TABLE OF CONTENTS
EXECUTIVE SUMMARY iRESUME vI. INTRODUCTION 1
A. Defining Breast Flattening 1
B. Methodology 3II. STUDY FINDINGS 5A. Origins of the Practice 5B.
Methods to Carry Out Breast Flattening 6
C. Practicing Groups and Individuals 9D.
Areas for Additional Research 11III. IMPACTS OF BREAST FLATTENING 11A. Biology of Normal Breast Development 11B. Impacts of Breast Flattening on Physical Health 13C. Impacts of Breast Flattening on Mental Health 14D. Impacts of Breast Flattening on Sexual Function 15E. Reflections on Reported Physical, Psychological, and Sexual Impacts 15IV. CONTEXT: MOTIVATIONS DERRIVING FROM EVOLVING &EXISTING SOCIAL CONDITIONS 18A. Changing Marriage Practices 18B. Control of Sexual and Reproductive Rights 20C. Unequal Power Relations between Girls and Men 23D. Understandings of Human Developmental Stages and Puberty 26V. BARRIERS TO CHANGE 27A. Existence of “Belief Traps” and Traditional Practices 27B. Limited Access to Alternative Options 29VII. APPROACHES TO END THE PRACTICE
30A. Advocacy Work by NGOs
30B. Existing and Proposed Legal Instruments 31VIII. CONCLUSIONS AND RECOMMENDATIONS 32APPENDIX A: LIST OF INTERVIEWS CONDUCTED IN CAMEROON 35APPENDIX B: INTERVIEW GUIDE 37