An Equitable Framework for Femtech
Femtech is a rapidly growing part of health care and is dedicated to delivering technology-based solutions, such as software and digital tools, that help people meet their sexual and reproductive health goals.
A recently published article in the Journal of Medical Internet Research issued three “guiding principles” to ensuring that emerging femtech solutions benefit everyone, not just those with the time, education, health, and money to take advantage of them. The authors’ guiding principles include: femtech solutions that proactively speak to critical gaps in health care and address health disparities, including involving community stakeholders from the ground up, and building on person-centered frameworks. The article also provides a guide of practical applications alongside examples of existing tools the authors use that embody their principles.
Mehret Birru Talabi, MD, PhD, is an Assistant Professor of Medicine in the Division of Rheumatology and Clinical Immunology at University of Pittsburgh and one of the principal authors of the article. Recently I spoke to her about the possibility of femtech’s ability to address persistent heath inequities.
Dr. Talabi, how did you get involved in femtech and how do you see it changing the way sexual and reproductive health is approached?
Femtech is a way to provide information directly to people that can help to answer questions they care about, enhance their decision-making and understanding about their health. In today’s legislative environment, people are increasingly at risk of losing autonomy over their bodies and lives and health decisions. Femtech has the potential to provide the information needed to empower people across all aspects of their sexual and reproductive lives.
In addition, as a rheumatologist, I care for patients with complex medical illnesses, some of which can be associated with adverse pregnancy outcomes. Some people with autoimmune diseases—importantly not all people—experience infertility as a result of their diseases or the medications used to treat their diseases. Some people experience fluctuations in their disease activity with their menstrual cycles. Others are not sure about whether their medications are safe to use in the context of pregnancy or breastfeeding. Others don't know if contraception or hormones in general are safe because of our diseases.
While our understanding of some of these issues is somewhat incomplete, we’re seeing startling evolutions in the field of rheumatology and medicine more broadly. We need to get essential information to patients quickly. We also need to get them the information they care about. And I've become drawn to femtech because it allows us to engage with patients and to give them updated, relevant, and timely information helps them to navigate their sexual and reproductive health as it relates to their diseases and all of the other important facets of their life.
Why do femtech innovators have a duty to ensure that their products can help everyone regardless of who they are, where they live, or what their socioeconomic status may be?
We know that some people do not receive equitable sexual and reproductive health care—particularly individuals from groups that have been historically marginalized, such as Black and indigenous people, as well as people who are poor, disabled, or otherwise marginalized. The promise of femtech is that people from these groups can be reached directly to ensure that all people have access to the information they need and care about. Many people have access to smart phones now, for example. Femtech is less helpful or impactful if it only reaches the most privileged, and that's really the challenge. As with all things, those people who have the most resources will be better equipped to get what they need. Femtech innovators usually want to reach as many people as possible. I'd frame it a little differently... we also have an ethical mandate to reach as many patients as possible.
What gaps do you hope to see femtech addressing in the next five years?
One thing we know is that menstruation seems to affect a number of different diseases and conditions. People with cystic fibrosis feel that their breathing gets worse. People with rheumatoid arthritis feel that their joints are more swollen and sore. People with multiple sclerosis experience flares. There are many other examples. We need to better understand how menstruation affects disease activity, so we can better counsel people who have periods about how it may broadly affect their health and well-being.
