Breast Ironing & Flattening
Breast flattening or breast ironing is the process during which young pubescent girls’ breasts are ironed, massaged, flattened and/or pounded down over a period of time (sometimes years) in order for the breasts to disappear or delay the development of the breasts entirely (National FGM Centre, 2022).
Breast flattening usually starts at the first signs of puberty, which can be as young as nine years old, and is usually carried out by female relatives.
The National FGM Centre provides a map indicating where breast ironing has been recorded. Countries highlighted include Cameroon, Togo, Chad, Kenya, Guinea Bissau, South Africa, Ivory Coast, Benin and Zimbabwe.
It should also be acknowledged that some adolescent girls and boys may choose to bind their breasts using constrictive material due to gender transformation or identity, and this may also cause health problems.
National FGM Centre (2022): Breast Ironing Map
In many cases, the abuser thinks they are doing something good for the child by delaying the effects of puberty and the practice is designed to:
- Make teenage girls look less “womanly” and no longer sexually attractive to men.
- Prevent pregnancy and rape.
- Enable the girl to continue and focus on her education.
- Prevent dishonour being brought upon the family if the girl begins sexual relations outside of marriage.
- Deter unwanted attention.
It is important to note that there are no health benefits to breast ironing or flattening.
Professionals should be aware of the signs and indicators listed below that may suggest a child is at risk of, or has experienced, breast ironing or flattening:
- A girl is embarrassed about her body.
- A girl is born to a woman who has undergone breast flattening.
- A girl has an older sibling or cousin who has undergone breast flattening.
- If there are references to breast flattening in conversation, for example, a girl may tell other children about it.
- A girl may request help from a teacher or another adult if she is aware or suspects that she is at immediate risk.
- A girl from an affected community is withdrawn from Personal, Social and Health Education (PSHE) and/or Sex and Relationship Education as her parents wish to keep her uninformed about her rights and body.
- A girl may be fearful of taking part in Physical Education (PE).
- One or both parents, or elder family members, consider breast flattening integral to their cultural identity.
- The family indicate that there are strong levels of influence held by elders who are involved in bringing up female children and support breast flattening/ironing.
- A girl/family has a limited level of integration within the UK community.
Due to the type of instruments that may be used in breast flattening, the type of force used and the lack of aftercare, significant health and developmental issue may occur. These may include:
- Severe pain
- Tissue damage
- Discharge of milk
- Dissymmetry of the breasts
- The complete disappearance of one or both breasts
- Breast cancer
- An impact on the child’s social and psychological wellbeing
- Relationship issues
- Long-term mental health issues such as post-traumatic stress disorder (PTSD), body dysmorphia or severe depression
Breast ironing is a form of physical abuse that has been condemned by the United Nations and identified as gender-based violence.
If you are concerned that a child is at risk of breast flattening, a referral must be made to the local Children’s Services team.
If you are concerned about someone:
- Recognise: Gather information, note information on the child/adult’s words, behaviour, presentation, physical, emotional and psychological state.
- Respond: Ask the right questions.
- Record: Keep clear and accurate records.
- Refer: Pass on as much information as possible
- ALWAYS REMEMBER – IN AN EMERGENCY DIAL 999.
You should also contact the Foreign, Commonwealth and Development Office if the girl has been taken abroad.
4LSAB and 4LSCP Multi-Agency Guidance on ‘Honour’ Based Abuse, Forced Marriage and Female Genital Mutilation – A multi‐agency guidance document for agencies and organisations to use with cases or suspected cases of ‘honour’ based abuse in Hampshire, Portsmouth, Southampton and the Isle of Wight.
Breast Flattening – National FGM Centre – The National FGM Centre, established in 2015 is a partnership between Barnardo’s and the local government association. From October 2017, the FGM centre expanded their remit to include breast flattening.
Breast Flattening Leaflet – This leaflet from the National FGM Centre provides an overview of what breast ironing is, the health implications, its prevalence, and signs to look out for in children.
Breast Ironing Map – This map from the National FGM Centre shows where reports of breast ironing are happening.
Metropolitan Police Information – The Metropolitan Police provide information about breast ironing and how to report concerns.
Breast Ironing: A brief overview of an underreported harmful practice – This article looks at important factors and the health and rights issues related to breast ironing.
Came Women and Girls Development Organisation – This is a registered charity and community-based diaspora organisation dedicated to improving the health and wellbeing of a variety of people from disadvantaged communities and black and minority ethnic groups. The charity supports these individuals to develop their potential and mobilises them to engage effectively in community development and regeneration activities and build their capacities.
Additional information and resources for supporting a young person who is binding their breasts using constrictive material due to gender transformation or identity:
National Health Resources (NHS Clinics) – This website provides information on how to find an NHS gender dysphoria clinic.
Tranzwiki Gender Identity Research and Education Society – A platform for exploring what is available within the local community.
Gender Identity Development Service – A highly specialised clinic commissioned by NHS England for young people presenting with difficulties with their gender identity.
Breakout Youth – A confidential support service for young people aged 11 to 21, who are lesbian, gay, bisexual, transgender, questioning (LGBTQ+) or unsure of their sexuality or gender identity. Young people who identify as LGBTQ+ or are unsure, often feel isolated and alone with their sexuality or gender identity. At Breakout Youth, young people will find a group of likeminded people that they can socialise with safely. Breakout Youth also find help with feelings of isolation. Breakout Youth run confidential youth groups in Southampton, Andover, Basingstoke, Eastleigh, Hart, Isle of Wight, Marchwood, New Forest, New Milton, Romsey and Rushmoor.