A Note on Language
In this toolkit, we will sometimes use the word woman/women and feminine pronouns for simplicity and to recognize the significant impact technology-facilitated violence has on women and girls. We recognize that TFGBV also impacts trans, non-binary, and Two-Spirit people. We hope that all people impacted by TFGBV will find these documents useful.
Many health and medical devices are now connected to the Internet, offering to help track information for the user or even send that information to a doctor. Unfortunately, these devices and systems can provide yet another, highly invasive way that technology can be misused to monitor, harass, threaten, or harm survivors. At the same time, they can also offer potential tools to strategically increase safety. There have already been examples where data from these devices was used successfully as evidence in criminal cases.
For more information and general tips about the Internet of Things and smart devices, see our Overview Document.
Below are some examples of connected health and medical devices.
An increasing number of devices are marketed to help people get active, lose weight, and support a healthy lifestyle. The most common devices are step trackers and smartwatches. Exercise machines now offer to connect to a mobile device to track and share information about the duration and intensity of a workout, as well as vital signs like heart rate. Athletic shoes can be connected as well, sharing information including location.
Newer devices for tracking vital signs collect, analyze, and share information, including blood pressure monitors and thermometers for tracking fertility. Medical equipment such as wheelchairs, pacemakers, and pill bottles can include the capability of tracking location or frequency of use and reporting that back to a doctor or medical facility.
Privacy and Safety Risks
While everyone may face privacy risks from unauthorized access to data from health and medical devices, women experiencing violence face specific risks to privacy and safety. Information about location, physical activity, vital signs, or habits could be misused to threaten or harm her. Sensitive personal information could be shared publicly in an attempt to ruin a woman’s reputation. For example, usage data from connected sex toys used by a woman as part of healing from abuse could be shared with an employer or others. Inadequate built-in security of devices, and the data they gather, raises concerns that the devices could be tracked or even disabled remotely. Additionally, information from connected devices is being fed into large sets of data held by companies and governments. These data sets may contain identifying, inaccurate, and potentially damaging information.
Potential Benefits to Survivors
Women with disabilities or those who face complex medical issues, have trouble remembering health-related tasks, or simply want to improve their health, may benefit from connected devices. The effects of trauma can hinder the ability to remember daily tasks, decrease motivation for physical activity, or impact heart rate and other vital signs. Connected devices could be part of a plan to improve well-being or track the impacts of trauma. The use of specific health and medical devices may help to lessen symptoms and illnesses that result from trauma or physical injury. All of these benefits may be undermined by a lack of privacy and security, so women and any health professionals they are working with should take these factors into account when selecting devices.
Recent news stories have covered cases in which data from health and medical devices have been used as evidence in criminal cases in the United States. Information about location, movement, and vital signs are likely to be used in future to support or counter a version of events surrounding crimes. This same evidence may also be used in civil legal settings to support protection orders or family law matters.
Evidence from connected health and medical devices may be stored on the device itself, on a mobile device, in a user’s account, or on the server of a manufacturer or medical provider. In some cases, a woman may have access to the data, and in other cases, a subpoena or court order may be necessary to access the data.
Questions about Health and Medical Devices
When considering connected health and medical devices, there are a few questions to consider:
- Does that particular device truly need to be “smart” or “connected”?
- Do the benefits outweigh the risks?
- How secure are the device and the app that runs it?
- Are there features that allow the user to individualise and increase privacy and security?
Strategies to Increase Privacy and Safety
Steps to increase privacy and safety include learning about the built-in security options of the device, turning it off when not in use, and changing the default passwords or other security settings. Ask doctors about using a device that is not connected to the Internet, or alternatives like keeping a handwritten log of the information that would otherwise be shared or other ways of setting up reminders to take medication or exercise.
If you suspect that a device is being misused, you can begin to document the incidents. Our Technology-Facilitated Violence Log is one way to document each occurrence. These logs can be helpful in revealing patterns and determining next steps, and may potentially be useful in building a case if you choose to involve the legal system.
You may also try to access evidence through the device, or the app or website that controls it. You can also try to reach out to the manufacturer to regain control over a device or the account associated with it. With these devices and others, it is also important to take steps to increase network and Wi-Fi security. For more information, see our handout on Wi-Fi security.
Technology-Facilitated Gender-Based Violence (TFGBV) is part of a continuum of violence that can be both online and in-person. If you or someone you know is experiencing TFGBV, you are not alone. You can use sheltersafe.ca to find a shelter/transition house near you to discuss options and create a safety plan. You don’t need to stay in a shelter to access free, confidential services and support.
Adapted for Canada with permission from NNEDV’s Safety Net project, based on their resource Connected Health and Medical Devices: Survivor Privacy Risks and Strategies.