Is Amateur Surgeon 4 censored by Apple?

Why it is unavailable

Five things can put an app out of one App Store. Each is weighed below against what can be seen from outside — open a card for the reasoning.

• A government or a court demanded itLikely

  and Apple complied. Apple publishes a count of these per country each year and never says which apps they were. Apple's 2025 App Store Transparency Report

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 12 other apps left mainland China the same day, Aug 18, 2020.
  • Apple reports 1,213 government-ordered removals in Russia for 2025, naming none of them.
• Apple applied a rule, unaskedLikely

  either its own review guidelines, or its own reading of a local law, with nobody having demanded anything. This is the largest category in Apple's own removal figures by a wide margin, and it covers distribution permits as well as content — Apple kept a free Bible app out of mainland China in 2021 for want of one. Apple's 2025 App Store Transparency Report

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 12 other apps left mainland China the same day, Aug 18, 2020.
• The developer withheld itUnlikely

  freely, or under legal advice of their own, or because Apple's guidelines require that kind of app to be limited to certain countries. Switching a country off is easy for a developer to do in Apple's own tools: it needs no new version of the app, and it leaves no public trace other than the app being unavailable.

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 12 other apps left mainland China the same day, Aug 18, 2020.
• Something brokeUnlikely

  a rejected update, a lapsed certificate, a payment or licensing problem, a mistake nobody has got round to noticing.

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 12 other apps left mainland China the same day, Aug 18, 2020.
  • Gone for 6 years.
• A local rule about paying for itRuled out

  gambling licences, financial rules, tax — the kind of law that governs a transaction. Apple can obey every one of them by refusing the payment, which is why this is the only restriction we would accept and the only one that cannot touch a free app.

  • It is free, so Apple sells nothing here.

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