In this thesis I examine the influence of a cultural model of tattooing on psychological and biological stress in a sample of Southern tattooed women. The handicap principle of sexual selection states that a high risk ornament is utilized by a mate to show high-quality health. The handicap principle in regard to tattooing would mean that tattooed people would be consistently rated as more physically attractive and healthier. This was not the case in previous studies because cultural factors also influence the opinions of tattooing. Women internalize different cultural models from their friends and family well before they make the decision to get tattooed. I sought to determine if these opinions of tattooing are associated with perceived stress among 50 participants, and if tattoo experience is associated with biomarkers of stress (salivary immunoglobulin A) among 25 of the same participants receiving a tattoo. I used mixed qualitative and quantitative methods to group participants by positive and negative opinion for comparison of perceived stress and by high and low tattoo experience for comparison of S-IgA change. Results indicate that the tattoo opinion models I constructed for this study were not the most important variables when predicting perceived stress, but that individuals with more tattoo experience have adapted to the biological stress of tattooing. These data suggest that the immune response is enhanced by tattooing, but that an evolutionary signaling theory of tattooing requires incorporation of cultural models. Tattoos may not indicate better health in an environment where tattoos come with numerous preconceptions.