits weren’t directly related to diseases or disabilities. Instead, they indirectly supported positive mental health by diverging from society’s homogenized and often unrealistic standards of beauty.
In 2022, Mattel introduced an expanded line of dolls with disabilities, this time consulting experts to ensure even more accurate representation of the conditions. The collection included a Barbie with a prosthetic leg, another with a behind-the-ear-hearing aid, and a Ken doll with vitiligo. AmeriDisability, which seeks to represent America’s disability community, lauded the introduction as “groundbreaking.”
Similarly, in 2023, ahead of the release of its first Barbie with Down syndrome, Mattel worked with the National Down Syndrome Society to ensures the doll’s accurate representation of the genetic condition.
So, in many ways a Barbie with type 1 diabetes is just another iteration of differently enabled dolls for Mattel, but what do these dolls mean for our society? Is their net impact positive or negative?
Given that neither dolls nor diseases are in my wheelhouse, I reached out to several people who could answer these questions more authoritatively: Dr. Kevin Barnes – a retired pediatrician, Dr. Sarah Jones – a nurse educator, and Meredith Schorner – an RN and school nurse.
Barnes said he appreciates that Mattel spent more than a year working with a diabetes organization in order to ensure the doll’s accuracy, and he believes that for some of the more than 200,000 children in the U.S. with type 1 diabetes mellitus, it could be therapeutic to play with a doll that experiences the same things they do.
However, he also expresses some valid concerns, for instance:
- Where do we draw the line on dolls representing childhood diseases, particularly ones that are somewhat “invisible” to others even though they greatly impact daily life, e.g., celiac disease, asthma?
- Given Barbie’s history of more often emphasizing style over substance, how much of Mattel’s motivation in making the doll is the positive publicity it generates?
Jones believes that the type 1 diabetes Barbie can potentially do much good by helping to make the condition more mainstream, or acceptable, which among other things, could encourage proper self-management. That care is critical given that the disease demands intensive insulin therapy with either multiple daily injections or an insulin pump.
With confirmation from a colleague who regularly cares for diabetes patients, Jones states that Barbie’s self-monitoring insulin pump is the standard for treatment, which Jones sees as positive overall. However, like Barnes, she also raises some important questions about the doll:
- Does its female Caucasian identity fall short in representing the disease’s well-documented impact across gender and racial lines?
- Could Barbie’s continuous glucose monitoring device and insulin pump create stigma for children whose insurance will not cover the advanced technology and for families that cannot afford it so they must rely on traditional injections?
- Could the doll make it more socially acceptable to have type 1 diabetes but not type 2? This may be an increasing concern given that incidences of type 2 diabetes, which is often associated with obesity, are on the rise among children.
Not surprising, Jone’s differentiation of the two sometimes conflated conditions coincides with that of the University of Virginia Health System, which states that “Unlike type 1, type 2 diabetes is not an autoimmune disorder,” rather it “occurs mostly in people over 45, or in younger people with obesity or genetic reasons.”
Besides her role as a school nurse, Schorner is a parent of young girls who believes the diabetic Barbie will be “an exciting new toy for many.” More than just a plaything for those who have type 1 diabetes, she expects the doll will raise questions for nondiabetic children and help them better understand the devices they see on some of their peers. She elaborates:
“Children need to know that their peers with type 1 diabetes (T1D) didn't do anything ‘wrong’ to become diabetic – they didn't eat too much sugar, and it certainly doesn't have anything to do with their weight. T1D is increasing in prevalence, and diabetic children need lots of support at home and at school. They need peers that can be not just understanding but also helpful to them in managing their diabetes.”
“Under the guidance of a knowledgeable adult, engaging in play with this doll may help young children develop a basic understanding of CGM readings, carbohydrate counting, and insulin requirements. It could also help children to know what to do if they encounter a person experiencing a diabetic emergency.”
Schorner has firsthand experience caring for children with type 1 diabetes. In one case, the child’s family chose finger sticks and insulin injections, at least in part because they were concerned that a more socially visible glucose monitor might label their child as a diabetic.
Another case involving a child who uses a glucose monitor and pump was different. Schorner recently had the privilege of telling this child about the new Barbie. When she did, the child’s face “lit up with excitement,” and they immediately asked to see a picture of the doll on Schorner’s phone. The child compared their technology to the doll's and although they weren’t the same, they appreciated seeing the doll with its accessories and seemed eager to add the Barbie to their nearly nonexistent collection of diabetes-related toys.
Notwithstanding this very positive response, Schorner added that not all states or insurance companies offer the same assistance to help cover the out-of-pocket cost of insulin pumps. Consequently, she can imagine how the Barbie could be discouraging to families of diabetic children that don’t have the means to purchase newer insulin-dispensing devices.
Over a decade of writing Mindful Marketing articles, I’ve often relied on experts to help me know the relevant facts and understand the nuances of complex ethical issues. The question of whether Mattel should market a Barbie with type 1 diabetes was certainly one for which I’ve needed such assistance.
The three experts on which I leaned for this piece have been extremely helpful to me in elucidating the case’s multifaceted, competing considerations. Despite the very real reservations that Barnes, Jones, and Schorner all offered, it seems that each believes there’s a place for a diabetic Barbie.
Their informed input certainly has shaped my opinion, but what may have been most impactful is the heartfelt reaction of a diabetic child who loves that a special Barbie will reflect their unique life experience.
No toy is perfect, but one that receives significant support from healthcare experts and that instantly delights a child with a life-altering disease most likely represents Mindful Marketing.
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Check out the book, Mindful Marketing: Business Ethics that Stick
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