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Better Living Through Body Surveillance

The fast-growing, multibillion-dollar ‘femtech’ industry is selling women information about their own bodies—but is it making them healthier?

by
Katherine Dee
December 01, 2022
Original photo: Getty Images
The secret of femtech’s success is in transforming the patient into a customerOriginal photo: Getty Images
Original photo: Getty Images
The secret of femtech’s success is in transforming the patient into a customerOriginal photo: Getty Images

Bea’s New Year’s resolution was to track the number of times she defecated in 2022. Not just that, she nervously clarified. She was going to track everything: what she ate and when; her glucose levels; her menstrual cycle; the number of times she had sex; how often she bathed; how these things impacted her mood. She was on a quest to capture the most holistic picture of herself possible, and there was a suite of gadgets and apps that were going to help her do so.

Almost every sector of the technology industry struggled in the fourth quarter of 2022. Cryptocurrency crashed; startups dematerialized; funding evaporated; stocks plummeted; even FAANG companies, which once could be relied on for their job security, experienced massive layoffs and hiring freezes. But amid the chaos, one of the big exceptions was “femtech,” a subset of the health technology field. Bea and millions of other women are embracing body optimization lifestyles in pursuit of a fully “quantified self”—the nearly decade-old buzzword yuppies and tech companies use to describe the datafication of one’s health. These self-optimizing women are also a multibillion-dollar growth industry.

Health tech drives the consumerization of health care by producing the things that make it easier for people like Bea to install surveillance systems on their bodies. Services like Circle Medical or Ever/body make scheduling annual checkups or even cosmetic procedures a click away, and prescriptions for Adderall or hormone replacement therapies orderable via apps on your phone.

Femtech does the same, but specifically for women. While the tech sector was rife with disappointing funding announcements, Maven Clinic, a teletherapy startup focused on women’s health, announced in November that it had raised a $90 million round of funding. According to at least one market insights report, femtech is projected to grow at a compound annual growth rate of 12% in the 2020s—making it a $13.3 billion market. The consultant class is also bullish. McKinsey declared the “dawn of the femtech revolution” in February of this year. For McKinsey, femtech is on the cusp of disruption, but there’s still “plenty of white space to fill.” In other words, it’s already making real money, but with half the planet’s population as potential customers, there’s ample room for growth. Femtech also taps into the even larger “wellness” trend that is rapidly replacing older health and fitness products with a more new age approach that emphasizes how people look and feel. In 2021, McKinsey estimated the global wellness market’s value at an astronomical $1.5 trillion.

Bea decided to self-optimize because she was plagued by a series of relatively minor but continuous maladies. She experienced unexpected emotional crashes that made it hard for her to focus on her work, earning her a performance improvement plan from her supervisor and a warning that she had three weeks to “get her act together.” An untamable and mysterious anxiety pushed her to often overshare about every ache, pain, and rumbling. Prone to diarrhea, constipation, and fads, she was the first and only woman I’ve ever known to publicly embrace the “hot girls have IBS” slogan popular on social media.

Bea claimed to have a gluten intolerance, though not an allergy per se. Her period made her manic; she experienced seasonal affective disorder during the summer—too much sun could do that, you know. And so she tried everything: cognitive behavioral therapy, dialectical behavioral therapy, SSRIs, hormonal birth control, a menagerie of restrictive diets, self-care regimens dreamed up by “postcolonial” health experts, having her birth chart read, juice fasts, crystals. With each failed attempt, she found that her body remained “in the way” until one day, she landed on a new approach: If she quantified the problem, maybe she would understand it better.

And if she understood it better—her own body and moods, that is—then maybe she could master them.

Complete bodily surveillance became a vehicle for freedom: Change one input here, get another output there, and nothing ever had to be “wrong” again. If things felt off, she’d always know why. Bea didn’t empty her bladder between 9:35 and 9:42 a.m. yesterday. She drank a milliliter less coffee than usual. Her glucose levels were 4% lower than usual. If things felt off, where Bea might once have consulted her horoscope or headed for hot yoga, she now quantified herself instead, as a laboratory clinician might log the activities of an organism under observation. The data was then decoded for insights: “My coconut water is usually refrigerated, and yesterday, it wasn’t.”

The secret of femtech’s success, it seems, is not in curing any particular ailments or even in making people healthier but in transforming the patient into a customer and making that customer more clearly defined. Femtech offers the same solution as every other digital technology: better living through more data.

Femtech offers the same solution as every other digital technology: better living through more data.

Femtech startup 28 describes itself as “the world’s first hyper-personalized, cycle-based fitness and holistic wellness experience for women.” It provides “free daily streaming exercises and nutrition profiles designed for hormone health and science-based emotional insights into yourself, your relationships, and your work.” According to the company, the profiles it generates “are tailored to your current physical and emotional state, all hyper-personalized to where you are in your natural cycle and controlled by you.”

Recently, skincare company L’Oreal partnered with the period-tracking app Clue to “help women better understand the relationship between skin health and their menstrual cycle.” In other words, L’Oreal used period-tracking data to help promote products that would allegedly be beneficial at different points during a cycle.

Some journalists have raised concerns about the industry, though not for the reasons you’d think. A recent article in Quartz argued that femtech was not sufficiently inclusive. By “defining women by their biology, these products only focus on the needs of cis rather than trans women.” This critique, if listened to, could also be lucrative for these companies. Why should femtech be limited to cis women and in what ways can it be better tailored to trans women, who also feel insecure in their womanhood, and may be even more vulnerable to marketing that promises a “more authentic” identity via any number of goods and services.

In the realm of disease, “chronic illness” is susceptible to becoming an identity in and of itself—one that provides meaning and community. Considering that up to 45% of women suffer from chronic illnesses—often nebulously defined ones like fibromyalgia—it’s not hard to imagine these communities developing their own subcultural niches that a smart company could exploit with branded consumer products and lifestyle accessories. Poorly understood afflictions like chronic migraines—or, more recently, long COVID—provide lucrative opportunities. Health care companies that emphasize wellness over more rigid standards of health can offer a buffet of treatment options to those affected. At the same time, they give an appealing alternative to the all too real flaws of the existing factory health care model and offer the allure of emotional validation to people sick of hearing from “traditional” providers that it’s all in their heads.

Outside of chronic illnesses is fertility, which is also poorly understood and emotionally fraught. For the Financial Times, Elaine Moore writes about how egg freezing is one of the fastest-growing treatments in fertility services:

An entire start-up sector has evolved to encourage women to see it as a relatively low-stakes way to control their fertility. Kindbody is known for its pop-up clinics in distinctive yellow and white vans offering free fertility checks.
Egg freezing, it says, is a way to “own your future.” [One company’s] adverts compared the cost to buying a frozen berry acai bowl every day, making it look more like a cozy lifestyle option than a surgical procedure.

She goes on to write that birthrates after egg freezing are less than 1 in 5. What happens if this becomes the norm? For many women and families, these procedures are life-changing and transformative. But how many women will be misled about the reality of their own fertility because egg-freezing and IVF procedures are being marketed as easy, frictionless options? As my grandmother often told me, “Hope is the last thing that dies.” When is it time to stop trying? It’s not merely that these companies are rewriting reality to trivialize the gravity and unreliability of these procedures, but that for many women, these remain sources of hope that might end up being tragically misplaced. And does a profit-driven company have any incentive to tell women that it might be time to give up?

Femtech companies aren’t just disrupting “women’s health” with clever branding opportunities, often euphemistically referred to as “more sensitive care”; they are disrupting the way women feel. Just as Tinder produces lifelong daters whose matches lead not to committed relationships that would take them off the site but to more swipes, consumerized medicine’s goal is to produce lifelong patients.

For femtech companies, womanhood is either a problem to be solved or a costume to be worn; they can get away with selling both.


Katherine Dee is an internet culture reporter and advice columnist. You can find her at defaultfriend.substack.com.

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