Breast flattening prevalence, psychosocial impacts, and educational implications among young females in Calabar South LGA, Cross-River State, Nigeria

Breast flattening, or breast ironing, is a damaging cultural practice popular in regions of West and Central Africa, especially Nigeria, where it is often conducted secretly. This study evaluated the prevalence and psychological effects of breast flattening on adolescent females in some communities in Calabar South LGA, Cross River State, Nigeria, and its influence on their educational participation. The study was guided by five research questions. The Breast Flattering Practice questionnaire was designed by researchers and validated by experts. The data demonstrated that breast flattening is a frequent practice in the study communities (mean = 3.18 on a 4-point scale; p < .001), with 57.1% of respondents reporting awareness of it. It is largely practiced without official medical supervision (mean = 3.07, p < .001) and is recognised as a cultural norm (mean = 2.84, p = .003). The practice substantially corresponds with lower academic performance (r = .572, p < .001), and victims encounter severe psychosocial hurdles, including self-consciousness (mean = 3.24, p < .001), avoidance of school activities (mean = 2.62, p = .004), and anxiety (mean = 2.98, p = .001). However, the study demonstrates the effectiveness of counselling interventions, including individual and group therapy and peer support, all of which were perceived as beneficial (weighted mean = 2.90, p = .002). Recommendations stress improving legal enforcement, conducting awareness programs (mean = 3.10, p < .001), establishing school support policies, and involving community and religious leaders to defend girls' rights and futures.