The Gendered Impact of Apple’s New Health App

I uploaded the new iOS software to my iPhone today and yes, there it was, a white square with a red heart in it. It wasn’t an app I’d selected. No. It’s Apple’s new app called “Health.”  And the thing about Health is this: you can’t delete it.

So why is that a problem?  Well, according to this article, the app is “literally dangerous” because with its weight tracking and calorie tracking features it triggers people who are attempting to recover from eating disorders:

The Health app is literally dangerous, specifically to people dealing with/in recovery from eating disorders and related obsessive-compulsive behaviors. Obsessive weight tracking and calorie counting are classic symptoms. These disorders literally kill people. A lot of people. Apple’s Health app is an enabler of this behavior, a temptation to fall back into self-destructive habits. The fact that it can’t be deleted makes it worse by orders of magnitude.

The majority of people with eating disorders are women (though the number of men with eating disorders is on the rise). My first thought was that people who don’t want to use the app can just not use it. I have a special folder on my phone for apps that I don’t use much, and some of those, like Apple’s “game centre” app and “stocks” app, can’t be deleted either.  I didn’t even remember I had them until I checked just now to see what was in my “unused” app folder.

But eating disorders aren’t like that. They involve compulsive behaviors that are difficult to control.  An app that tracks weight can be as tempting to someone trying to deal with an eating disorder as an open pack of cigarettes might be to someone trying to quit smoking.

So not allowing people to delete can actually threaten their health.  And in this area of health, it’s women who are more at risk than men.

I actually don’t quite understand why Apple is so intent on making every iPhone user keep the health app.  It’s not the greatest app in the world. It’s quite clunky and not all that intuitive.  You can read more criticizing it as a health app here.  At the moment, it doesn’t seem to do anything other than record data from other apps or that users enter themselves.  I am not opposed to using apps to track things like health, but my first impression of this app is that I’m not likely to use it because it doesn’t seem user friendly at all.

The other interesting gendered aspect of the app that this article and this article point out is that it has nothing for tracking periods.  The post, “why can’t you track periods in Apple’s Health app?” points out that there are some good health reasons for women with menstrual cycles (and that’s quite a few women) to want to keep track of them. The author says that “menstruation, changes in menstruation, or lack of menstruation can be signs of other health problems.” And frankly, to my mind, it’s just good to know what’s happening with the cycle.  The author goes on to say:

I wanted to know how many people are of menstruating age at any given time. Worldwide data from the US government census for 2013 is banded by age groups, so to be err on the side of caution I’ve selected ranges between 15 and 49 as the menstruating ages. Of course not all of those people will actually menstruate, but I hope that the difference is insignificant.

By this estimate, over 1.8 billion people are currently of menstruating age. That’s just over a quarter of the population. If you also include people who have menstruated or are yet to menstruate then of course that number is approaching half the world’s population. That’s a huge potential audience, of whom a large proportion might be interested in recording their cycles at some point in their lives.

Tracking cycles isn’t anything new, it has been done since the dawn of time, in many different forms. I am pretty sure it was the first ever occurrence of Quantified Self movement, although for reasons I cannot understand cycle tracking doesn’t feature very prominently in it.

So why hasn’t Apple included it in Health?

The author speculates that since “Stocks” is undeletable, Apple must have thought that more people would be interested in keeping up with the stock market than in recording their periods. I’m not sure that follows exactly, but what it does suggest is that Apple thought of people who want to keep up with the stock market but did not think of people who might want to track their menstrual cycles.

The Pacific Standard post makes a great point, which is that app design is not neutral.  I think this is the most interesting aspect of these discussions, since it draws a further conclusion from these gendered oversights:

Both of these problems are part of a larger design issue, and it’s one we’ve talked about before, more than once. The design of things—pretty much all things—reflects assumptions about what kind of people are going to be using the things, and how those people are going to use them. That means that design isn’t neutral. Design is a picture of inequality, of systems of power, and domination both subtle and not. Apple didn’t consider what people with eating disorders might be dealing with; that’s ableism. Apple didn’t consider what menstruating women might need to do with a health app; that’s sexism.

This all reminds me of one of the early criticisms that feminist philosophers of science made of health research. They pointed out that so much of the findings were based on studies on men, and then the conclusions were generalized to apply to everyone, not taking into account that not everyone is a man. This meant not only that health issues specific to women were for a long time under-researched, but also that women’s health was at risk because many of the treatments hadn’t actually been tested on them.

Apple has done the same sort of thing with this app, designing a health app that’s meant to be neutral when, in fact, it isn’t.