Objective: To compare the results of a 1996 study of tattoo possession and motivation for tattoo removal with those of a 2006 study, in light of today's current strong mainstream tattoo procurement and societal support within the young adult population. Design: Descriptive, exploratory study. Setting: Four dermatology clinics in Arizona, Colorado, Massachusetts, and Texas. Participants: The 2006 study included 196 tattooed patients (66 men and 130 women). Main Outcome Measures: Incidence of purchase and possession risk, as measured by a 127-item survey and factor analysis. Results: In contrast to the 1996 study, more women (69%) than men (31%) presented for tattoo removal in 2006. Women in the 2006 study were white, single, college educated, and between the ages of 24 and 39 years; they reported being risk takers, having stable family relationships, and moderate to strong religious beliefs (prayer and closeness to God). Commonly, tattoos were obtained at approximately 20 years of age, providing internal expectations of uniqueness and self-identity. Tattoo possession risks were significant, cited when the quest for uniqueness turned into stigmata (P<.001), negative comments (P<.003), and clothes problems (P<.004). Conclusions: In both the 1996 and the 2006 studies, a shift in identity occurred, and removal centered around dissociating from the past. However, in the 2006 study, more women than men were notably affected by possession risks. Societal support for women with tattoos may not be as strong as for men. Rather than having visible tattoos, women may still want to choose self-controlled body site placement, even in our contemporary society.