Investing in Vaginas

Dr. Betsy A.B. Greenleaf D.O., FACOOG(Distinguished), FACOG, FAAOPM, MBA

April 2021

Yes, I used the "V' word.  Some of you will be curious and read further while others will run with fingers in your ears, "La-La-la, I don't hear anything." It is 2021, and despite advances in civilization, we are still not talking about our "private parts." Sixty-five percent of women are uncomfortable using the word vagina[1]. Fifty percent of men are uncomfortable discussing gynecologic conditions with their partners[2].  But let us face the facts either you have a vagina, or at some point, you came from a person who had a vagina. 

What is the harm of not talking about genital organs?

Language provides us the ability to communicate, create and advance as a civilization[3].   But we are not talking about women's health even though eighty percent of women will have a pelvic health disorder at some point in their lives[4]. Lack of conversation surrounding personal health prevents medical advances creating continued ignorance and suffering, a vicious, self-perpetuating cycle [5].   Pelvic health is not a void space that will go away if we ignore it.

Systemic eurotophobia

Systemic eurotophobia, or the fear of female genitalia, prevents those of us who want to bring the conversation to light. Coined by the television show Grey's Anatomy and popularized by Oprah, the term "vajajay" was created as a euphemism for vagina due to restrictions in saying proper terminology in media.

In what has been termed as "Vaginagate,' in 2012, two United States female politicians were banned from addressing the house of representatives due to their use of the word vagina during a discussion on abortion legislation[6].

Greater than 80% of the marketing is performed through social media; however, pelvic health is not a subject that meets "community standards [7]." Not only is the word vagina not allowed in advertising, but even OB/GYN has been met with criticism [8].

The constraints placed on feminine health impede women from obtaining much-needed information and femtech entrepreneurs from spreading the word on their products.

Women consumers have been ignored.

           The world population is approximately 49.84% female, accounting for 3.9 Billion individuals[9],[10]. However, businesses have ignored the female consumer, who accounts for $28 trillion in worldwide consumer spending[11]. Women's concerns have been overlooked when it comes to apparel, beauty, and financial services. If these easily talked about subjects leave women wanting, the pelvic health sector is non-existent. 

Female funding is lacking.

           Only 20% of startups raising their first round of funding are female-founded, and only 2-3% of global venture dollar volume is given to female founders [12]. Men make up 89% of V.C. deciders, and based on heuristic theory, male decision-makers will favor businesses that address their male relevant issues[13],[14].

The rise of Femtech

It has been 61 years since the women's movement of the 1960s created advances in reproductive rights with the approval of "The Pill" [15]. Yet, advances in women's issues have remained stagnant.  But times are changing. The femtech industry is finally blooming[16]. Funding for femtech companies has increased by 812% between 2014 and 2018, and femtech companies are expected to raise over $297 Million by 2024[17]. These numbers are moving in the right direction; however, the World Economic Forum's Global Gender Gap Report demonstrates that gender differences are not expected to be resolved anytime soon.  The world's average to reach parity is 108 years from now, while the United States lags way behind 208 more years[18].

 Desensitization

Our only way around this issue is desensitization. The more influencers thought leaders, and experts tout the anatomical words, the less taboo the topic will become.  It may put a few female comedians out of business, but it will open a world of innovation [19].  

What is a woman to do?       

In the meantime, entrepreneurs in the femtech space need to keep pushing forward. The market is expected to grow by a CAGR of 12.65% to reach $3 Billion by 2030 but could exceed this if startups get creative in their marketing and funding efforts. Here are the top suggestions.

1.    Victory for the "V" word

Utilize the power of organically grown social media, email lists, and YouTube to build awareness of pelvic health terminology, conditions, and products. Please do not rely on paid advertising which will censor pelvic-related words. Post using images and videos containing your words instead[20].

Know your audience. Do not pull out the vagina word in a meeting full of conservatives unless you are purposely going for shock value.  It will take time before the general population feels comfortable talking about genitalia, baby steps.

2.    Fellowship of Friends

Access your closest friends and family for funding. Thirty-eight percent of startups utilize funds from family and friends.  This could be an untapped potential to focus on, especially if you can get friends and family to rally behind your cause[21]. 

3.    Collective Community

Crowdfunding is an excellent option for femtech companies for gaining funds and build a loyal community that can support you along the way. Creating a sense of tribe and belonging can take a brand far. Kickstarter and Indiegogo are traditional options but also look at crowdfunding sites dedicated to women, such as iFundWomen.com

4.    Incubate with Insight

With a new rise in femtech comes new opportunities in accelerators and incubators—approximately 27 programs spanning the globe. Programs range from self-directed virtual courses to 8-week programs to one year in residency programs[22].   These programs can provide business direction, planning, and access to vital resources.

5.    Align with Angels

As mentioned earlier, funding has been traditionally male-oriented, but this is turning around as more female angel investors enter the scene. The number of female angels has tripled between 2009 and 2019[23]. Currently, twenty-two percent of investors are female[24]. As female investor numbers grow, it is expected to increase innovation, not just in the femtech world[25].

6.    Garner Grants

In the world of medical research, only 2.5% of public funds go towards research in women's health[26]. Public funding may be more challenging for startups since the application process is arduous and tends to favor those who have a history of grant awards. However, the private funding route is a better option for femtech entrepreneurs. Private funds take some hunting, though Femtech Insider is doing a great job compiling information to support entrepreneurs[27]. Other sources for funds include Amber Grants and the Eileen Fisher Women-Owned Business Grant [28].

7.    Vet the V.C.'s

Though venture capitalist firms have not been vagina-friendly in the past, that does not mean they are out of the running. V.C.'s are starting to catch on, having invested in 365 femtech ventures in the last ten years[29]. 

For femtech startups, take time to investigate the firm you are applying to. Do they have an excellent femtech track record? Pitchbook has posted the top 13 femtech friendly V.C.'s. Once again, know your audience. You may need to adjust your pitch with entendres not to offend a room full of older men.

The Future Is Bright

The future of women's health and femtech is bright.  Though a young industry, it is developing and is on the rise.  It will be amazing to see what the next ten years bring.  I challenge you with saying the word "vagina" out loud as a women's health supporters until you lose your discomfort. Say the word to others until the discomfort passes.  And most of all, support and invest in femtech. Let’s “save this world, one vagina at a time”[30].

Works Cited

1.           Richards, V. Why are we so afraid of vaginas? September 2, 2014 [cited 2021 April 15]; Available from: https://www.independent.co.uk/voices/comment/why-are-we-so-afraid-vaginas-9706933.html.

2.           Graham, S. Over Half of Men Are Uncomfortable Talking About Their Partners' Vagina. September 5, 2017 [cited 2021 April 15]; Available from: https://www.vice.com/en/article/evvwez/over-half-of-men-are-uncomfortable-talking-about-their-partners-vagina.

3.           Wrench, J., Stand Up, Speak Out: The Practice and Ethics of Public Speaking. 2011: Flat World Knowledge.

4.           Koumans, E.H., et al., The Prevalence of Bacterial Vaginosis in the United States, 2001–2004; Associations With Symptoms, Sexual Behaviors, and Reproductive Health. Sexually Transmitted Diseases, 2007. 34(11): p. 864-869.

5.           Kingsberg, S.A., et al., Female Sexual Health: Barriers to Optimal Outcomes and a Roadmap for Improved Patient-Clinician Communications. J Womens Health (Larchmt), 2019. 28(4): p. 432-443.

6.           Jones, S. Vaginagate: US politician banned for saying 'vagina' in abortion bill debate. June 15, 2021 [cited 2021 April 21]; Available from: https://www.theguardian.com/world/2012/jun/15/michigan-politician-banned-using-word-vagina.

7.           Chen, J. 36 Essential social media marketing statistics to know for 2021. February 3, 2021 [cited 2021 April 21]; Available from: https://sproutsocial.com/insights/social-media-statistics/.

8.           Rannard, G. The Vagina Bible adverts blocked by social media. September 2, 2019 [cited 2021 April 21]; Available from: https://www.bbc.com/news/blogs-trending-49500822#:~:text=Twitter%2C%20Facebook%20and%20Instagram%20blocked,without%20these%20words%20was%20approved.

9.           Banl, W. Population, female (% of total population). 2019 [cited 2021 April 15]; Available from: https://data.worldbank.org/indicator/SP.POP.TOTL.FE.ZS.

10.        Meters, C. World Population. 2021 [cited 2021 April 15]; Available from: https://countrymeters.info/en/World.

11.        Sayre, M.J.S.a.K. The Female Economy. 2009 [cited 2021 April 15]; Available from: https://hbr.org/2009/09/the-female-economy.

12.        Teare, G. EoY 2019 Diversity Report: 20 Percent Of Newly Funded Startups In 2019 Have A Female Founder Diversity-Venture 2020, January 21 [cited 2021 April 18]; Available from: https://news.crunchbase.com/news/eoy-2019-diversity-report-20-percent-of-newly-funded-startups-in-2019-have-a-female-founder/.

13.        Lenhard, J. Inside VC Firms: The Gender Divide. Diversity-Venture August 14, 2019 [cited 2018 April 18]; Available from: https://news.crunchbase.com/news/inside-vc-firms-the-gender-divide/.

14.        Wikipedia. Heuristic. April 14, 2021 [cited 2021 April 18]; Available from: https://en.wikipedia.org/wiki/Heuristic.

15.        Tobey, O.R.a.D. Contributed: The Rise of Femtech. December 11, 2020 [cited 2021 April 18]; Available from: https://www.mobihealthnews.com/news/contributed-rise-femtech#:~:text=The%20term%20%E2%80%9Cfemtech%E2%80%9D%20%E2%80%93%20short,by%20the%20end%20of%202030.

16.        Wikipedia. Ida Tin. December 13,2020; Available from: https://en.wikipedia.org/wiki/Ida_Tin.

17.        Lovett, L. Femtech on the rise, but new companies have homework before they're ready for payers. Global Edition Digital Health January 14, 2020 [cited 2021 April 18]; Available from: https://www.mobihealthnews.com/news/femtech-rise-new-companies-have-homework-theyre-ready-payers.

18.        Zahidi, S. Accelerating gender parity in Globalization 4.0. June 18, 2019 [cited 2021 April 18]; Available from: https://www.weforum.org/agenda/2019/06/accelerating-gender-gap-parity-equality-globalization-4/.

19.        Mock, R., Stand-up comedy and the legacy of the mature vagina. Women & Performance: A Journal of Feminist Theory, 2012. 22: p. 9-28.

20.        Zirker, T. 5 Forbidden Phrases You Absolutely Must Avoid in Your Facebook Ad. January 19, 2019 [cited 2021 April 22]; Available from: https://www.entrepreneur.com/article/326928.

21.        Daily, B.N. Family and Friends Provide a Key Lifeline for Entrepreneurs. February 24,2020 [cited 2021 April 22]; Available from: https://www.businessnewsdaily.com/9617-friends-family-business-support.html#:~:text=A%20survey%20by%20Guidant%20Financial,as%20a%20source%20of%20capital.

22.        Insider, F. Femtech and Healthtech Accelerators. 2020 [cited 2021 April 15]; Available from: https://femtechinsider.com/femtech-health-accelerators/.

23.        Stengle, G. Funding Female Founders: If Male VCs Won’t Do It, Women Angels And Limited Partners Will. December 2020 [cited 2021 April 17]; Available from: https://www.forbes.com/sites/geristengel/2020/12/02/funding-female-founders-if-male-vcs-wont-do-it-women-angels-and-limited-partners-will/?sh=6333c9b0405f.

24.        Shuster, E. The World Needs More Female Investors. August 3, 2020 [cited 2021 April 18]; Available from: https://www.calcalistech.com/ctech/articles/0,7340,L-3799491,00.html#:~:text=According%20to%20data%20from%20the,in%20France%2C%20the%20data%20shows.

25.        Sylvia Ann Hewlett, M.M., and Laura Sherbin. How Diversity Can Drive Innovation. December 2013 [cited 2021 April 18]; Available from: https://hbr.org/2013/12/how-diversity-can-drive-innovation.

26.        Slawson, N. 'Women have been woefully neglected': does medical science have a gender problem? December 18, 2019 [cited 2021 April 18]; Available from: https://www.theguardian.com/education/2019/dec/18/women-have-been-woefully-neglected-does-medical-science-have-a-gender-problem.

27.        Femtech Investors, Angels & Funds. 2021 [cited 2021 April 22]; Available from: https://femtechinsider.com/femtech-investors/.

28.        Nykiel, T. Small-Business Grants for Women: 10 Go-To Spots. January 7, 2021 [cited 2021 April 20]; Available from: https://www.nerdwallet.com/article/small-business/small-business-grants-for-women.

29.        Olsen, D. The top 13 VC investors in femtech startups. November 2, 2018 [cited 2021 April 22]; Available from: https://pitchbook.com/news/articles/the-top-13-vc-investors-in-femtech-startups.

30.        Bruno, K., Quote " I am saving the world, one vagina at a time.". 2011.