The Vagina Business (eBook)

INTRODUCTION

SKIN IN THE GAME

Did he actually just say that? For a moment, she thought she’d misheard him. Farah Kabir had come to an island in the English Channel to pitch her company to a group of investors. Flying in from London, she had gone straight to a conference center hotel, the kind you see all over the world, with cold gray floors and lukewarm coffee. She straightened her clothes and felt her hands shake as she reached for a glass of water. It had taken blood, sweat, latex, and her life savings to get to this point.

The idea for her company had come to her a few years earlier when Farah came off the contraceptive pill. There were too many side effects: weight gain, mood swings, and greasy skin. “Hormonal contraception just wasn’t working for me,” she says. Condoms became her preferred option.

One day, she went to a shop on her lunch break at work to buy condoms. “You walk down the condom aisle, and you see they’re garishly packaged, they promote a man’s conquest, and you don’t really know what the ingredients are,” she says. With other products you apply to your body, you can usually see what they’re made of, “But it’s not like that with condoms. Either way you don’t want to be down the condom aisle for too long.” Which is exactly what happened.

As Farah rummaged around the condom aisle looking for information on ingredients, she bumped into her boss. “I was absolutely mortified. He would’ve seen the bright red pack in my hands.” What was embarrassment at first turned into frustration. “Because internally I was thinking: why is it OK for me to take control of every other aspect of my health but not my sexual health?”

Over lunch, she told her friend Dr. Sarah Welsh, who is a gynecologist, about the awkward bump in with her boss, and asked: “Why isn’t it acceptable for women to carry contraception?” Sarah was not surprised. In her line of work, she had seen women come into her clinic with hard-to-treat STIs and women who said they didn’t carry protection because it was “a man’s job” or they didn’t want to be seen as promiscuous. “So, we had this light bulb moment there and then: why don’t we create a condom designed with women in mind?”

The two women decided to take a closer look at the industry to see whether there were any condoms that had been created considering the preferences of female customers. “We were so shocked that nobody had done this in Europe,” says Farah. Then, they surveyed two thousand women and discovered that when it comes to condoms, women care about the ingredients and sustainability. The women in their survey didn’t like the smell of latex or garish packaging, but equally they didn’t want something girly, pink, and floral. “We carved out a product from what our survey respondents wanted,” says Farah. “Our condoms are vegan and biodegradable. They have no nasty chemicals in them like anesthetics that make a man last longer but are irritating to the walls of a vagina.”

“We put all of our life savings into creating condoms,” she says. To take their company Hanx further, they needed to raise money from investors. At her pitch, Farah was the only female founder facing a group of predominantly male investors that day. That’s when she heard the question that threw her. One investor laughed and said: “Can you demonstrate how to put on a condom?”

She realized the question was meant to mock her. “They didn’t take me seriously as a woman trying to raise investment for a business that currently is in a male-dominated industry,” she says. It’s a throwback to the classrooms of decades-old sex education, where teenagers laugh while pulling condoms over bananas. Who would have thought this attitude would carry on into investor board meetings led by men with silver hair?

It’s my job to ask impertinent questions as a journalist. Over the last decade, I’ve been writing about business, technology, and culture. Stories like that of Farah drew my attention to a new field that’s at the cusp of a revolution: female technology—femtech, which is technology focused on female bodies around maternity, birth, periods, sex, menopause, fertility, and contraception and beyond. The question I wanted to answer became: What stands in the way of such innovation? And how can this new generation of entrepreneurs succeed?

I set out to interview a range of female entrepreneurs in the space for an article. Every entrepreneur I spoke to told me outrageous stories about reactions from investors, who tend to be predominantly male. It’s hard enough for female entrepreneurs in any industry to raise money, but for those with a vagina-centric innovation it’s even harder. Not only do investors not relate to the issue at hand, but they are too embarrassed to discuss it in a business setting. It isn’t proper, they think, twiddling their ties. It’s not polite conversation. As one well-known venture capital investor put it: “I don’t want to talk about vaginas in my Monday morning partner meeting.”

My article was published in Wired magazine and went viral. It was read and shared by tens of thousands of people. Messages came flooding into my inbox from female entrepreneurs: “I loved your article. I think it really captured how particularly difficult it is for women.” Perhaps more surprisingly, I received messages from younger, millennial male investors too. “Super cool article,” one wrote. “As an investor, I definitely had that problem initially. Now, I am way past it.” Like others who were squeamish at first, he was making a foray into femtech.

I realized this was just a flash of the ankle. The more founders I spoke to, the more I learned about the stigma they deal with, the censorship they face from mainstream media as well as social media platforms, and also, the tremendous potential they have in an industry that could capture 50 percent of the world’s population. This, I knew, has to become a global movement.

Society has mostly overlooked female health—from the detrimental side effects of the birth control pill to a lack of groundbreaking innovation in childbirth and menopause. Designing technology—largely by women, for women—is a novel approach. After all, most technology is still designed by men, for men. This bias starts with ever-growing smartphones, which don’t fit into our hands, and extends to bigger tech, like seat belts and the broad-shouldered, masculine car crash test dummies, as Caroline Criado-Perez has shown in her groundbreaking book on the gender data gap, Invisible Women. Prosthetics, voice recognition, and protective clothing for healthcare professionals have all been designed for male bodies. A world that was designed around a male default ultimately impacts our health and safety.

The more I immersed myself in the world of femtech, and its wider ecosystem, the more it puzzled me. Women make 80 percent of healthcare decisions in the United States, according to the U.S. Department of Labor, but are hardly involved in the design of the healthcare system. It was only in 1993 that women and people of color were officially included in U.S. clinical trials, and much of our current medical knowledge has been shaped by earlier research. Women were long excluded from research because of our cycles; even animal testing tends to exclude female mice, because of their hormones.

The consequences have been catastrophic. Women are 50 percent more likely than men to be given a wrong diagnosis after a heart attack. Across 770 types of diseases, women are diagnosed an average four years later than men. And a delayed diagnosis means women are more likely to suffer pain and complications.

Female-specific diseases are met with a raised eyebrow, as polycystic ovary syndrome (PCOS) is routinely misdiagnosed. It can take close to a decade to get a diagnosis for endometriosis. Even Oprah was repeatedly misdiagnosed when she had heart palpitations as part of menopause.

The dosage of most drugs is calculated based on studies overwhelmingly conducted on male participants, even though in women, drugs tend to linger longer, as our liver and kidneys process them differently.

Only 4 percent of all healthcare research and development is focused on women’s health issues, according to PitchBook data. In the UK, less than 2.5 percent of publicly funded research is dedicated to reproductive health and childbirth. Women’s health is both underfunded and underresearched.

This disparity has existed for millennia. In ancient Greece, people believed women’s health problems were caused by our uterus wandering around our body; say if it got stuck in the chest, we’d have chest pain. In the nineteenth century, doctors blamed “hysteria,” which comes from the Greek word hystera for “uterus,” as a cause for female health issues. Today, women continue to be brushed off for “complaining.”

Female pain has been normalized, from childbirth to menopause, as society shrugs and says “Welcome to being a woman” instead of coming up with better solutions. The terms we use are revealing. There’s nothing quite like “morning sickness” to trivialize what can be a debilitating experience in pregnancy, confined not only to the morning. Another contender for...