Getting good healthcare is often very frustrating for women. What is tech’s role?
During my lifetime the message I have heard, with respect to feminism, has changed from “Women leaving the home has ruined society” to “Go girl, you can have it all”. Seriously. And, I’m not that old.
The increasing instances of female empowerment and economic growth can make it seem like the balance of power, opportunity, and quality of life for each of the sexes has become more equal. However, if you ask a woman how she feels about her experiences with a health care provider, her experience is more likely to be negative than a man. Gender bias in medicine is alive and well.
Society’s view of women’s bodies tends to be simplistic. Conversations around our bodies often focus on our giving roles, such as our potential to create more humans, or our appearance in youth when we are the objects of desire. IMHO, women’s bodies are too often viewed as vehicles for someone else’s desired outcome rather than as the flesh and blood homes of intelligent beings. And, in a patriarchal society, we are often viewed as second class. Our competence is continuously questioned, either outright or through narratives around our decisions. This permeates every aspect of our lives, including health care. It is no wonder that many of us feel frustrated by a system that was designed by men that has a long history of having sexist bias entrenched and that continues to underserve us.
When we can get seen by a health care provider, which in my part of Canada is difficult, the patriarchal view of us as emotional, needy, and unreliable witnesses to our own health symptoms makes the interaction challenging. This even happens with female doctors, which is unsurprising given the aforementioned biases in the system that trains them. When we do get care, often the treatments often don’t work for us. Frequently there are few or no women in clinical trials and we were not included until 1997 in Canada. This is problematic because our size, body composition, and hormones impact pharmacokinetics and pharmacodynamics of drugs prescribed. While we are now included more regularly in clinical trials, key aspects of our bodies are often not measured such as our cycles or what reproductive stage we are in such as pre-, peri- or post-menopausal.
I am a member of the FemTech Canada Slack channel where I have had the pleasure to virtually meet many women who are developing FemTech technology to close the gap in healthcare outcomes. However, I do see a large amount of the effort specifically focused on the bikini areas (breast and gynae). While I understand the need for women founders in areas of reproductive health, since this has been underserved, there are so many other gaps in the health care system for women.
As we start managing more of our health with apps and other technology-based tools, I wonder how our view of women’s bodies impact these products? How they are designed, if they are funded, and how well they are are adopted. Will we gather the sex-disaggregated data needed to reveal the right treatments for women’s bodies? At the moment, we are really challenged to leverage AI to improve women’s health due to a lack of sex-disaggregated data.
Since many start-ups come from recently graduated student or academics, it may be helpful to look at what’s happening in research with respect to gathering sex-disaggregation data. I looked for studies that showed trends in grants in health and any requirements for recording gender and sex-based difference. I came across one paper that describes only a very marginal improvement in how data are collected, just a 1.57% increase in grants mentioning sex from 2009–2020, in spite of the CIHR implementing recommendations in 2010 and requirements in 2019.
While sex-disaggregation of data is a start, it is not enough. Since hormone levels impact heart, brain, and skeletal health, just to name a few, data related to hormonal cycles or menopausal status seems like an obvious ask. However, hormonal-level related data traditionally have not been collected, neither during routine health visits nor during clinical trials. There are companies that collect data on women’s hormonal cycles and indicators of menopausal status, although most are intended to assist with reproductive health and not used as part of larger drug trial data. Some example companies include Clue, Glow, and Flo.
One notable exception to this data desert is My Normative. This company has created a platform to collect sex-disaggregated data as well as data related to hormonal levels. If these data are gathered during clinical trials and other scientific research, imagine what can be learned about into how sex, gender and hormones intersect with how a patients feels and their response to the treatment. The opportunity to truly change how women receive health care is mind blowing. I have only one response — what took us all so long to get here?
As usual, I have an opinion on that about that. Recently, I spoke with a potential founder in a VC run program. She received feedback that her ideas around purposeful inclusion of women’s data is “just” healthcare. The message was that she was not doing anything novel and there is no market gap. I believe the problem is that so many of the founders and VCs are men, or have internalized the views of the dominant male views in this area. (See comments earlier about patriarchy in medicine.) If there was no market gap then McKesson and the World Economic Forum would not have identified a massive opportunity in women’s health. Clearly not every VC has gotten the message that there is a huge opportunity here.
Also — to be honest — women’s internalization of the message that we are niche or complex or somehow undeserving of the effort to reveal how our bodies work is also problematic. In my struggles with the health care system I have, at times, accepted less because that’s how its always been. I stopped being indignant because it didn’t help. Kudos to all of the young women who are disrupting the status quo, because we really do need you.
So what can be done? I think we need funders to provide money to researchers and start-ups that address the data and treatment gap for women. Specifically, it needs to happen within a system that holds the requirements. Its not enough to say that research needs gender and sex-based data but then not reject grants that don’t include it. Its also not enough for governments (or government funded orgs) to promise money for for female founders but to not deliver. If you are in a democratic system, like Canada, use your vote to demand better . Afterall women are 51 % of Canada’s population, not a niche market.
As always, this is an opinion piece and your views may differ. If you have a suggestion for solutions, feel free to add a comment.
