Dr Suzanne Crowe: FemTech can fight medical misogyny — but not if it's going to be used to monitor us
As a mother of two young women, my interest was piqued by the term the company used in the description of their innovative product: FemTech.
FemTech is the term for the pairing of technology with women's health and wellbeing. It was coined in 2016 by Ida Tin, a Danish entrepreneur who co-founded a menstrual tracking app called Clue.
In almost a decade, there has been an explosion of devices, services and software applications aimed at longstanding deficits in women's healthcare. Novel technology solutions include contraceptive prescription and delivery, fertility-tracking and advice, health support for new mothers and their newborn babies, at-home testing for sexually transmitted infections, smart lactation pads, osteoporosis predictors, and psychology assessments.
As one friend put it to me, "men get trading platforms for shares and fitness trackers, women get sold stuff to 'fix' their bodies". FemTech is now a massive industry, with Flo, the period-tracking app valued at almost a billion dollars.
Dr Suzanne Crowe: 'It's hard not to see the rapid growth of FemTech as a comment on women's healthcare as it is currently provided.' Picture: Moya Nolan
Both my daughters have used menstrual apps since they were young teenagers, enjoying the accessibility and responsiveness. It's a world away from the coy TV ads I grew up with, depicting strange blue fluid being poured onto pads.
Historically, medical research focused almost uniquely on white men, and women's health concerns were often overlooked or dismissed. Dr Hazel Wallace's book The Female Factor captures the extent of medical misogyny and women's exclusion from diagnosis and treatment.
Restriction extended to the development of medications, where women were excluded from testing for many years, leading to dose ranges based only on men's bodies. Coupled with a pervasive shame attached to sexual health, mental health and women's bodies, traditional medical practice has unwittingly created a significant gap which healthcare 'disruptors' are eager to capitalize on. This is largely a positive thing.
But if technology solutions become the dominant offering, they may contribute to leaving ever-increasing service gaps unaddressed. Technology bypasses some issues but not all, fostering more empowered, but increasingly frustrated, women who continue to require intervention from an overwhelmed local hospital. It is a tool, not a replacement for a functioning health service.
Technology won't do much to change attitudes among healthcare professionals to women's health needs either – that needs to come from deep listening, respect, kindness and education.
The potential benefits are clear: technology empowers women to input their personal information, identify symptom patterns, and possible health issues, and use that data to receive personalised healthcare. Using software, they can consider a diagnosis, learn what their choices are, and make informed decisions.
Digital platforms carry no judgment, with women from different ethnic origins and/or the LGBT+ community finding understanding there.
Of course, empathic patient-focused care, delivered in partnership is fundamental to healthcare. So, it's hard not to see the rapid growth of FemTech as a comment on women's healthcare as it is currently provided.
As FemTech moves to fill a perceived gap, it would be easier to leave traditional views undisturbed rather than reflecting on how our people-based service can improve. Just as vinyl records gave way to CDs, and CDs ceded to music streaming, traditional health services must apply humility, excise stigma and barriers, and improve their offerings or be left behind.
Data tracking
Not only do we risk losing our imperfect humanity in a technology-dominated health service, but we also risk the negative consequences of commercialising health data. Putting a price on data and its interpretation may make this assistive technology too expensive for the marginalised groups it was aspiring to reach.
More worryingly, a research group in Cambridge University's Minderoo Centre for Technology and Democracy have raised significant concerns about the use of data collected by fertility tracking apps. Data collected on apps is designated 'special category' rather than treated as medical data from a regulation perspective.
It potentially could provide a valuable advertising tool for companies – or worse. The report's authors caution that information from cycle tracking apps in the wrong hands could result in risks to job prospects, workplace monitoring, health insurance discrimination, and in some countries, limit access to termination of pregnancy.
In an ideal world, new digital solutions would become publicly owned, allowing integration into real-life health services, leading to better outcomes for society. However, tech entrepreneurs are not going to wait for Valhalla.
As women's healthcare needs are finally validated, it is vital that new technologies are evaluated for potential benefits, and or potential harms. Any likely harms, for example compromise of privacy, require informed consent and regulation, especially when it comes to the retention and use of highly personal data.
FemTech is here to stay. We must ensure the hand guiding its use is an ethical one.
Dr Suzanne Crowe, consultant in paediatric intensive care, President of the Medical Council
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A period of life we need to talk about — the stigma that still surrounds menstruation
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