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00:00:09.871Undisciplinary is recorded on the unceded lands of the Wadawurrung peoples of the Kulin Nation in Geelong and the Gadigal peoples of the Eora Nation in Sydney.
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00:00:12.948We pay our respects to Elders, past and present.
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00:00:17.129The world's first heart transplant has been performed.
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00:00:19.949Medical history has been made in South Africa.
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00:00:29.628Reports of systemic racism in the healthcare system and COVID-19 has made the issue even more urgent.
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00:00:40.893Welcome to Undisciplinary, a podcast where we're talking across the boundaries of history, ethics and the politics of health, co-hosted by Chris Mays and Jane Williams.
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00:00:48.250I'm Jane Williams, Okay, so welcome to another episode of Undisciplinary.
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00:00:50.012Hello Jane, how are you?
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00:00:51.473I'm very well, Chris.
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00:00:52.054How are you going?
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00:00:57.560Very good.
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00:01:15.234So last episode, as you may recall, we were having a conversation about COVID and five years since and reflecting on memory of that and also masking and how some people do mask still and what that means.
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00:01:16.016And that actually reminds me.
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00:01:26.239We had our university open day just the other day and there were some people who were masking inside, which was fine and good and I, you know, have no issues there.
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00:01:34.572But we were talking about how that is being read more and you did a call out to see if anybody had any reflections on that.
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00:01:56.409So we did get one from Pat McConville saying he thought it was an interesting discussion and says that, as someone who routinely masks and is trying to encourage institutions to take durable measures to ensure indoor environments have clean air, the spectrum of reactions runs from bemusement through suspicion and resentment to downright hostility.
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00:02:09.788I haven't responded to Pat via Blue Sky, which I probably should because that's what social media is for, but yeah, I mean that's interesting, the downright hostility as well.
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00:02:12.706Yeah, that doesn't surprise me.
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00:02:15.707And also A, Pat, thank you for engaging.
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00:02:41.721And B, I think there's been this really unanticipated politicisation right, really unanticipated politicisation right of masking or sort of visible efforts to not be infected with viruses, which is crazy, but it's a thing, we're seeing it, we have.
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00:02:42.723Who do we have to blame?
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00:02:57.289Maybe our politicians, I don't know, but yeah, Well, it is interesting how, with protest laws that are coming in, they are also criminalising or, you know, not allowing people to wear masks at protests and those sorts of things.
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00:03:01.210So there is that demonisation of mask wearing in general.
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00:03:17.689So at the recent Palestine march in Sydney, the very big one, um, there was a lot of encouraging people to wear masks, um, just for reasons of, I suppose, anonymity, if I'm honest, um, that was, that was the vibe.
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00:03:19.554Um, I forgot.
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00:03:50.626So sorry about that, but yeah, no, I think masking as a symbol of a sort of assumed political leaning is a really bizarre thing, and I'm not saying for a second that that's why people do it, but that is, I'm sure, sure, what is driving animosity and yeah, it's a huge bummer.
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00:04:00.193Yes, in an attempt to do a segue, and I'm not sure how this is going to go Give it a go.
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00:04:01.723But it is.
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00:04:11.491You know, the manosphere does perhaps have a part to play here, as does podcasting, and we were reflecting on five years of podcasting too.
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00:04:12.353So there's another link.
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00:04:40.346But I was telling some colleagues about the topic that we're going to have, or part of the topic this week about period tracking and menstruation tracking, and this colleague was not really familiar with my podcast and so maybe rightfully assumed this was going to be a bunch of dudes talking about period health, and I did inform them that this is not that kind of podcast.
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00:04:59.541So we are very glad to have our guest today who's going to talk about femtech and a range of other issues and approaches to health that I'm very excited to talk about, and I will introduce our guest now to flip the script a little bit.
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00:05:09.666Andrea Ford is a cultural and medical anthropologist at the Centre for Biomedicine, self and Society at the University of Edinburgh School of Medicine.
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00:05:23.894Her research explores childbearing, menstruation, endometriosis and hormones more broadly, investigating how ideas about gender bodies, knowledge, nature and technology shape the cultural surrounding medicine and reproduction.
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00:05:31.458She also practices as a birth doula and is dedicated to working towards reproductive, environmental and social justice.
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00:05:58.399In 2024, she began a five-year Wellcome Trust project investigating the femtech industry, including the changing relationship between public and private institutions of knowledge and private institutions of knowledge, production and care provision, and concerns about surveillance, how it intersects with promissory ideas about digital health, and also has a number of really great books and publications that I hope to be able to discuss.
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00:05:59.983So, andrea, welcome.
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00:06:01.648Thank you so much.
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00:06:02.571It's a pleasure to be here.
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00:06:06.048Can I ask an introductory question?
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00:06:11.930Is your name pronounced andrea or andrea it?
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00:06:13.274varies by the country.
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00:06:18.211I'm not precious about it, but I uh I've been asked your name.
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00:06:26.488This is a shout out to the uh beverly hills 90210 watchers who learned?
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00:06:39.108Sometime in the 1990s that Andrea is pronounced Andrea in the US, so I just wondered if it might be that Thanks so much for joining us today.
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00:06:43.071So wait, andrea or Andrea, which do you prefer?
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00:06:44.175Andrea, andrea, which do you prefer?
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00:06:51.526Andrea, although one of my good friends, who we also lived together for a while, is Andrea, so that was very fun.
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00:06:56.449And then, yes, with the Australian accent we are well.
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00:06:59.827I am probably making it sound all kinds of strange as well.
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00:07:01.692A lot of vowels in there.
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00:07:13.630And speaking of talking to people about this, before the thing, before the podcast, I told someone we were talking about Femtech and because of my accent they were like what?
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00:07:15.446And that was as far as we got.
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00:07:19.267So I will try to be.
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00:07:19.850Yeah, I know.
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00:07:23.360Femtech, fem anyway.
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00:07:28.232So I'll try and be a bit less new zealandy with my ease.
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00:07:42.029Um, yes, so part of part of what we do on this podcast is, uh, talk about the undisciplinary or the unplanned paths that people take to get to where they are now.
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00:07:47.060Um, and it's possible that you didn't have an unplanned path.
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00:07:51.221You might've been planning this path since you were five and I would love to hear about it if you did.
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00:07:57.281But can you tell us a little bit about yourself and how you got to where you are academically?
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00:08:02.781And also I'm interested in the kind of intersection with being a doula and doing this work as well.
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00:08:04.565For sure.
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00:08:08.783I think it might be quite a bit more interesting if I had known from the time I was five.
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00:08:12.550Quite rare, no, not at all.
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00:08:17.947And so I have studied interdisciplinary fields.
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00:08:23.442My ba was in interdisciplinary studies, um, which is something that uc berkeley offers.
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00:08:25.464You could kind of make your own program of study.
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00:08:49.469And then I did an interdisciplinary MA in African studies, a scholarship at the University of Ghana, decided to apply to PhD programs but was interested in essentially African economics and different ways of thinking about value and circulation, and then did a 180 in my PhD program to in some ways kind of come full circle.
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00:09:05.214My whole family are medical professionals of various sorts, so I grew up surrounded by medicine and I've always thought that the body is quite fascinating as a place where different cultural ideas come to meet.
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00:09:21.373So switched topics two years into my PhD to look at pregnancy, which I thought was one of the coolest things a body could do, to not just be an obnoxious bystander in labor and delivery rooms.
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00:09:35.048I thought, oh, train as a doula, that's an interesting way to be involved and kind of give something back to the people I'm chatting with Research interlocutors, as they're sometimes called and then I ended up really liking that work.
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00:09:44.149The kind of presence that it requires and the function that it serves in a lot of medical systems is increasingly.
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00:10:02.144People are increasingly paying attention to that sort of gap where a patient advocate kind of continuity, emotional care, support, respect um birth is much more than a physiological process and those, those kind of more soft qualities, really affect how physiology happens.
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00:10:04.467That was really fascinating.
00:10:04.467 -->
00:10:16.437And then for my postdoc I moved into an interdisciplinary center, so my PhD was in anthropology and that was my only disciplinary training, which I really value.
00:10:16.437 -->
00:10:30.990Actually, having moved into this interdisciplinary science and technology studies center, I think there's some kind of happy medium between having a discipline that you bring to bear um into an interdisciplinary space.
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00:10:38.431But let's, maybe everyone will have kind of a different preference with regards to that, or a different personality perhaps, um.
00:10:38.431 -->
00:10:45.974And then the last thing is that that center is within the medical school, so I'm always talking with people from different social science and humanities disciplines.
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00:10:58.467But then trying to engage with clinicians and kind of more quantitative public health researchers and also basic scientists is challenging and fascinating.
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00:11:08.770Yeah, that's not even touching on the kind of personal life aspects which you mentioned are so often key to those sorts of transitions and decisions.
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00:11:18.672Yeah, I think that's something that Chris and I but maybe me more than you, chris, because I'm in a school of public health come up.
00:11:18.672 -->
00:11:38.868I wouldn't say come up against, but it's not always against, it's with, sometimes, you know, people working on health and epidemiology and so on and trying to find a shared language and shared approaches, which is sometimes incredibly rewarding and sometimes really frustrating.
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00:11:42.903So as you said though I think that's like a personality thing as much as anything else.
00:11:42.903 -->
00:11:48.330You know, yeah, I mean I'd also say that's like a personality thing as much as anything else, you know, yeah, I mean I'd also say that it sorry, you go.
00:11:50.221 -->
00:11:55.765Just the transition also between countries and kind of navigating between disciplines.
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00:12:03.924But I moved from the US to the UK, so sometimes it's hard to figure out what the difference is that you're trying to bridge even.
00:12:04.467 -->
00:12:04.749Yeah.
00:12:11.019 -->
00:12:15.413Yeah, it's hard to figure out what the difference is that you're trying to bridge even yeah, yeah, I was just going to say about being going from a more disciplinary context into an interdisciplinary context.
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00:12:54.721Um, it in some ways keeps you honest when you are talking about or maybe not honest, but it it means that you need to be on your toes, or when you're talking about medical matters in a way where if you don't seek out those engagements with people working in epidemiology or public health or those sorts of things, you can in some ways get a little detached from what you're doing, and philosophy has that built into it already.
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00:13:00.443So you know it's important to have those collaborations and engagements yeah, for sure.
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00:13:09.570I sometimes think about anthropology as applied philosophy or empirical philosophy and it's.
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00:13:25.366It's just interesting because it's so slippery between studying biomedicine and how it makes sense of bodies and being collegial with biomedical researchers who I work closely with, the the kind of colleague and subject.
00:13:25.366 -->
00:13:32.952Lots of people have written about that, but it's always interesting and challenging.
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00:13:35.644Just related to that.
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00:13:48.274So when you were talking about training to be a doula, were you doing that as part of your, or or kind of in concert with your, phd work?
00:13:48.274 -->
00:13:53.306So you were huh yeah, exactly interesting.
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00:14:14.741Um a lot of times in anthropology you'll have to have a plan for an in to your field site also want to talk to you and engage with you and, and in so many ways, you're kind of who you are as a person and what sort of uh, background demographics you bring to a situation, shape, what kind of project you can do.
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00:14:28.150Um, and yeah, the fact that I I ended up really liking doula work and was, uh, I don't know like for example, I had a colleague who was similarly inclined but was really squeamish and didn't end up enjoying being in a birth room at all.
00:14:28.653 -->
00:14:43.923But for whatever reasons, maybe our gruesome dinner table conversations growing up like oh, this is fine, yeah yeah, yeah and then moved into the kind of femtech curiosities about how new technologies are being applied more broadly than birth.
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00:14:52.052Per your invitation to speak with you today, although birth and reproduction more properly still crop up quite a lot in my work.
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00:15:05.008The first work of yours that I read, andrea, was a 2021 paper called Hormonal Health Period Tracking Apps Wellness and Self-Management in the Era of Surveillance Capitalism.
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00:15:47.506So that paper reports on a pilot study about period tracking and presumably that's a pilot that led to or contributed to your current grant, and I was really interested in reading it because and I feel like there's maybe a generational gap, because it's not that I'm unfamiliar with period tracking like period tracking was a good way to not get pregnant, to get pregnant, to know when you need to have tampons with you, you know that sort of thing, but I hadn't ever thought about it in any other way, except for, essentially, the bleeding part, well, and, I guess, the ovulation part.
00:15:47.506 -->
00:16:11.769I was really interested, I guess, in the paper in the role of reassurance and period tracking, so people keeping track of their periods in order to I don't know tell themselves a kind of reassuring story about their health.
00:16:11.769 -->
00:16:23.509I was wondering if you could like talk us through that paper and the findings that you had when you were talking to the people and the role of period tracking as reassurance.
00:16:23.828 -->
00:16:24.932Sure happy to.
00:16:24.932 -->
00:16:26.426It's such a huge question.
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00:16:34.044Yes, so that paper and the little pilot study which came from the idea of an undergraduate student of mine at the University of Chicago.
00:16:34.044 -->
00:16:37.279So that's Olivia Miller's Curiosity which sparked my curiosity.
00:16:37.279 -->
00:17:01.096When I did that little pilot study, which was very fun, all the people that we spoke to were kind of middle-aged like 30s or late 20s, kind of upper class or more educated, kind of university affiliated, living in urban environments.
00:17:01.759 -->
00:17:21.604A lot of them were kind of internationally mobile, so a very specific demographic people who are very inclined towards healthism, I would say right, capitalizing on how they care for their bodies as a um, as a form of capital, as a form of status, but also less explicitly about um.
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00:17:34.410I think there's a lot of anxiety it's not just like performative um a lot of anxiety that gets, as you say, reassured or assuaged through these kinds of practices, um, and what was striking was that none of them were using it for contraception or conception.
00:17:34.410 -->
00:17:45.333They were using tracking apps for this kind of understanding your body in a very expansive sense, um, which isn't Well.
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00:17:47.038It's new in some ways and old in others.
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00:17:48.101I guess, Right.
00:17:51.230 -->
00:18:20.421So people have some people, some scholars have called that queering of menstrual tracking or apps or menstrual health, and that it's not oriented around reproduction as part of being a body, but not part of reproducing per se, to sort of reclaim it as something that shapes embodied experience without having that experience be subject to reproductive logics which have governed women's health for a long time.
00:18:20.421 -->
00:18:28.372So there's that aspect and there's certainly a long history of knowledge about your body being considered empowering.
00:18:28.372 -->
00:18:36.164The general takeaway that we argued for in that paper is that sure, it can be empowering, but not within contexts of your choosing.
00:18:36.164 -->
00:18:48.705So the context of surveillance capitalism, where your data is marketed towards advertisers but also potentially offered up for criminalizing purposes if needed.
00:18:48.705 -->
00:18:50.134Offered up for criminalizing purposes if needed.
00:18:50.134 -->
00:19:10.670There's post the repeal of Roe v Wade in the US, as you said, there's a swath of anxieties about period tracking data being used essentially to criminalize people who may have had abortions and there's a very blurry line between an abortion and a miscarriage and how you talk about that, how you attribute agency.
00:19:11.571 -->
00:19:19.631Um is a gray zone which is brought up interestingly in this, but very real, very real material concerns around safety.
00:19:19.631 -->
00:19:41.931Um, right, so there's that condition of surveillance capitalism, uh, and surveillance criminalization, and then there's the pressure to optimize and the kind of generation of healthism where you don't just need to be healthy but you need to be the best possible version of yourself, and this, uh, was kind of like a female version of that.
00:19:41.931 -->
00:19:53.612So, um, aligning your life around your cycle has, since that study in 2020, 2019, really kind of exploded and grown.
00:19:53.612 -->
00:20:33.190This idea of cycle syncing, so you would, the kind of common knowledge about it, although not necessarily based on any scientific research, is that you'll have more energy during ovulation and maybe be more withdrawn during what might be considered a PMS period or pre-bleed period, and that you would, you know, schedule your big work presentation where you want to, or like your big party hosting thing during your ovulation, and then you know, like work from home when you'd be more inclined to be crabby or not have the energy for that, or there's all sorts of different ways that people kind of think through what you should do at different phases of your cycle.
00:20:33.570 -->
00:20:46.853A new aspect of this that's really getting increasing research is about athletics and what sort of training and diet you should do if you want to ramp up your athletic performance as a menstruating person.
00:20:46.853 -->
00:21:00.083So some some research is being done into that, um, and some of some of this kind of cycle syncing world takes a more spiritual tone as a sort of empowerment, um, but in any case, the idea is that you need to.
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00:21:17.906You need to be the best version of yourself, um, and in many cases you need to fit within some kind of external ideal, like a nine to five workday, or like job demands or social demands that you don't really have a way out of.
00:21:17.990 -->
00:21:42.877So you have to kind of fit yourself into that container and the period tracking app is a way to mediate that mediate that, so that that to me is so fascinating because I feel like, um, for a long time and now I'm thinking, a long time ago in my life, all of this stuff was weaponized.
00:21:42.877 -->
00:21:44.079Really it wasn't.
00:21:44.079 -->
00:21:45.742It wasn't about optimizing, right.
00:21:45.742 -->
00:21:51.173It was like if you get angry, people are going to accuse you of of being premenstrual.
00:21:51.173 -->
00:22:01.826You know like you can't actually be angry, it can't be that that something's really annoying or that, yeah, that somebody else is doing the wrong thing.
00:22:01.826 -->
00:22:03.810It's on you because your hormones have gone haywire.
00:22:03.810 -->
00:22:21.162So it's interesting to me that there's this kind of mix going on of, like, old school, oh it's just the hormones, and new school, it's the hormones, and let's embrace that maybe, or let's kind of capitalize on the knowledge, or I don't know.
00:22:21.162 -->
00:22:26.522For me it's a really complex dance, yeah.
00:22:27.372 -->
00:22:42.099Yeah, complex for sure, and I think there's in some ways it echoes these really old debates in feminism about the role of the biological and the reality of a bodily difference, um, and in other ways it's very current, based on current changes.
00:22:42.099 -->
00:22:49.462Um, there's a fun kind of fact that cosmopolitan magazine dubbed the year the period went public.
00:22:49.462 -->
00:22:52.020So there's all you know.
00:22:52.020 -->
00:22:56.980Since then, in the past decade, there's been a lot of attention towards period poverty.
00:22:57.450 -->
00:23:05.079I live in Scotland where there's been a parliamentary act to make period products free for anybody, which is often touted as the first of its kind.
00:23:05.079 -->
00:23:10.592That's not necessarily or strictly true, but it is pretty cool first of its kind.
00:23:10.592 -->
00:23:11.854That's not necessarily or strictly true, but it is.
00:23:11.854 -->
00:23:12.234It is pretty cool.
00:23:12.234 -->
00:23:18.755Um, there's been lots of attention towards, uh, whether it's acceptable to see blood or bleeding menstrual blood in advertisements or film.
00:23:18.755 -->
00:23:34.089Um, there's been a kind of you know, anti-shame movement which is more or less successful, attention towards periods in low and middle income countries and how that affects people's opportunities.
00:23:34.089 -->
00:23:44.422So in some ways reclaiming hormones as awesome, is part of this.
00:23:44.422 -->
00:23:47.605Like reclaiming periods and anti-stigma and anti-shame.
00:23:47.605 -->
00:23:51.269Like reclaiming periods and anti-stigma and anti-shame.
00:23:51.269 -->
00:23:55.823But it is certainly a double-edged sword because it is still used to shame and dismiss.
00:23:55.823 -->
00:23:58.839The idea of the hormonal female is still very much alive.
00:23:58.839 -->
00:24:12.453Spain recently introduced period leave from work, so you can take a few days off if you want, but people don't really use it For one it's a bit burdensome.
00:24:12.473 -->
00:24:21.153You need to get like a doctor's note saying that your periods are, I don't know, especially difficult to manage, but also there's a fear of retribution or being seen as less productive.
00:24:21.153 -->
00:24:24.339And that's all still very, very much alive.
00:24:24.760 -->
00:25:08.315Yeah, I mean I've been finding reading some of your articles, you know, really fascinating and this I mean I've been finding reading some of your articles really fascinating and this I guess tension or double edged sword that you're talking about, with of sort of admonishments which you know, I guess play into long histories, both of sort of patriarchal responses to women, but also the whole idea of rational agency as opposed to the irrational body and the bodily impulses and these sorts of things.
00:25:09.692 -->
00:25:25.090So I was quite interested in the paper where you talk about this idea of hormonal health, um, and that it's sort of you just to read a quote from it and I'd be interested to hear sort of your further thoughts on it.
00:25:25.090 -->
00:25:34.846Um, you describe hormonal health as a way of caring for and knowing about bodies like the hormones to which menstrual cycles are biomedically attributed.
00:25:34.846 -->
00:25:44.136Period tracking straddles the subjective and the objective experience, medical and non-medical approaches to health, and personal and societal jurisdiction.
00:25:44.136 -->
00:25:56.244So it it seems to be this very you know, hormonal health, but also the period tracking an interesting way into.
00:25:56.244 -->
00:26:06.578I guess it opens up all of these different kinds of ways of thinking about not just the body and health but also, yeah, personal and societal jurisdictions, et cetera.
00:26:07.332 -->
00:26:13.279I think hormones are absolutely fascinating for that reason because they straddle these supposed divisions and binaries.
00:26:13.279 -->
00:26:18.881I've worked on a project for a number of years.
00:26:18.881 -->
00:26:20.636We call ourselves, like the hormones hub.
00:26:20.636 -->
00:26:49.523There's between five and 10 people who are anthropologists and sociologists of hormones and find that slipperiness really fascinating, or the kind of cascades you have a medical intervention that transforms into a social thing and then vice versa and at length birth, um to this research because hormones in birth, oxytocin during labor and different ways that that interplay between physiology and the social environment in the birth room.
00:26:49.523 -->
00:27:08.757They're very similar to something like thinking about your progesterone and estrogen levels and how they might affect your mood and then make you more reactive and then in turn that can affect um not as well in some.
00:27:08.757 -->
00:27:16.702In some hormone cascades go back and forth, like if you're anxious that will raise cortisol, for example, and then there's kind of these loops or cycles.
00:27:18.631 -->
00:27:23.021But it's also really interesting, I think, because hormones are not necessarily gendered.
00:27:23.021 -->
00:27:34.679They do have a gendered history and they're conventionally separated into sex hormones and other hormones, so progesterone, estrogen, testosterone and everything else.
00:27:34.679 -->
00:28:02.201But that's very much a cultural division as new research is exploring and then you get these similar sorts of hacking, but there's a phenomenon called dopamine hacking, which takes various forms, related to, often related to technology use and then kind of making a game out of your attention and addiction, feedback loops and how you experience pleasure, in order to optimize whatever kind of goal you have.
00:28:02.201 -->
00:28:08.000So dopamine is not gendered in the same way, um, but is a hormone that plays into these.
00:28:08.000 -->
00:28:13.836The slipperiness that I think is fascinating about menstrual hormones are kind of.
00:28:13.836 -->
00:28:30.818Another interesting aspect of this is that there are, there is some current research that frames periods not as hormonal or as hormonally driven, but as inflammatory, and that hormones are kind of the again, not the drivers, but almost the effects of an inflammatory process.
00:28:31.579 -->
00:28:52.454And that's that's being advocated, um, as like stop stop this hormonal myth-making about the female body so like I don't really understand that this the kind of I was going to say, this whole inflammation thing is sounding very sort of boomer, but, but I don't really understand what that means.
00:28:53.236 -->
00:28:59.792Um, do you, does anyone feel free to shout out to the podcast?
00:28:59.792 -->
00:29:06.171You know, but, but, but increasingly, um, a lot of uh, I was going to say health complaints.
00:29:06.171 -->
00:29:17.621It's not just health complaints, but body changes and states and so on are being described as inflammatory responses, and I just, I don't know, maybe we need a doctor on the show.
00:29:19.451 -->
00:29:22.942I mean, it is very much a social and cultural phenomenon.
00:29:22.942 -->
00:29:40.844So the person who does the inflammatory periods is Sally King, and a colleague, julia Swallow, has a big welcome grant to study inflammation and disease, but from a social perspective and how inflammation is being seen as key to various diseases from a medical perspective.
00:29:40.844 -->
00:29:48.474But also is this sort of cultural phenomenon where you get, you know, tiktok and Instagram posts about an anti-inflammatory lifestyle or diet.
00:29:48.474 -->
00:29:55.961I think it follows on from older discussions about chronic stress which have been around for a while.
00:29:55.961 -->
00:29:59.965My understanding is that inflammation is a well.
00:29:59.965 -->
00:30:01.047Cortisol links them.
00:30:01.086 -->
00:30:08.080Both a kind of inflammatory response and a stress response are very similar.
00:30:08.080 -->
00:30:25.555And so then there's these concerns about high-paced lives, fast-paced lifestyles, kind of over-industrialized environments, and how those all cause different kinds of stress and so we're all chronically inflamed, which leads to lots of non-communicable diseases etc.
00:30:25.555 -->
00:30:34.059So there's an interesting book called Inflamed which links us to histories of colonialism as well and kind of violence in the world and how that becomes embodied.
00:30:34.059 -->
00:30:38.057So for sure it's a medical question, but it's also a social question.
00:30:38.057 -->
00:30:41.124That's fascinating.
00:30:44.113 -->
00:31:11.271I mean, this may seem well obvious, I guess, in some respects, but what we're talking about with the gendered nature of hormones in at least our societies, and one thing that, or perhaps an example of that, is, you know, when I teach sort of gender and medicine and medical ethics, you know talk about anatomical maps and how they're often depict the male body as the sort of normal body.
00:31:11.271 -->
00:31:17.792And, yeah, I was struck by when I googled hormone and went to the wikipedia page as a good researcher.
00:31:17.792 -->
00:31:34.330You know, the first thing is a picture or you know, drawing of a female adult hormone, uh, loop image, um, whereas then, yeah, with other discussions of yeah anatomy, those sorts of things, it's the
00:31:34.391 -->
00:31:47.343sort of male body, that, or the appearing male body that's sort of taken as the norm, um, and so I guess one thing that you know I'm interested in a number of things.
00:31:47.343 -->
00:32:15.839Maybe this is a maybe more in some respects straightforward, maybe a bit boring question, but I do recall seeing a um paper once, I think it was at the australian sociology association where some people were looking at this would have been about 10 years ago some things about sort of period tracking apps and they were criticising that they were often made by men, like early on in some of the early development of these.
00:32:15.839 -->
00:32:21.938So yeah, going back about 10 years, I'd be interested to know what with femtech?
00:32:21.938 -->
00:32:31.270Is it also who's driving a lot of the I guess, commercial side of these sorts of devices and apps?
00:32:31.330 -->
00:32:34.096and yeah, the commercial side is fascinating.
00:32:34.096 -->
00:33:09.185Um, I I don't know if this is true, but I have heard, kind of apocryphally, that it was, you know, silicon valley tech bros who wanted to know when their girlfriends were going to pms it's so depressing again, not sure that that's true, but it fulfills the stereotype that it's um technology aimed at women but not necessarily for women or certainly not necessarily feminist, and that's interesting ambiguity in femtech as a, as a term, but also analytically is it it's supposed to be for women.
00:33:09.446 -->
00:33:24.637But then you have these edge cases like a number of um startups that deal with sperm health would be countered, counted as because of the historical conflation of women's health and reproductive health, so not necessarily for women, but supposedly for women.
00:33:24.637 -->
00:33:28.736And then is is that feminist, like, even if you have a female founder of a company?
00:33:28.736 -->
00:33:33.454What are feminist values?
00:33:33.454 -->
00:33:37.759Does it mean being able to succeed again in this kind of hyper-competitive capitalist context?
00:33:37.759 -->
00:33:39.575Is that a feminist goal?
00:33:39.575 -->
00:33:45.953It might empower women, but that might not be the best sort of vision of a future that we could imagine for women.
00:33:48.559 -->
00:33:51.576The kind of nuts and bolts of the venture capital economy are.
00:33:51.576 -->
00:33:59.166There was an interesting series of Guardian articles, I think last year, showing that.
00:33:59.166 -->
00:34:07.488So the projected value of the femtech industry is exponential, like it's.
00:34:07.488 -->
00:34:14.405You get these different figures and they just rise to skyrocketing heights, which is the whole point of venture capital that you'll get massive returns.
00:34:14.405 -->
00:34:19.387And then it's really difficult for female founders to actually break into venture capital.
00:34:19.387 -->
00:34:31.632They're seen as less reliable, including for something like a femtech app, when you would think that they would have a kind of built-in credibility.
00:34:31.632 -->
00:34:51.961The part of that study was showing that if they use kind of activist terms like empowerment or rights or, you know, changing misogynistic and outdated health care, they're seen as having a chip on their shoulder, whereas if a man uses those terms you see a male founder uses those terms he's seen, as you know, savvy marketing.
00:34:51.961 -->
00:35:08.106So there's, there's still so much just straight up kind of misogyny and gender bias within venture capital that it is very tricky for, even on the most conventional terms, for femtech to be empowering to women.
00:35:09.760 -->
00:35:13.969Do you think so in the 2021 paper?
00:35:13.969 -->
00:35:26.018And this is just one of those like standard introduction lines, but there's a line in there about, um, that femtech would be as an industry would be worth 50 billion dollars by 2025.
00:35:26.018 -->
00:35:28.182So now we're in 2025.
00:35:28.182 -->
00:35:35.500I'm really curious to know whether that is, I guess, the value of the of the tech.
00:35:35.500 -->
00:36:03.880I don't even know how you value tech, so this, this is like, but I suppose more it's like are people still really enthusiastically taking up these apps, um, or the idea, I guess, of I want to say surveillance, really like surveilling the self rather than being I want to say surveillance, really like surveilling the self rather than being kind of surveilled.
00:36:08.672 -->
00:36:10.659Is that a thing that is still really popular?
00:36:10.659 -->
00:36:20.264Yes, I don't know, off the top of my head, if the projected value is the current assessed value, but it does continue to be projected to increase exponentially and that it and that it has increased exponentially.
00:36:20.264 -->
00:36:31.820Um, and it's growing, and um partially, that's measured by increasing usage of apps and downloads of apps, um partially by the number of companies that are within the sector.
00:36:31.820 -->
00:36:36.666So there's loads and loads of new femtech companies which are not just about period tracking.
00:36:36.666 -->
00:36:40.650That's the kind of popular lore.
00:36:40.650 -->
00:36:49.112Is that Ida Tinn, who founded Clue, a period tracking app based in Germany, she coined the term femtech in 2016.
00:36:49.112 -->
00:36:56.771That's sort of where the idea of this as a sector of the broader venture capital health tech industry came about.
00:36:56.771 -->
00:37:00.356Sector of the broader venture capital health tech industry came about.
00:37:00.396 -->
00:37:07.056And then since then, existing companies have been kind of pulled under the umbrella for something like breast pumps or pelvic floor trainers, which have existed for a while.
00:37:07.056 -->
00:37:08.000But also there's these novel technologies.
00:37:08.000 -->
00:37:09.905A lot of them are app based.
00:37:09.905 -->
00:37:22.047Some of them are not necessarily about tracking but about communities, so connecting you with various kinds of support people undergoing similar experiences, maybe around miscarriage or postpartum.
00:37:22.047 -->
00:37:26.159This is becoming increasingly ai mediated.
00:37:26.159 -->
00:37:27.882So you have chatbots for these things.
00:37:27.882 -->
00:37:42.005Chatbots for postpartum depression have recently had an uptick, and then some of the thing the companies that are being uh launched within the femtech sector are hardware or devices.
00:37:42.005 -->
00:37:58.791So something like nettle has this period, a headband that delivers transcranial nerve stimulation, um, which is supposed to alleviate period pain and perhaps pms symptoms or pmdd, which is premenstrual dysphoric disorder.
00:37:58.831 -->
00:38:02.867So quite a severe form Transcranial, like in your head.
00:38:03.588 -->
00:38:11.693Yeah, and it says neuromodulation, which again, I don't have a stake in whether or not this works.
00:38:11.693 -->
00:38:16.527It's not like I'm in a position to pass that sort of assessment.
00:38:16.527 -->
00:38:24.824But what I think is really interesting about it is that it's another instance where periods are not seen as hormonal, they're seen as neural and that they can be neurally modified.
00:38:24.824 -->
00:38:34.641I think your pain receptivity is in your brain, is the claim, and that whatever your hormones are doing, you could be more or less affected by it by moderating your brain.
00:38:34.641 -->
00:38:49.092So that's a piece of hardware which is part of the Femtech ecosystem, or something like at-home test kits for your hormone levels those are really popular or at-home sperm collection kits if you want to bank your sperm.
00:38:49.092 -->
00:38:59.335Or there's like a wristwatch that brands itself as your menopause thermostat, your personal thermostat.
00:38:59.335 -->
00:39:17.199So just lots of sometimes creative, often very hype, hypeful, sometimes quite genuinely intriguing and potentially transformative ideas for technologies broadly understood that might change women's lives.
00:39:17.822 -->
00:39:24.889Yeah, I guess they're all like if 2015 was the year of the period or just that one year that we all started bleeding.
00:39:24.889 -->
00:39:31.833I guess I feel like last year was the year of menopause, right.
00:39:31.833 -->
00:39:45.954So it's just seeing an opportunity and being like, oh, maybe if we talk about this more, then we're creating more I don't know more demand for all of it, for the hacks.
00:39:47.840 -->
00:39:58.844The menopause boom is really interesting and there's this sort of valorization of older life and the pushing against the way that older women in particular have been dismissed In terms of hormones.
00:39:58.844 -->
00:40:00.228There's a really interesting reversal.
00:40:00.228 -->
00:40:15.608So right now you're seeing a lot of younger people rejecting hormonal contraception because of the side effects, but you're seeing this huge, huge, almost in many cases rights-based claims towards HRT, which is hormone replacement therapy for menopause.
00:40:15.608 -->
00:40:29.086So very similar kind of interventions, pharmaceutical interventions, but framed very differently, socially speaking, as empowering or the kind of contraception.
00:40:29.086 -->
00:40:31.519One is like why are we just being fed hormones all the time?
00:40:31.519 -->
00:40:35.987Like, give us some real options here, um, versus with HRT?
00:40:35.987 -->
00:40:37.369It's like why are?
00:40:37.369 -->
00:40:39.612Why are we not being given you know?
00:40:39.612 -->
00:40:43.965Why are we told we should suffer through through the symptoms of menopause?
00:40:43.965 -->
00:40:48.112Um, yeah, um so I've been.
00:40:48.873 -->
00:42:04.188Yeah, I was reading another article of yours, uh, well, I mean, we'll stay on the um, the current article about, uh, hormonal health period tracking apps, the one that we've been talking about, but the other article was, um, how to categorize disease, endometriosis, inflammation and self out of place, and that was, yeah, really fascinating um, and I think, as sort of mentioned and earlier, just the way, thinking about, about the body, that we think about health and that we think about, um, I guess, some of these sort of questions around what is normal, what is pathological I'm not we don't need to go fully into george's cangium here, but you know, this idea of illness and wellness, um, these, these lines, um, that are blurred, and I guess you know to put it into a more specific question.
00:42:04.248 -->
00:42:08.047And back to the other, the other paper, uh, the first paper that we've been talking about.
00:42:08.409 -->
00:42:53.061You know, one of the subsections is um, a period is more than a period, transcending categories and it's it does seem that, in reading your research around hormones and period tracking, that they are providing this way for people to think about their bodies in very new and different ways me, at least, I mean, but but also new to, I guess challenging some medical orthodoxy about both how to practice and, um, how to categorize and how to um label certain certain conditions, um, or whether they're even labeled as such.
00:42:53.061 -->
00:42:53.824Uh.
00:42:53.824 -->
00:43:04.280So I guess it would be interesting if you could just for those who haven't had the pleasure of reading your articles like this idea of a period is more than a period.
00:43:04.280 -->
00:43:06.889So these people are using these tracking devices.
00:43:06.889 -->
00:43:11.143We haven't really sort of touched on the different ways that they're using them in.
00:43:11.143 -->
00:43:31.572You know, some of the participants were saying they take their data, I guess, to their appointments with their therapists and their psychologists, and what are the hormones and what are these tracking devices telling them about their bodies that they are using in this particular way?
00:43:34.621 -->
00:43:35.827Such a good question.
00:43:35.827 -->
00:43:37.146Lots in there to unpack.
00:43:37.146 -->
00:44:05.244I think one of the things that people who might not use a period tracking app are unaware of is that a lot of them not all of them, but a lot of them have not just am I bleeding today, um, but I uh the clue last time I checked, which was a few months ago, has over 200 different things you could track like on any given day, and that would be like your stool quality, whether your hair is brittle, whether you have energy or where you feel slothful, whether you've had sex.
00:44:05.244 -->
00:44:07.731What kind of protection did you use, if any?
00:44:07.731 -->
00:44:14.628Um, like whether you've been stressed because of something or went out partying, or you know.
00:44:14.688 -->
00:44:31.701There's just like a huge range of things that might possibly be relevant and some of them have, uh, theories, I would say whether they're backed up by scientific or medical evidence or not theories about potential relationships between these things, but a lot of them are.
00:44:32.282 -->
00:44:58.362It's kind of like this big experiment, um, where you correlate your own data with your own experience and kind of figure out oh, for me, the week three, the luteal, or like the, the different phases, I, my hair gets, my acne gets really bad or my hair looks terrible at this time of the month and great at this time of the month or um, like your digestion changes and your, your stool will be different if you're closer or farther from your period.
00:44:58.362 -->
00:45:06.940For a lot of people, and sometimes it's just like oh, that's something I never thought about, that um hasn't been paid attention to because it's been considered unimportant.
00:45:06.940 -->
00:45:24.248Some of it is like there is such poor research into, uh, hormonal cycles and how they affect bodies for, for female or menstruating bodies um, that maybe there are these correlations that nobody knows about and I can kind of figure that out.
00:45:24.248 -->
00:45:25.320Part of it's very personal.
00:45:25.380 -->
00:45:43.255It's like a kind of diy personalized medicine, but um so a period is more than a period is open to however a given person wants to engage with making sense of possible data.
00:45:43.677 -->
00:45:52.065I suppose there is then a question about companies using the data submitted for research, which a number of the bigger companies have done.
00:45:52.065 -->
00:45:57.005They've published papers in really well-regarded journals Flow and Clue do this.
00:45:57.005 -->
00:46:09.389A lot Interesting questions around whether the data is a high-quality data, because obviously people aren't necessarily thinking of themselves as participating in a research study when they're using a tracking app.
00:46:09.389 -->
00:46:14.385Questions about consent, if they know their data is being used in research, even if it's anonymized.
00:46:14.385 -->
00:46:16.065So that's a kind of bookmark.
00:46:18.141 -->
00:46:22.867The other thing that came up when you were asking the question and this idea of normal and pathological.
00:46:22.867 -->
00:46:33.282So I did, I did revisit kong yam in preparation and the the dual sense of the normal or the normal statistically, like what's common but also what's normalized.
00:46:33.282 -->
00:46:38.090Is so relevant to pain during periods, like are periods painful?
00:46:38.090 -->
00:46:39.793It's a really genuine question.
00:46:39.793 -->
00:46:40.054Mine aren't.
00:46:40.054 -->
00:46:41.115I don't have period pain and I know that I'm really.
00:46:41.115 -->
00:46:42.398Is so relevant to pain during periods, like are periods painful?
00:46:42.398 -->
00:46:43.179It's a really genuine question.
00:46:43.179 -->
00:46:43.418Mine aren't.
00:46:43.418 -->
00:46:47.449I don't have period pain and I know that I'm really lucky and unusual in the kind of normal statistical sense.
00:46:47.449 -->
00:46:59.586But then there's the question of how many people with endometriosis, for example, just get told that period pain is normal and that it doesn't matter and there's nothing for it, and that's just what it is to be a woman, have a period, etc.
00:46:59.586 -->
00:47:01.751Um, so it's very normalized.
00:47:01.751 -->
00:47:07.507So in in that sense, I'm abnormal, um, and it, or I guess, in both senses.
00:47:07.527 -->
00:47:24.652Sorry, uh, but the question of what, what is a period, is also very social and it's also like the normal as desirable thing, right, so you might be abnormal, but also awesome.
00:47:26.300 -->
00:47:32.907You know that sounds like maybe there's possibilities for people to generally not have pain.
00:47:32.907 -->
00:47:40.768What would be required for a society to enable people to not have pain or to be addressed?
00:47:44.264 -->
00:48:25.293So, towards the end of the article, one of your participants said this really great phrase that I'm surprised I've never, you know, maybe it has been put on T-shirts or those sorts of things, but they say anything you, you can do, I can do bleeding, which I thought was, um, you know, quite quite a pithy phrase of you know, empowerment and um, and also, yeah, pointing out, uh, some, I guess, of the sort of patriarchal denial of the sort of experiences of menstruation and those sorts of things that we've been talking about.
00:48:26.402 -->
00:48:39.041But then in the following paragraph you talk and this was alluded to earlier, again quoting from the article period tracking apps also grapple with issues at the very center of feminism.
00:48:39.041 -->
00:49:18.369Um, and, and part of what you're sort of going on to talk about is this sort of vision, of sort of feminist empowerment that sort of sort of celebrates and centers this sort of um, the ideas of, and reproduction of women, these things that have been labelled shameful, but instead sort of empowers them through phrases, I guess, like anything you can do I can do bleeding but then you're saying on the other side of that that this risks becoming an iteration of menstrual determinism, drawing on legacies of historia to foreground female reproductive capacities in a discriminatory and prescriptive way.
00:49:18.369 -->
00:49:26.380I just thought, yeah, throughout the article, this sort of tension between both, I guess celebrating these things as a kind of empowerment.
00:49:26.380 -->
00:49:30.648But there is a trap to that, perhaps as well.
00:49:32.333 -->
00:49:32.833For sure.
00:49:32.833 -->
00:49:35.208Yeah, I would say that's the central tension.
00:49:35.208 -->
00:50:15.284In addition to who should be included in feminism, I would say the central tension of feminism is do we become more like men, more like valorized ways of being in the world, like cutting out childbirth pain, for example, or not resting during your period but doing anything that anybody could do while bleeding, or do we valorize, like no rest is important, like and if I'm doing that because I'm bleeding, then more power to me, because we need to valorize uh kind of cyclical or softness or um, the sorts of qualities that have been associated with women and devalued.
00:50:15.284 -->
00:50:15.545But?
00:50:15.545 -->
00:50:23.090But then this trap is that you sort of shoot yourself in the foot by saying I'm not productive and I need to be soft and I can't cope.
00:50:23.090 -->
00:50:25.166So it's a tangle.
00:50:25.981 -->
00:50:51.409I've got one very quick final question, andrea do you notice a difference culturally between the US, where you started doing this work, and the UK, where you're working now, in terms of the way that people talk about, uh, talk about their periods and talk about period tracking and talk about this idea of of sort of data hacking as as optimizing the self?
00:50:51.409 -->
00:50:51.889I suppose?
00:50:52.291 -->
00:50:52.451um.
00:50:52.451 -->
00:50:59.052So the the forthcoming ethnography will compare the US andS and the UK, and I haven't done very much yet.
00:50:59.052 -->
00:51:03.208I don't have a lot to say about the.
00:51:03.228 -->
00:51:03.268US.
00:51:03.268 -->
00:51:05.684You don't have to the specific way yet.
00:51:05.684 -->
00:51:16.750Hopefully soon there has been like the global repercussions from Roe v Wade being repealed can definitely be felt here in people's kind of.
00:51:16.750 -->
00:51:26.983Even though it's a much legally safer environment for period tracking and reproductive choice, you can still feel a sense of anxiety and people being very.
00:51:26.983 -->
00:51:41.335There's a big, a big wave of people deleting their period tracking apps after that and then, interestingly, people, there's a big wave of people downloading different ones which have either changed themselves or marketed themselves as secure.
00:51:41.335 -->
00:51:50.179So there's, you know, in some ways there's hesitance and in some ways there's just like, well, we need this, this is the obvious way forward.
00:51:50.179 -->
00:51:51.320So how are we going to do that?
00:51:51.320 -->
00:51:57.929While compromising or not compromising on issues that are costly, on issues that are costly.
00:51:57.929 -->
00:52:11.764So currently I would say that the data security is the biggest, both difference and similarity between the two places.
00:52:11.764 -->
00:52:12.865Sorry if that was confusing.
00:52:12.905 -->
00:52:19.335No, no, that was fantastic and very interesting and let us know when you've written your next book.
00:52:19.335 -->
00:52:22.983Cool, and we'll talk again.
00:52:23.985 -->
00:52:24.965Yes, thank you so much.
00:52:24.965 -->
00:52:36.702It's been a fascinating conversation and, yeah, all the best with the future research, and I mean we could talk about so many more things.
00:52:36.702 -->
00:52:39.271Maybe a more boring thing, though, is shout out to the Welcome Trust.
00:52:39.271 -->
00:52:42.769I mean, how good is it with them supporting so much.
00:52:42.769 -->
00:52:48.599You know we've got nothing like that here in Australia, so it's good to see this kind of.
00:52:48.820 -->
00:52:53.871And I can't imagine the scramble to get something like that funded here, Like it just wouldn't happen.
00:52:54.253 -->
00:52:55.000So it's really great.
00:52:55.000 -->
00:52:57.166Yeah, super cool.
00:53:00.760 -->
00:53:02.960Yeah, I feel like I still have a million questions.
00:53:02.960 -->
00:53:35.275I really enjoyed talking about this stuff, um so, thank you.
00:53:35.275 -->
00:53:45.958Datification of um of life in second sorry, chris, no, no, no.
00:53:47.360 -->
00:53:50.411I think was that an animal?
00:53:50.994 -->
00:53:52.360that was an animal yeah, okay.
00:53:52.360 -->
00:53:57.708I'm so sorry that was.
00:53:57.708 -->
00:54:07.443We literally just got a brand new chair and that was the cat pulling all the things on that and I was like that cat has been ejected from the room.
00:54:07.443 -->
00:54:32.092Thank you,
