Wait… What?

‘Breast flattening,’ also known as ‘breast ironing’ or ‘breast massage,’ is a practice whereby a young girl’s developing breasts are massaged, pounded, pressed, or patted with an object, usually heated in a wooden fire, to make them stop developing, grow more slowly or disappear completely.

Rebecca Tapscott* spent last August in the area of Bafut, in the Northwest, Anglophone region of Cameroon, where a 2006 study by the German Society for International Cooperation (GIZ) found an 18% prevalence rate of breast flattening. The practice has been known as breast ‘ironing,’ however, Rebecca opts to use the term ‘flattening’ to decrease stigma and encourage open conversation about a practice that remains largely hidden.** Rebecca wanted to understand the role of breast flattening in the broader context of adolescence in Cameroon, including past and present motivations for breast flattening; cultural foundations; relation to other forms of gender-based violence such as female genital mutilation or cutting (FGM/C); how and where it is practiced; the psychological and the physical implications of the practice on individual girls.

Rebecca published her findings via the Feinstein International Center in May 2012, in a paper titled: Understanding Breast “Ironing”: A Study of the Methods, Motivations, and Outcomes of Breast Flattening Practices in Cameroon.

She visited our office late last year to share the results of her work with staff at the Plan USA office, explaining that there is currently very little research or documentation of breast flattening. The GIZ study is the only quantitative study on the practice, and there do not seem to be any medical studies on breast flattening. It’s a practice that is believed to affect 1 out of 4 girls in Cameroon, more commonly in some regions than in others. Of note is that research on breast flattening has thus far only been conducted in Cameroon, thus creating the impression that the practice is uniquely Cameroonian, when in reality, it may be a regional phenomenon.

Organizations working to end breast flattening do so with the aim of protecting girls. However, the question of protection is an interesting one depending on who you talk with. Rebecca found that those who practice breast flattening also believe they are protecting girls. “Many mothers believe that unattended, a girl’s breasts will attract advances of men who believe physically developed girls are ‘ripe’ for sex. Breast flattening is seen as a way to keep girls safe from men so that they are able to stay in school and avoid pregnancy.”

According to Rebecca, breast flattening is practiced out of a desire to delay a girl’s physical development and reduce the risk of promiscuous behavior. Proponents of the practice consider that “men will pursue ‘developed’ girls and that girl children are not able to cope with or deter men’s attention. They see that promiscuity can result in early pregnancy, which limits educational, career, and marriage opportunities, shames the family, increases costs to family (newborn, loss of bride price, health complications from early childbirth or unsafe abortion).” In addition, there is the belief that girls are not sufficiently intellectually developed to learn about puberty, and therefore should not yet develop breasts. Another reason given for the practice is the belief that girls who develop before their classmates will be the target of teasing and become social outcasts. There is also, for some, the belief that large breasts are unattractive or not fashionable.

Rebecca cites a poor understanding of human biology as one reason that the practice persists. Some of the beliefs around it include: “Belief that sensitivity and pain during breast development indicates that the growth is too early and must be artificially delayed until the girl is older. Belief that when a girl develops breasts she will stop growing taller. Belief that puberty can be delayed by delaying breast development. Belief that for breasts to grow properly, the first growth should always be repressed (like baby teeth). Belief that if breasts begin growing at a young age, they will grow too large or be misshapen, resulting in a displeasing or disproportionate female form. Belief that breasts and other outward signs of sexuality develop in accordance with a girl’s interest in sex, and therefore a developed girl is soliciting sexual advances or is a ‘bad’ girl. Belief that when a girl develops breasts, she believes she has matured and subsequently, she becomes less obedient. Belief that it will improve breast feeding at a later age.”

“…For mothers there is the perception that we should delay the development of girls as much as possible, believing that physical development shows maturity. Men look at girls and talk amongst themselves and say, “she’s ripe for sex.” They are not looking for marriage prospects…Men are aggressive. In pidgin, they say “she got get done big,” meaning, she’s matured and ready for sex. I can go after her now. Women, on the other hand, know that their daughters are just kids.” ~ journalist that Rebecca interviewed.

Rebecca also heard explanations such as “A girl will stop growing taller because the weight of her breasts will hold her down. One can delay puberty by delaying breast growth. If the breasts hurt during puberty, they are developing too early.” There are also many beliefs related to a girl’s development and her sexual reputation. Some of these beliefs include that a girl with large breasts is a ‘bad girl’. This stems from the belief that breasts start to develop when a man touches them or if a girl is thinking about sex, going to night clubs or watching pornography. Rebecca found that many of these beliefs were held across all segments of society, from the very well educated to those with no formal education.

“The body responds to psychological ideas. If a girl looks for a “friend,” her breasts will grow faster. If she is interested in boys or watches pornography, her body will develop faster.” ~ Interviewee at the Ministry of Social Affairs

“If a girl is interested in sex and thinks about it a lot, she will develop faster. I saw two girls of 12 years, one of whom was very developed physically and the other was not. The one who was developed could speak very frankly about sex, showing that she was knowledgeable from some experience, while the other girl was very naive and shy.” ~ Teacher

Because of potential stigma or harm to girls who talked about undergoing breast flattening, Rebecca only interviewed a few teenaged girls directly during this phase of her research. Instead, she mainly interviewed older women, as well as a few boys and men. She found that most women who had experienced breast flattening didn’t seem to remember the experience as extremely traumatic; however, she commented, “most are remembering from back in the day. Most at first said didn’t really hurt but then after a while into the interview, they’d remember, well, yes it hurt.” Rebecca was surprised at the number of people who said that heated leaves were used, because the media normally reports that a grinding stone or pestle is used for breast flattening.

“When I was 11 years old, my grandmother did a form of breast flattening to me. This was in 1984. I was walking around with her shoulders hunched forward to hide my developing chest, so my grandmother called me to the kitchen. She warmed some fresh leaves on the fire and said something in the dialect, like a pleading to the ancestors or spirits. Then she applied the leaves to my chest, and used them to rub and pat my breasts flat. She would also rub and pat my back, so as to make the chest flat and even on the front and the back. It hurts because the chest is so sensitive then—but they are not pressing too hard.” ~ 38 year old woman from the community

“To do the practice, I warmed the pestle in the fire, and used it in a circular motion to press the breasts flat. I did it once per day for over a week—maybe 8 or 9 days. I massaged them well, and they went back for seven years.” ~ 53-year-old woman attending a maternal health clinic in Bafut, attending with a different daughter whose breasts she did not flatten

“Until about a year ago, I believed that when a girl is interested in sex, watches porn, or lets boys touch their breasts, her breasts will grow larger. I think my mother must believe this. My ideas changed when I saw my own friends—I knew they were virgins, but they had large breasts. Also when my own breasts got bigger, and it was not because a man was touching them.” ~ Journalist in Bamenda

There is currently no consensus on whether the practice is effective at reducing the size of a girl’s breasts or if it has long-term effects on breast size. “People told me completely different things gave the same result, or people cited the very same practices as yielding different results,” said Rebecca.

Rebecca’s findings indicate that the practice of breast flattening is not a longstanding ‘traditional’ practice. Many people reported that it became more popular with urbanization. “People [who immigrated to cities] didn’t know their neighbors and they were worried about the safety of their daughters. It seems that an old practice that was used for ‘shaping’ was repurposed and adapted. Breast flattening is a very intimate and personal thing between mother and daughter. It doesn’t happen to all daughters. It’s very difficult to track, and there is no association with ethnic groups, education, socioeconomic levels, religion, etc.,” she explained.

“Most men don’t know about it. One boy said he thought it was good to protect girls.” When she talked holistically with men about what they look for in a woman, Rebecca said, “an interest in chastity and virginity came out very clearly. In Cameroon the average age for girls to lose virginity is 13-17, and it’s the same for boys. According to studies, for most, the first sexual experience is unwilling.”

Most doctors that Rebecca talked to had never heard of the practice. One doctor in Yaoundé said he had seen first and second degree burns as a result. Some cite that edemia may be a result. Development organizations like GIZ say it can cause cysts, cancer, and other difficulties but also cited that only 8% of women report suffering negative side effects, while 18% report that their breasts “fell” or sagged at an early age.

Many women who Rebecca interviewed considered the practice a very low concern compared to other problems that impact on their development, such as illiteracy, sexual exploitation, poverty and unemployment. “The women that I talked to,” said Rebecca, “often asked me, ‘Why are you asking me about this? It’s such a small thing compared to other things we have to face.’”

Given that there is not much research or consensus around breast flattening in Cameroon and the broader region, Rebecca’s work may be of use to local and international organizations that are working to promote women’s and children’s rights. Rebecca emphasizes that most people who engage in what are commonly referred to as ‘harmful traditional practices’ including female genital cutting (FGC) and breast flattening, actually do so with their child’s best interest in mind, as a means of protecting and promoting the child within the community and following social norms. Therefore, frightening or berating people may not be the best approach to discourage the practice of breast flattening. Community input will be needed to identify the root causes of the practice for it to become obsolete. Better sex education and a reduction in stigma around talking about sexual reproductive health may also help. Men will need to be part of the solution, and so will mothers who currently feel the need to take protection of their daughters into their own hands. Like many similar practices, it’s not likely that breast flattening will end until other systems and environments that set the stage for it also change.

*Rebecca worked with Plan Cameroon for several weeks on the Youth Empowerment through Technology, Arts and Media (YETAM) Project last June and July. She traveled to Bafut following her internship to conduct independent research.

**This distinction is similar to the difference between the terms female genital ‘mutilation’ and female genital ‘cutting.’

Read the full report.

Contact Rebecca for more information: rebecca.tapscott [at] gmail.com

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