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When Karen Elson was a young hopeful trying to make it in Paris, a model scout took her to a nightclub. After long days on the Métro trekking to castings that came to nothing, and evenings alone in a run-down apartment, she was excited to be out having fun. The music was good and the scout, to whom her agent had introduced her, kept the drinks coming. She started to feel tipsy. A friend of the scout’s arrived, and the pair started massaging her shoulders, making sexual suggestions. “I was 16 and I’d never kissed a boy,” she recalls. “It was my first experience of sexual – well, sexual anything, and this was sexual harassment. They both had their hands on me.”

She told them she wanted to go home, and left to find a taxi, but they followed her into it, kissing her neck on the back seat. When they reached her street, she jumped out, slammed the taxi door and ran inside. The next day she told another model what had happened, and the scout found out. “His reaction was to corner me in the model agency and say: ‘I’ll fucking get you kicked out of Paris if you ever fucking say anything ever again.’”

Twenty-six years later, Elson is telling me this story from her sixth-floor suite in the Ritz hotel in London. The scout did not get her kicked out of Paris. She got booked for a shoot in Tokyo by an up-and-coming young American designer called Marc Jacobs, then Donatella Versace hired her as a fitting model to help her fine-tune her clothing. On Elson’s 18th birthday, Steven Meisel photographed her for the cover of Italian Vogue, her strawberry blond hair chopped into a Louise Brooks bob and tinted crimson, her pale skin exaggerated to alabaster, and a career as a supermodel began. Karl Lagerfeld called her “the beauty of the new millennium” and she is still going strong. At Paris fashion week this autumn, she walked in the Balmain show between Milla Jovovich and Carla Bruni-Sarkozy; in Milan, she was on stage alongside Kate Moss and Gigi Hadid for a collaboration between Italian powerhouses Fendi and Versace.

Today, the trappings of success are all around. A vast bouquet sits in its cellophane, a plate of fanned sliced fruit is untouched on the desk. But Elson takes a sip from a bone china teacup and tells me that the legacy of her 25 years at the top of the modelling game is “a shit ton of PTSD”. Her distinctive Elizabethan colouring is still radiant against black cashmere, her complexion still peachy and wrinkle-free (more of which later), but her verdict on fashion lands with a punch. “Modelling looks like it’s all glamour, and it really is not,” she says. “I survived sexual harassment, body shaming and bullying. And I am supposedly one of the lucky ones.”

‘I could smell the misogyny’: corset adjustment before the Victoria’s Secret 2001 lingerie show. Photograph: Evan Agostini/Getty Images

Not long after that night in Paris, Elson was living in Milan, signed to “an agency run by women who gave it to me straight: ‘Do not go to clubs, because the men who take models to clubs are sleazy and you will be in danger.’” Some of the girls in Elson’s apartment were not so lucky. “I remember one waking up with bruises on her neck. We were all horrified. They were young models, full of hopes and dreams, and the people who were supposed to be their guardians were preying on them. The agents had prestige names on their books, girls who were in Vogue and getting big campaigns, but they also had young models they went to nightclubs with.” Models who are earning little money are given free drinks in clubs, sometimes taken to fancy restaurants, in return for being arm candy. “Sometimes there is a fine line between modelling and escort work, and the girls don’t realise it. I’m not shaming them for that.”

Last year, a Guardian investigation by Lucy Osborne revealed decades of alleged abuse by former Elite Models boss Gérald Marie. This summer, the model Carré Otis filed a suit against Marie – who denies all allegations against him – for rape and sex trafficking, abuse she claims began when she was 17. Elson, who has led calls to reform the model agency system, booking most of her own shoots for the past four years, immediately offered her support. “We need to figure out why the fashion industry enables so much toxicity and [we need to] finally make positive changes,” she wrote on Instagram.

For a time, Elson was also represented by Marie. “My impression was he was a sleazy man,” she says, speaking publicly about him for the first time. “But I never had anything happen with him. To be blunt, I don’t think I was … well, that I was a bit odd-looking and ginger granted me some protection. Not always, but sometimes.”

Model Karen Elson in checked dress, sitting on floor, against blue background‘I just wanted so badly to fit in.’ Photograph: Silvana Trevale/The Guardian. Dress, trousers and sandals: Jil Sander. Earrings: Bar Jewellery

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Elson has seen how a toxic blend of international travel, lack of transparency and an unequal power structure can shade modelling into trafficking. In March, she began running “model mentor” workshops online, giving advice to young people in the industry. A young eastern European woman at one session told Elson her passport had been confiscated when she tried to leave an agency. “I was like: withholding your passport, that’s human trafficking. And her agency was also telling her she’d get kicked out of the country if she left.”

In 2001, the Victoria’s Secret televised lingerie show was in its pomp, with 12 million viewers tuning in. Rupert Everett was the host; Mary J Blige performed that year’s inescapable hit, Family Affair. It was a high-profile, lucrative job, but Elson recalls “walking out and seeing a bunch of lecherous men in the audience. I could smell the misogyny. I didn’t feel beautiful, I felt ridiculous. I felt like someone else’s fantasy of a redhead, in a red G-string and devil horns, or whatever the fuck I was wearing.” Later, I look up the pictures. Elson is in a red G-string and corset, though no devil horns. Most of the other models toss their ringlets and flash toothy grins; Elson, half hidden under long straight hair, looks stone-faced. “I felt sad the whole time I was doing it,” she says.

Karen Elson shot in bed with a crocodile shot for the December 2008 issue of British Vogue by Tim WalkerElson with a crocodile, shot for Vogue in 2008. Photograph: © Tim Walker Studio

Elson has never been a cookie-cutter beauty queen. Growing up in Oldham, “with frizzy red hair and ghost-white skin and no boobs” at a time when every teenage boy she knew had a poster of Cindy Crawford on his wall, she kept her early modelling ambitions quiet. After signing to Boss Models in Manchester, she left school early every Thursday to go there, claiming she was off to see the orthodontist. The day after she finished her GCSEs in June 1995, she caught the train to London, dragging her suitcase straight to the office of Models 1.

Photographer Tim Walker’s Vogue portraits of Elson have featured her in bed with a giant crocodile, or in white tuxedo trousers with braces and no blouse. He met Elson and fellow model Erin O’Connor for the first time in 1997 and thought they didn’t look like models: “They looked like people I knew, art college friends.” With her marble skin, flaming hair and fine bone structure, Elson can look “androgynous and ethereal, so I wasn’t so much the sexualised object,” she says.

But being pigeonholed as otherworldly came with its own issues. “I was put in this box where I was a freak, and as a result it was as if I wasn’t real. I wasn’t supposed to have feelings.” Having reached the supermodel ranks, she experienced a kind of impostor syndrome. “I just wanted so badly to fit in. I wanted to be Claudia Schiffer and instead I felt like the red-headed stepchild.”

Now, if someone wants to take a nude, they have to explain why. Funnily enough, no one ever asks me any more

Despite Elson’s slender frame, through much of her career she has been bullied over her weight by people in the industry. A well-known Italian designer once described her, to her face, as “a beast” and “disgusting”. A US model agent offered to pay her money for every pound she could lose. Once, in desperation to get work, she booked into a “health spa” in California where she fasted for seven days. She flew straight to Milan for fashion week (“looking skeletal”) and the compliments – and bookings – flooded in.

Just before our interview, Elson texts to say she is about to order room service, asking if I want anything. When her lunch arrives, she ignores the food, saying she feels too self-conscious to eat during the interview. (It is under a silver dome, but I think it’s a salad.) Clumsily, I comment on her “self-control”, to which she replies with a wry smile that “self-control is my achilles heel”.

Eating disorders have plagued her since she was seven when, unsettled by her parents’ increasingly unhappy marriage, she stopped eating and was admitted to hospital. “Food has always been attached to trauma for me,” she says. “And then I went into an industry that played into my biggest insecurities.”

With the help of “a great therapist, who used to be a ballerina and understands body dysmorphia”, Elson has reached a “safety zone”. “I sincerely do eat these days. I will never do another diet as long as I live because they make me feel like I’m losing my mind, but if I’m on set and a dress doesn’t fit, it’s really hard not to go to that place where you start thinking, if I was 12lb skinnier … I’m not going to do anything drastic any more, but the thoughts still appear. I run really fast four times a week and, yes, I love it mentally, but I also love how it makes me look, and it’s important to be candid about that. It’s a rollercoaster for me still.” Her therapist would like her to give up modelling, she says.

Behind the lip service to diversity, fashion’s obsession with thinness persists. “I looked at photos from a catwalk show recently and the models were so, so thin. Not the kind of thin you get by going for a healthy jog in the morning – the kind you get when you stop eating. I find it heartbreaking to see that still.” Recently, someone in the industry greeted her with: “You’ve lost so much weight in your face, you look great!” she recalls. “I said to him, ‘You know, “Hello, how are you?” would be nicer.’”

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Model Karen Elson sitting on a white chair against a grey background‘I will never do another diet as long as I live.’ Photograph: Silvana Trevale/The Guardian. Dress, earrings and heels: Fendi. Belt: Missoma

But there have been good times, too. She danced for Alexander McQueen’s landmark Deliverance show in 2004 and this year starred in a mini-musical for Moschino. When she feels a connection with a photographer on set, being a model is like being “lightning in a bottle”, she says. In her memoir The Red Flame: a Journey of a Woman, she writes about her breakthrough shoot with Meisel. “We shot for two glorious hours. I had never felt more excited. I left the studio to go back into the snow with only a single subway token, but I had never felt so joyful.” But while her unique looks caught the eye of the most creative photographers, being stereotyped as edgy often meant being expected to take her clothes off.

“I would suddenly be given a see-through dress, or a pair of knickers and no top, and told: ‘That’s the image.’ My opinion didn’t come into it,” Elson says. Sometimes the results were poetic, beautiful images of which she is proud – her memoir includes nude portraits by Walker, Peter Lindbergh, Mert and Marcus – but there are other images she dislikes because she felt uncomfortable on set. These days, she has learned to set out boundaries. “If someone wants to take a nude, they have to explain the context, why it’s necessary and how they intend to ensure I feel safe and comfortable.” She laughs. “Funnily enough, no one ever asks me to be nude any more.”

Because our society struggles to distinguish what a woman looks like from who a woman is, models have become ciphers for femininity. Debate about them is charged because it is never just about models, but about the institutionalised misogyny of a world where the female experience can feel like a never-ending beauty contest in which even the winners are shortchanged. “Power is so elusive as a model. Even as a supermodel, it doesn’t feel like you really own your power,” Elson says.

You know what’s really messed up about fashion? When I was totally exhausted and fragile was when people loved me most

Her words remind me of a point made by Emily Ratajkowski in her essay collection My Body – that exploitation is inevitable in “a value system that revolves around men and their desire”. Elson is encouraged “by Emily taking control of her own voice, the way other people have taken control of her image”. Yet when she describes Ratajkowski in person, Elson’s articulate, crisp sentences dissolve into breathlessness. She was “blown by how beautiful, how ridiculously beautiful, she is. It’s like … how is your stomach so flat? How is that even possible? Everything about her is just … And God Created Woman, you know?” Everyone, it seems, is conditioned to objectify Ratajkowski-level beauty, even supermodels campaigning against objectification.

There is a fractiousness in the conversation around models that model and labour activist Sara Ziff, founder of the Model Alliance, has termed the “empathy gap”. Ziff argues that the job’s ultra-glamorous image does a disservice to most models by giving the impression that anyone with their picture in a magazine is flying first class with suitcases stuffed with cash. “The biggest misconception about modelling is the money,” Elson says. “Most working models are barely getting by.”

Elson’s father was a joiner in construction; her mother stayed at home, occasionally taking odd jobs to make ends meet. Elson and her twin sister, Kate, shared a bed held up by tin cans. She has rarely known the luxury of not worrying about money. Because her off-kilter looks tended to appeal more to editorial clients than to commercial ones, her income has been erratic. “I’d get home from a shoot and once all the expenses were added up, I’d be in debt.” For a prestigious magazine, a 20-hour shoot might pay a flat fee of only £150, “and if you’re flying yourself somewhere, the debts can rack up”.

Model Karen Elson in brown shoulderless dress against blue background‘I felt like someone else’s fantasy of a redhead.’ Photograph: Silvana Trevale/The Guardian. Styling: Melanie Wilkinson, assisted by Peter Bevan. Hair: Shukeel Murtaza at the Only Agency. Makeup: Beau Nelson at the Wall Group. Dress: Khaite, from Selfridges. Earrings: Alighieri

A lack of financial transparency is symptomatic of the way models “are made into powerless, passive entities in their own industry, rather than treated as professionals”, she says. “The agents’ attitude was always – you’re just a pretty face, get out there and milk it until the wrinkles arrive, then you’ll be carted back to your home town.” Elson says she would ask an agent how much she’d be paid for a job and “practically hear the eye roll over the phone – here she goes again, being difficult”. Now she is represented by a talent agent and a publicist: “I’m never signing with another model agency as long as I live.”

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In 2005, Elson, ghostly in white tulle and teetering on her heels, starred in a music video for Blue Orchid by the White Stripes. Within a few weeks, she and frontman Jack White had eloped to the Amazon rainforest where they were married by a shaman. They divorced in 2013. Her memoir makes no mention of the restraining order she took out against him that year, saying only that “eventually the dust settled” and the two are now “loving co-parents” to their children Scarlett, 15, and Henry, 14.

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Having long harboured musical ambitions, Elson released her first album as a singer-songwriter, The Ghost Who Walks, in 2010, followed by Double Roses seven years later. Her music – a gothic kind of blues, part folksy Americana, part Left Bank chanteuse – has won over sceptics of the “model marries rock star, makes record” narrative. (“Ethereal pop majesty with a mesmerising talent,” wrote this paper in 2017.) An EP of covers recorded during lockdown, Radio Redhead, will be followed next year by a third album, Green. Yet music, Elson has discovered, can be as misogynistic as fashion. “In fashion, the misogyny is more superficial – the men don’t necessarily want to sleep with me, they want to objectify me in a picture. In music there are still powerful straight white men who operate under the myth of the tortured genius. There have been men who said they believed in my talent and then it turned out they wanted to sleep with me. It was humiliating.”

We are living in the era of supermodel reparations. Paulina Porizkova and Carla Bruni-Sarkozy have joined Elson in offering support to Carré Otis. Linda Evangelista, who has posted about being “permanently deformed” by complications after a cosmetic procedure on her face, is “a good friend. It is so difficult to be a supermodel getting older and have what you looked like 20 years ago held up as a comparison the whole time. I’ve had two kids, and to walk on set and be given an outfit that would work on a 17-year-old is hard.” Evangelista speaking out “is really brave because it goes against decades of conditioning to be the beautiful face and stay silent”.

At 42, Elson’s own face is wrinkle-free. “I have had Botox, and I like it,” she says. “I haven’t done filler yet, but I probably will.” She kneads her sculpted cheekbones with manicured nails, miming an imaginary lift. She’d love to champion natural beauty, she says, but she isn’t going to pretend she’s not “feeling the pressure. Let’s just talk about it, you know? The cloak-and-dagger around Botox isn’t helpful, because not admitting to it perpetuates images that aren’t realistic.”

Elson’s next appointment has arrived – a film crew, pacing the corridor outside – and she still hasn’t had a chance to eat her salad. She promises she will call to say goodbye properly, and a few days later is on the phone from Nashville, Tennessee. The city is home, she says, because, years ago, “my husband Jack and I fell in love with Nashville and bought a house here, kind of impulsively. Two kids later, I looked around and I was like – huh, I guess I live in this town now,” she laughs.

“Having kids taught me boundaries, and Nashville gave me an escape from fashion. The realness to life here is such a blessing.” To her kids and her neighbours, she isn’t a supermodel; she is “a dorky British woman, sitting here on my bed with a cup of tea, my big tom cat Fergus on my lap.” She has come a long way from Paris, in every sense. “You know what’s really messed up about fashion? The moments when I was totally exhausted and fragile were when people loved me most. It was like, she’s major! But at the expense of my health and my sanity. And I got to a point where I thought, I’m a grown fucking woman, you know? I’ve got two kids. I’m a good mother. I don’t want to be a broken doll any more.”

In March, Elson will appear in a Sky Documentaries series, telling the story of sexual exploitation in the modelling industry. Building on an investigation by journalist Lucy Osborne, first published in the Guardian’s Weekend magazine, it will be produced by Wonderhood Studios and the Guardian.

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