Updated September, 2020

Introduction

Breast ironing is a painful practice where heated objects are pounded on the breasts of young girls to suppress the growth of their breasts.^[1] Stones, hammers, brands, pestles, brooms, leaves, large spatulas, and similar objects are heated over hot coals or in ovens, and then beat on the breast tissue of prepubescent and pubescent girls.^[2] To further prevent the breasts from developing normally, some girls may also be subject to elastic belts wrapped around the chest.^[3] Perpetrators of breast ironing believe that beating breast tissue with hot grinding stones will melt the breast fat, causing impairment and cessation of growth of the breast, and delaying the age at which girls are viewed as ready for marriage or sexual activity.^{[4] [5]} This violence is performed because of a belief that preventing the natural development of breasts protects the girls from rape, child marriage, abduction, harassment, and pregnancy, allowing for girls to continue their education and stay in school.^[6] Perpetrators believe they are engaging in an act helpful to a young girl by enabling her to continue her education.^[7] Yet, breast ironing is ineffective at protecting women from sexual harassment and exploitation. Nearly forty percent of children in Cameroon are married by their 18th birthday; more than a quarter of teenage girls are mothers; and twenty percent of girls drop out of school after becoming pregnant.^[8] Breast ironing is ineffective at slowing physical maturity and dangerous to physical and mental health.^[9]

Prevalence

Breast ironing affects nearly four million girls and women around the world and is considered an under-reported crime relating to gender-based violence.^[10] Girls will often remain silent because they believe it is for their own good for practice to be carried out.^[11] There is no correlation of the practice with socioeconomic level, urban or rural living, religious affiliation, or ethnicity.^[12] The practice is mostly performed by family members – the girl’s mother is responsible 58 percent of the time.^[13] Between 25 and 50 percent of girls in Cameroon are affected by breast ironing, but the geography of the practice is not limited to Cameroon.^[14] Girls in Benin, Ivory Coast, Chad, Guinea-Bissau, Kenya, Togo, Zimbabwe, Guinea-Conakry, and other locations of the Cameroonian diaspora, including nearly 1,000 girls in the United Kingdom, are thought to be at risk of breast ironing.^[15] The younger that girls are at the onset of puberty, the more likely they are to be subjected to breast ironing, with girls who show puberty before the age of nine more than twice as likely to undergo breast ironing.^[16]

The practice is also prevalent in refugee camps, where women and girls have reported sexual harassment by host communities and other refugees.^[17] Female refugees and displaced people are at a high risk of sexual harassment and exploitation.^[18] The United Nations is aware of a high level of "survival sex" - women turning to sex work out of desperation - and many incidents of sexual harassment and exploitation, likely go unreported.^[19] The high rates of sexual harassment and exploitation in refugee camps can increase the practice of breast ironing, since perpetrators of the practice believe breast ironing deters sexual attacks.^[20]

Health Consequences

Breast ironing is a form of physical mutilation that also damages a child's social and psychological wellbeing, and contributes to the high rate of school dropout among girls subject to the abuse.^[21] The effects can be traumatic. In addition to causing pain, breast ironing can cause girls to feel shame over their bodies.^[22] Girls often trust the decision of their mothers or older female relatives to iron their breasts, not questioning the practice, and not realizing it can be harmful.^[23] Some girls even believe they experience breast ironing because they disappointed their parents.^[24] Once breast ironing starts, it can lead to school absences, embarrassment, and a fear of changing for physical activity due to scars showing or visible bandages.^[25] Emotional distress also results. Low self-esteem can affect girls in their career, education, or public and social life, and can give girls the impression that their breasts are wrongful, which can also cause anxiety, shame, and frustration.^{[26] [27]}

Very few studies have examined the impact of breast trauma, so most accounts of the medical consequences of breast flattening are anecdotal,^[28] yet breast ironing exposes girls to numerous health risks, including abscesses on the breast, itching, abnormal discharges, infections, breast asymmetry, cysts, infections, fevers, tissue damage, and potentially the disappearance of one or both breasts.^[29] It is unclear if there is a link between breast ironing and breast cancer, but some doctors hypothesize a connection.^[30] Breast ironing can also make it difficult for girls to breastfeed or produce milk later in life.^[31] The practice causes trauma to breast tissue and lead to difficulties with physical intimacy.^[32] In all cases, breast ironing is a form of abuse and violates of bodily autonomy.^[33]

The practice is ultimately ineffective, since it does not stop breasts from developing and it does not prevent unwanted male attention.^[34] Unfortunately, the fears over rape, early pregnancy, and child marriage are not unfounded.^[35] The root problem is violence against women and gender inequality: instead of systemic choices to value women as equals, breast ironing is viewed as a way to make girls less attractive and protect them from gender-based violence.^[36]

Legal Response

There are no laws anywhere in the world that criminalize breast ironing by name or description.^[37] Although, there are many potential legal mechanisms for stemming the practice. For example, there is no law in the United Kingdom that specifically criminalizes breast ironing, but it can be considered a form of physical abuse or child cruelty and be prosecuted under those criminal statutes.^[38] In the United Kingdom, the government has said it is “absolutely committed” to ending the practice, but no specific steps have been taken, likely because there is little "political will to tackle something that historically has been accepted as cultural practice."^[39] In 2019, the United Kingdom’s Home Office vowed to confront the practice, but as of July 2020, nothing has been done.^[40] In Cameroon, where the practice is prevalent, no law has been passed against breast ironing, despite significant advocacy.^[41] There are also no known examples of legal intervention, detention, or arrest in connection with breast ironing in Cameroon.^[42]

Under international law, breast ironing is a form of violence against women and girls that violates basic human rights.^[43] The practice of breast ironing denies girls of equality, security, dignity, self-worth, and the right to enjoy fundamental freedoms. Multiple treaties and human rights instruments reinforce the obligation of governments to commit to ending harmful practices. Gender-based violence is denounced by the United Nations Declaration on Human Rights (UNDHR), the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW), the Convention on the Rights of the Child (UNCRC), the African Commission on Human and Peoples’ Rights (ACHPR), and the Protocol to the ACHPR on the Rights of Women in Africa. These international agreements highlight the right for girls and women to live free from gender discrimination and free from torture by reaffirming the right to dignity and bodily autonomy. Countries are required to adopt domestic legislative and other measures, with full legal force and effect, to meet these international obligations. For example, under the UNCRC, governments must take measures to abolish traditional practices prejudicial to the health of children.^[44] Under the CEDAW, countries must end gender discrimination in general, and end social and cultural customs based on the idea of the inferiority or superiority of either of the sexes.^[45]

Several United Nations Human Rights Treaty Committees address breast ironing in their country reviews.^[46] For example, the nation of Cameroon has garnered much attention by the international community on this subject. The CEDAW Committee expressed concern for the continuing practice of breast ironing in Cameroon, stating, “The Committee urges the State party [Cameroon] to enact national legislation to prohibit female genital mutilation, as well as any other harmful practice, such as breast ironing, in all instances, to strengthen its awareness-raising and educational efforts, targeted at both women and men, with the support of civil society, and to eliminate the practices of female genital mutilation and breast ironing and their underlying cultural justifications.”^[47]

In 2010, the UNCRC Committee urged Cameroon to criminalize breast ironing into law and ensure prosecution of those who perpetrate the act.^[48] The UNCRC Committee also requested that Cameroon establish recovery programs for child victims, increase awareness and educational programs on the negative effects of the practice, and develop measures to tackle and eliminate breast ironing.^[49]

In 2010, the Committee Against Torture also recommended that Cameroon “pass legislation to prohibit female genital mutilation and other harmful traditional practices, in particular breast ironing, no matter what the circumstances, and to ensure its effective enforcement.” ^[50] The Committee also urged Cameroon to “raise awareness and educate both women and men regarding the pressing need to put an end to the practices of female genital mutilation and breast ironing.”^[51] In 2012, the Committee on Economic and Cultural Rights recommended the adoption of a stronger legal framework to "combat violence against women and girls and to ensure that domestic violence, female genital mutilation and sexual harassment, along with breast-ironing and marital rape, are made punishable under the Criminal Code and that perpetrators are prosecuted.”^[52]

Some breast-ironing awareness advocates believe a law against breast-ironing would help send a message that the practice is harmful.^[53] Others believe a more subtle intervention is appropriate otherwise the practice could be hidden and difficult to prosecute, which is also one of the difficulties in combatting female genital mutilation.^[54] If the practice is criminalized, perpetrators are less willing to talk about the practice.^[55] Further, criminalizing the behavior is not necessarily effective since victims are often too young to report, and unlikely to report a family member.^[56]

UN Women, the United Nations entity for Gender Equality and the Empowerment of Women, advocates for legislation that clearly and explicitly condemns the practice of breast ironing, in addition to establishing and funding education and public awareness programs regarding the consequences of breast ironing.^[57] UN Women believes that legislation should also impose reporting duties on medical providers and teachers that become aware of breast ironing, authorize courts to issue protection orders, and provide services for survivors, including legal, medical, and other types of rehabilitation services. ^[58] Most importantly, UN Women argues, legislation and other practices that perpetuate breast ironing, including sexual assault and harassment, should be amended or abolished.^[59] Breast ironing highlights the problems in legal systems that fail to “adequately prevent and punish sexual assault and sexual harassment, leaving it instead to civilians to resort to harmful practices as perceived prevention.”^[60] Breast ironing is ultimately linked to a lack of control over sexual and reproductive rights and marriage practices, which create unequal systems for women and girls.^[61]