Times have changed since The Who famously honored body art as the equivalent of testosterone: “Welcome to my life, tattoo. I’m a man now, thanks to you.” Tattooing is no longer seen as the exclusive domain of men and women are flocking to tattoo artists in record numbers. A study earlier this year by Oxygen Media revealed that 59 percent of people with tattoos are female, with the most popular images being hearts and angels.QUIZ: Do You Love the Skin You’re In?The choice of an image is a totally individualized expression of personality, creativity and aesthetics. A particular picture may make a women feel pretty or sexy or powerful or artsy, and that feeling can boost her self-esteem and give her more control over how she presents herself to others.As with other forms of self-expression, why a woman gets a tattoo and what form it takes depends on the woman.I worked with a young woman for many years as she struggled and triumphed through a serious eating disorder and self-harming behaviors. Now in college, she recently got her first tattoo: the expression “this too shall pass” in Hebrew across the back of her neck. Through the years, her father used that phrase often to soothe her during difficult times, as his mother had when he was a child. For her, the tattoo represents love and strength, and connects her to her father, as well as to her own sense of endurance and inner peace.COLUMN: How Do You Present Yourself to the World? Sometimes women tattoo themselves to tell a story, either privately to only themselves and intimate others, or publicly for the world to see. A tattoo may reflect a special place or event, a favorite thing, or a meaningful quote or idea. Angelina Jolie’s tattoos famously and publicly commemorate the birthplaces of her children. In contrast, Penelope Cruz has refused to reveal the personal significance of her “883” ankle tattoo.Traditionally, many tattoos pay tribute to a relationship—current or lost. The ubiquitous “MOM” on the sailor’s bicep is a prime example. Many women choose to honor a significant other, or a child with inked designs or names. Pets and special friends appear as well. As part of a current relationship, a tattoo can be a bonding experience and an expression of commitment. Choosing a tattoo that honors a lost loved one can feel like a way to keep the memory alive, and to create a never-ending connection. A woman I know who has experienced several miscarriages has a lovely tattoo of angel wings in honor of those losses. For some, tattooing can be a valuable part of the grieving process, and facilitate moving forward in life.GALLERY: Celebrity Tattoos—Guess Who!And sometimes a tattoo is just a tattoo. A woman may choose a tattoo simply because she likes the way it looks. It’s creative expression through a permanent piece of art. I’ve taken an informal survey of friends and colleagues, and besides hearts and angels, we’ve seen flowers, horses, sunsets, Disney characters, soccer balls, skulls, guitars, boats—it seems that almost anything is possible in the hands of a talented artist.Considering a tat? As with most forms of self-presentation, a tattoo is most likely to be the right choice when it’s well thought out and when all the short- and long-term effects are carefully weighed. Tattoos are permanent, after all.It’s most likely to be a fulfilling expression of self when it’s chosen for a healthy reason—for example, to commemorate a triumph or permanently capture a design you love—rather than to hold on to a wandering boyfriend or satisfy an insistent friend. In other words, you are most likely to be happy with a tattoo forever if you get it because, after thinking about it for a while, it really truly feels like the right choice for you.MORE: Body Art SafetyIf you’re wondering why a woman you know chose a particular tattoo, or why she chose to tattoo at all, the best way to find out is to ask her. Ink is as individual as the woman who wears it.Visit BluebirdPages.com for more stories, advice and information to help you feel better in your life, in your relationships and in your own skin, from our Self-Image Expert, Heather Quinlan. Topics include relationships, sadness, food, weight, body-image, stress, work, self-esteem, trauma and self-care.