‘Thin Line’ highlights bias in women’s reproductive healthcare

Having an abortion is not a game, but respecting women’s reproductive rights is subject for play. “Thin Line,” a mobile virtual reality (VR) experience created by Israeli Rony Kahana, a Carnegie Mellon University graduate, utilizes an interactive narrative by enabling players to experience a woman’s thoughts while navigating the healthcare system.

“Thin Line” begins with a player receiving a call from “Dad” inviting her home to help pack for an upcoming move. In the process of boxing items, memories are spurred, including those related to a budding college romance with John. The player quickly realizes she is pregnant. An initial visit with a gynecologist reveals physician-imposed biases, and as the game continues, the subject returns home, weighs her options, speaks with John and chooses to get an abortion. A visit to the hospital affords another negative experience with a healthcare professional.

Later stages of the game bring college graduation, a break-up with John, the beginning of medical school and residency, a proposal from a new boyfriend and an eventual return to a gynecologist. A conversation with the gynecologist includes an inquiry whether the previous pregnancy “ended in miscarriage or termination.” After the player indicates the latter, the doctor replies, “I understand. I’m really glad you told me. Abortion is a normal part of reproductive healthcare,” and continues to discuss prenatal care. “Thin Line” concludes with the memory sequence disrupted by a call from “Dad” who says he is returning home.

The game’s goal is not to “preach to the choir but to try and find a way to have everybody be more open to a woman’s experience when she is looking to have an abortion,” said Kahana.

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Although “Thin Line” is available at the Google Play and Oculus stores and has won several awards, it was almost never made. Months prior to Kahana’s May 2018 graduation with a master’s in entertainment technology, she and a friend pitched the idea for “Thin Line” to CMU.

“We got a mixed type of feedback,” said Kahana. “Some people felt it was a bit too pro-choice and had like zero chance of actually convincing people.”

Kahana accepted the criticism, consulted with subject matter experts and determined “the things that we felt strongly that we should and shouldn’t say” before tweaking certain elements and pitching the game again. This time “Thin Line” was approved, and along with a “tiny team of four talented ladies,” Kahana began a 15-week process of playtesting sessions during which reviewers offered feedback and designers identified flaws, she said.

During the nearly four-month period, Kahana and her team engaged 126 testers and presented a dozen prototypes, including iterations showcased at multiple conferences. The back and forth with evaluators rendered a relationship between player and creator more intimate than other interactive projects Kahana had worked on, even those treating racial biases or teen empowerment, she said.

“I learned early on that when a person takes off the headset, it’s my turn to sort of be quiet and listen if they want to talk about things,” she said. “I’ve heard a lot of people’s personal stories about how the topic sort of touched their lives.”

Wherever players fall regarding abortion, Kahana hopes “Thin Line” enables people to appreciate the biases and difficulties women experience in the healthcare system. Creating such awareness is one of her goals in making video games.

“My goal would be to sort of push for more of a change in the games that we play and make them more inclusive and add more diversity,” said Kahana. “I grew up playing games in which it was mostly a white male character, and I was like, ‘I’m totally fine with that,’ but at some point when you start playing games and have a female lead, you’re like, ‘Wow, this is crazy. This feels so different.’”

Such inclusion would benefit a significant number of gamers. Although 97 percent of teenage boys reported playing video games, 83 percent of teenage girls similarly reported playing video games “in some form or fashion” on a computer, cell phone or console, according to a 2018 Pew Research Center finding.

The abundance of teenage gamers represents “a cultural tsunami,” noted Lenny Silberman, a former Pittsburgher and CEO of Henry Kaufmann Campgrounds in New York City who founded Lost Tribe Esports. “Young people are always drawn to social and cultural phenomena during adolescence, but the ones that approach unanimous participation contain a common element — they offer a new vehicle for self-expression and connection with peers,” Silberman wrote in a May 21 piece for eJewish Philanthropy.

As an assistant producer for Big Huge Games, a Maryland-based video game developer, Kahana works on projects quite different from those she developed at CMU. Her current endeavors include collaborations with larger teams, working on bigger games with “a lot of player input and more moving parts,” she said. But Kahana still praises smaller-scale enterprises.

Players should seek out “more indie games,” as they “have a lot of good messages and they’re very short,” she said. An example would be the 2018 text messaging adventure “Bury Me, My Love,” which follows the story of Nour, a Syrian refugee as she attempts to travel safely to Europe. Video games like that can enable players “to learn more about the world,” said Kahana.

So, too, can “Thin Line.” While the women’s reproductive health game has yet to achieve the popularity of other interactive experiences, Kahana’s not worried so much about the number of downloads.

“It would feel great if it’s making a difference in people’s opinions,” she said. “That would be amazing.” PJC

Adam Reinherz can be reached at areinherz@pittsburghjewishchronicle.org.