Commoditization of Blood-Stained Underwear: A Critique of Menstruation Tracking Apps

September 20, 2021

Photo: #cuelgatusbragas by gaelx (Attribution—ShareAlike 2.0 Generic (CC BY-SA 2.0)).

Written by guest bloggers Amelia J. Hood and Marielle S. Gross.

Imagine you wake up to find that you have begun your period. You throw your sheets in the washing machine, start coffee, and take a quick scroll through your phone. As you flip through your apps, you notice that the advertisements presented to you are for menstrual cups, or period underwear. Kind of creepy, right? 

By now, many smartphone users have had a similar experience—the ads you see are eerily related to something you could have sworn you mentioned one time in a recent, offline conversation. Whether this algorithmic prescience excites or repulses you, we increasingly entrust our internet-of-things with sensitive, intimate information. 

Intimate health information is privileged, special, typically not disclosed to anyone, except your doctor or closest confidantes. In fact, users of menstruation tracking apps and other health apps expect the same level of privacy protections that these sensitive data would receive in other sanctified contexts in which they are shared. 

However, profitability relies on users’ data. In the case of menstruation tracking apps, data such as bodily functions, sexual encounters, mood, and more are used to characterize individuals for targeted advertisement, typically by third parties. Despite recent proliferation of this business model, and its formal disclosure in the oft-ignoredterms of service, recent reports of monetizing and sharing this type of data were met with outrage, violation, and most recently, a slap on the wrist for one among many offenders. 

The asymmetric accumulation of billions of dollars in wealth via the commodification of users’ intimate data in exchange for simple symptom tracking, and the moral distress this arrangement evokes, are evidence that the terms of the exchange are intrusive and unfair. 

Nevertheless, the potential benefits of these apps present an ultimatum: accept the cookies or forgo the benefits. Broad access to high-quality (self-)knowledge could empower users to manage their own health. Prolific data collection could expand the medical evidence base in an unprecedented, and much needed, way.

In this context, the once-discrete realms of targeted advertising, personalized healthcare recommendations, and research on human subjects overlap significantly, and our regulatory structures for each are insufficient. 

In our paper “Pay No Attention to That Man Behind the Curtain: An Ethical Analysis of the Monetization of Menstruation App Data,” published in the International Journal of Feminist Approaches to Bioethics, we expose the sex- and gender-related violations underlying current arrangements and advance arguments for holding app developers accountable as fiduciaries in possession of our (surprisingly lucrative) dirty laundry. 

Amelia Hood (@emmiiieeeeee) is a researcher at the Johns Hopkins Berman Institute of Bioethics. She works on public health ethics, the ethics of health research, and, most recently, data ethics.

Marielle Gross (@GYNOBioethicist) is Assistant Professor of Obstetrics, Gynecology and Reproductive Services at the University of Pittsburgh Medical Center and the University of Pittsburgh Center for Bioethics and Health Law. Her research focuses on the application of technology and elimination of bias as means of promoting evidence-basis, equity and efficiency in women’s healthcare.

Their article, “Pay No Attention to That Man Behind the Curtain,” appears in the latest issue of the International Journal of Feminist Approaches to Bioethics.

The UTP Journals blog features guest posts from our authors. The opinions expressed in these posts may not necessarily represent those of UTP Journals and their clients.

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