Laurie and Debbie say:

Melanie Testa’s “Shirts off, Underwear on:, Play Out, Breast Cancer and Gender Expectations” is superb.

Perhaps I am an anomaly in the world of breast cancer, having chosen against reconstruction while also choosing not to wear prosthesis. I was certainly made to feel as if my choice was abnormal by my doctors when I was asked to see a psychiatrist to make sure I was of sound mind in my ‘contralateral decision making process’. At that same office, my fellow sisters who chose reconstruction were not asked to justify their surgical choice to a psychiatrist, regardless of their contralateral choices. Perhaps my doctor wanted to be entirely sure that that they would not be removing a breast that I might come to miss, and regret my decision. I could have chosen to keep the unaffected breast. There was no question that a unilateral mastectomy was medically necessary, but I chose a bilateral mastectomy – a decision I have never regretted.

This bias is unacceptable, and clearly illustrates a preference for reconstruction to the shape of a breast and breastedness in general. It also serves to make it difficult for women to choose otherwise.

Testa’s observations both inform and are informed by Patricia Anderson’s post on Kotaku about “breast physics” and how and why video games gets breasts so wrong.

Plenty of people theorize about why games often feature bad breast physics, but there is little hard information about the actual breast-creation process. After looking into it a bit, I found that many amateur developers seemed to genuinely have a problem figuring out how to tackle breast physics in their games. There are a startling number of forum posts and tutorials where people discuss the best ways to achieve good breast physics online. One person even created a four-part Powerpoint presentation titled “The Quest for Boob Jiggle In Unity.” People have developed specialized tools for other developers to use, to help demystify the enigma that is “how do breasts work.”

For an excessively jiggly set of videogame breasts go here.

Anderson basically says that animating bones and rigid body action is easier than animating soft tissue body action. After explaining why realistic breasts are expensive to animate, she concludes (surprise!) that “absurd breast physics aren’t always unintentional.”

“Ultimately though, I sort of suspect that when a developer doesn’t get breast physics looking right, it’s because, for whatever reason, somebody wanted them to look that way,” [Tim Dawson, an indie developer] said.

So what does this have to do with Testa, and women with breast cancer?

As many as 58% of women who have mastectomies after cancer either do not reconstruct or do reconstruct and then later deconstruct, either out of choice or because of failed reconstruction. I pondered just how many of those breastless women disliked wearing prosthesis and presenting an image of a woman with breasts. Prior to my diagnosis, I had never knowingly met a single-breasted or bilaterally flat-chested woman. I imagine there are many women who don breast forms with hesitation, annoyance, or even resentment. Why do we feel that we need to promote the false impression that all women have breasts?

The bulk of her piece concerns the pressure on women to get reconstructive surgery and/or breast forms and not to “go flat,” including substantial medical and psychiatric pressure. She has had a lot of trouble being believed when she says: “Wearing fake breasts would do nothing positive for me, physically or emotionally; I quail at the idea of presenting two body types, a breasted public image and a flat private image.”

Reading these two pieces together, we can’t help but see that the psychiatrists and surgeons trying to force Testa into a false-breast look are influenced by, and themselves reinforcing, the game developers who like implausible breasts enough to keep making them. Of course, neither the medical establishment nor the game designers are working in a vacuum: they are both reflecting an obsession which is everywhere in the Western world, from billboards to fashion runways and everywhere in between.

In other words, Testa is talking about real breasts: why we want them, what they mean to us, what losing them means, what visibly losing them means. Anderson, to some extent, and the video game industry and breast surgery industry to a large extent, are talking about breast fantasies.

Both industries will come of age when women without breasts become part of their mental landscape. Testa says: “The sooner doctors and researchers collectively agree that women sometimes choose flat or bilateral mastectomy without reconstruction, the better. Get out of our minds.” She could also be talking about animators.