GSL in The Lancet: Women’s Health, Inc.
By Joseph Dov Bruch and Sarah Richardson
The GenderSci Lab’s Healthcare Finance team has spent the past five years documenting and studying the implications of dramatic increases in corporate investment in women’s health. While growing financial investment in “women’s health” has been celebrated by many as a victory for women and a sign of progress within the healthcare system, we challenge this idea in our new Lancet perspective “Women’s Health, Inc.”
The increasing financial interest in women’s health has been modestly documented in news stories, industry reports, and research studies, but the scope and the impacts of corporate investments in the women’s health arena remain very much an open and pressing question. In prior empirical work, we showed the extensive scope and rapid expansion of these investments in the US, identifying 1,340 offices and 3,989 OB-GYN and fertility clinicians that gained private equity affiliations between 2010 and 2019, and demonstrating that almost 30% of assisted fertility cycles now occur at private equity-affiliated practices.
In our Lancet essay, we zoom out from these empirical findings to offer a framework that we call the “women’s health industry” for understanding the transformations that corporate investment has wrought in this arena. Once defined as a social justice movement, the feminist goals of women’s empowerment and gender health equity are no longer synonymous with the term “women’s health.” This reality is underscored, of course, by the recent Texas federal court decision, in which the concept of “women’s health” is mobilized by anti-choice activists attempting to restrict access to essential medications for reproductive health for the supposed protection of the health of women and girls. Corporate investment is another site in which the construct of “women’s health” is being radically transformed.
“Clinicians, researchers, and policy makers need to scrutinize the emerging women’s health industry and to engage it with care, ethics, and vigilance.”
The “women’s health industry” refers to a range of corporations and health care companies (e.g., private equity and venture capital firms, startups, and pharmaceutical companies) selling services, technologies, and products that target women. We chose “industry” rather than another word like “sector” because we want to emphasize the corporatization, business incentives, and financial motives inherent in an industry (and here a hat tip is in order to our lab manager, Kelsey Ichikawa, who thought of the clever title, “Women’s Health, Inc.”). This characterization lays bare the contrast between these incentives and the goals of early women’s health activism.
We wrote this Lancet piece for clinicians working in obstetrics, gynecology, and fertility; health systems administrators and regulators; investors; and feminist STS scholars of health, medicine, and the clinic. We hope it will spur debate and new scholarship on the financialization of women’s health and the evolution of “women’s health” as a construct.
Major takeaways:
The women’s health arena has become a target of rapid financialization in recent years. This is clear from the rise of the femtech sector, the increasing proportion of private equity-owned reproductive healthcare services, and the explicit use of women’s health discourse in framing of corporate initiatives and projects.
Based on what we know about financialization in other sectors, we predict that these trends will negatively affect the quality, safety, and accessibility of women’s health, including: cost increases for reproductive services, more frequent turnover and a less reliable clinical workforce, unregulated data mining and surveillance, and a health care infrastructure in which access for particular populations largely depends upon how profitable it continues or is speculated to be.
Across the women’s health industry, companies are championing women’s health as an equity issue and reviving the empowerment discourse of the early women’s health movement. But such claims need to be viewed skeptically given the relentless market imperatives that guide corporate investments.
In contrast to the mantra that corporate women’s health investment is unquestionably a win for women’s health and gender equity, we conclude that reproductive justice, women’s empowerment, and healthcare provisioning inclusive of all genders and sexualities may be under threat rather than advanced by the women’s health industry. We call on clinicians, health care administrators and policymakers, and researchers to vigilantly track the development of the women’s health industry and its consequences. Any analysis of contemporary women’s health is not complete without attention to these trends in financialization.
What’s next?
The Health Care Finance team within the GenderSci lab probes the business of health systems and health care management and their implications for women and gender minorities. Equipped with a feminist analytical lens, we examine the impacts of corporate investment in “women’s health,” and how constructs of gender, sex, and sexuality interact with the health system and the financial sector.
Our next big project within the Health Care Finance team focuses on femtech companies and examines the strategies these firms take to market themselves as empowering alternatives to the patriarchal offerings of traditional health care. Stay tuned!
Media Contact: Joseph Bruch, jbruch@uchicago.edu
Recommended Citation
Bruch, J.D. and Richardson, S. S. “GSL in The Lancet: Women’s Health, Inc.” GenderSci Lab Blog. 2023 April 13. genderscilab.org/blog/womens-health-inc
Statement of intellectual labor
Joseph Bruch drafted this blog post with support in writing and outlining from Sarah Richardson. Kelsey Ichikawa, Annika Gompers, Marina DiMarco, and Jamie Marsella revised and offered substantial feedback on versions of this blog.