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Dr Suzanne Crowe: FemTech can fight medical misogyny — but not if it's going to be used to monitor us

Dr Suzanne Crowe: FemTech can fight medical misogyny — but not if it's going to be used to monitor us

Irish Examiner6 days ago

A couple of months ago I was contacted through LinkedIn seeking support for a start-up company keen to target women seeking health services using a digital platform. Specifically, mental health services.
As a mother of two young women, my interest was piqued by the term the company used in the description of their innovative product: FemTech.
FemTech is the term for the pairing of technology with women's health and wellbeing. It was coined in 2016 by Ida Tin, a Danish entrepreneur who co-founded a menstrual tracking app called Clue.
In almost a decade, there has been an explosion of devices, services and software applications aimed at longstanding deficits in women's healthcare. Novel technology solutions include contraceptive prescription and delivery, fertility-tracking and advice, health support for new mothers and their newborn babies, at-home testing for sexually transmitted infections, smart lactation pads, osteoporosis predictors, and psychology assessments.
As one friend put it to me, "men get trading platforms for shares and fitness trackers, women get sold stuff to 'fix' their bodies". FemTech is now a massive industry, with Flo, the period-tracking app valued at almost a billion dollars.
Dr Suzanne Crowe: 'It's hard not to see the rapid growth of FemTech as a comment on women's healthcare as it is currently provided.' Picture: Moya Nolan
Both my daughters have used menstrual apps since they were young teenagers, enjoying the accessibility and responsiveness. It's a world away from the coy TV ads I grew up with, depicting strange blue fluid being poured onto pads.
Historically, medical research focused almost uniquely on white men, and women's health concerns were often overlooked or dismissed. Dr Hazel Wallace's book The Female Factor captures the extent of medical misogyny and women's exclusion from diagnosis and treatment.
Restriction extended to the development of medications, where women were excluded from testing for many years, leading to dose ranges based only on men's bodies. Coupled with a pervasive shame attached to sexual health, mental health and women's bodies, traditional medical practice has unwittingly created a significant gap which healthcare 'disruptors' are eager to capitalize on. This is largely a positive thing.
But if technology solutions become the dominant offering, they may contribute to leaving ever-increasing service gaps unaddressed. Technology bypasses some issues but not all, fostering more empowered, but increasingly frustrated, women who continue to require intervention from an overwhelmed local hospital. It is a tool, not a replacement for a functioning health service.
Technology won't do much to change attitudes among healthcare professionals to women's health needs either – that needs to come from deep listening, respect, kindness and education.
The potential benefits are clear: technology empowers women to input their personal information, identify symptom patterns, and possible health issues, and use that data to receive personalised healthcare. Using software, they can consider a diagnosis, learn what their choices are, and make informed decisions.
Digital platforms carry no judgment, with women from different ethnic origins and/or the LGBT+ community finding understanding there.
Of course, empathic patient-focused care, delivered in partnership is fundamental to healthcare. So, it's hard not to see the rapid growth of FemTech as a comment on women's healthcare as it is currently provided.
As FemTech moves to fill a perceived gap, it would be easier to leave traditional views undisturbed rather than reflecting on how our people-based service can improve. Just as vinyl records gave way to CDs, and CDs ceded to music streaming, traditional health services must apply humility, excise stigma and barriers, and improve their offerings or be left behind.
Data tracking
Not only do we risk losing our imperfect humanity in a technology-dominated health service, but we also risk the negative consequences of commercialising health data. Putting a price on data and its interpretation may make this assistive technology too expensive for the marginalised groups it was aspiring to reach.
More worryingly, a research group in Cambridge University's Minderoo Centre for Technology and Democracy have raised significant concerns about the use of data collected by fertility tracking apps. Data collected on apps is designated 'special category' rather than treated as medical data from a regulation perspective.
It potentially could provide a valuable advertising tool for companies – or worse. The report's authors caution that information from cycle tracking apps in the wrong hands could result in risks to job prospects, workplace monitoring, health insurance discrimination, and in some countries, limit access to termination of pregnancy.
In an ideal world, new digital solutions would become publicly owned, allowing integration into real-life health services, leading to better outcomes for society. However, tech entrepreneurs are not going to wait for Valhalla.
As women's healthcare needs are finally validated, it is vital that new technologies are evaluated for potential benefits, and or potential harms. Any likely harms, for example compromise of privacy, require informed consent and regulation, especially when it comes to the retention and use of highly personal data.
FemTech is here to stay. We must ensure the hand guiding its use is an ethical one.
Dr Suzanne Crowe, consultant in paediatric intensive care, President of the Medical Council
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A period of life we need to talk about — the stigma that still surrounds menstruation

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Dr Suzanne Crowe: FemTech can fight medical misogyny — but not if it's going to be used to monitor us
Dr Suzanne Crowe: FemTech can fight medical misogyny — but not if it's going to be used to monitor us

Irish Examiner

time6 days ago

  • Irish Examiner

Dr Suzanne Crowe: FemTech can fight medical misogyny — but not if it's going to be used to monitor us

A couple of months ago I was contacted through LinkedIn seeking support for a start-up company keen to target women seeking health services using a digital platform. Specifically, mental health services. As a mother of two young women, my interest was piqued by the term the company used in the description of their innovative product: FemTech. FemTech is the term for the pairing of technology with women's health and wellbeing. It was coined in 2016 by Ida Tin, a Danish entrepreneur who co-founded a menstrual tracking app called Clue. In almost a decade, there has been an explosion of devices, services and software applications aimed at longstanding deficits in women's healthcare. Novel technology solutions include contraceptive prescription and delivery, fertility-tracking and advice, health support for new mothers and their newborn babies, at-home testing for sexually transmitted infections, smart lactation pads, osteoporosis predictors, and psychology assessments. As one friend put it to me, "men get trading platforms for shares and fitness trackers, women get sold stuff to 'fix' their bodies". FemTech is now a massive industry, with Flo, the period-tracking app valued at almost a billion dollars. Dr Suzanne Crowe: 'It's hard not to see the rapid growth of FemTech as a comment on women's healthcare as it is currently provided.' Picture: Moya Nolan Both my daughters have used menstrual apps since they were young teenagers, enjoying the accessibility and responsiveness. It's a world away from the coy TV ads I grew up with, depicting strange blue fluid being poured onto pads. Historically, medical research focused almost uniquely on white men, and women's health concerns were often overlooked or dismissed. Dr Hazel Wallace's book The Female Factor captures the extent of medical misogyny and women's exclusion from diagnosis and treatment. Restriction extended to the development of medications, where women were excluded from testing for many years, leading to dose ranges based only on men's bodies. Coupled with a pervasive shame attached to sexual health, mental health and women's bodies, traditional medical practice has unwittingly created a significant gap which healthcare 'disruptors' are eager to capitalize on. This is largely a positive thing. But if technology solutions become the dominant offering, they may contribute to leaving ever-increasing service gaps unaddressed. Technology bypasses some issues but not all, fostering more empowered, but increasingly frustrated, women who continue to require intervention from an overwhelmed local hospital. It is a tool, not a replacement for a functioning health service. Technology won't do much to change attitudes among healthcare professionals to women's health needs either – that needs to come from deep listening, respect, kindness and education. The potential benefits are clear: technology empowers women to input their personal information, identify symptom patterns, and possible health issues, and use that data to receive personalised healthcare. Using software, they can consider a diagnosis, learn what their choices are, and make informed decisions. Digital platforms carry no judgment, with women from different ethnic origins and/or the LGBT+ community finding understanding there. Of course, empathic patient-focused care, delivered in partnership is fundamental to healthcare. So, it's hard not to see the rapid growth of FemTech as a comment on women's healthcare as it is currently provided. As FemTech moves to fill a perceived gap, it would be easier to leave traditional views undisturbed rather than reflecting on how our people-based service can improve. Just as vinyl records gave way to CDs, and CDs ceded to music streaming, traditional health services must apply humility, excise stigma and barriers, and improve their offerings or be left behind. Data tracking Not only do we risk losing our imperfect humanity in a technology-dominated health service, but we also risk the negative consequences of commercialising health data. Putting a price on data and its interpretation may make this assistive technology too expensive for the marginalised groups it was aspiring to reach. More worryingly, a research group in Cambridge University's Minderoo Centre for Technology and Democracy have raised significant concerns about the use of data collected by fertility tracking apps. Data collected on apps is designated 'special category' rather than treated as medical data from a regulation perspective. It potentially could provide a valuable advertising tool for companies – or worse. The report's authors caution that information from cycle tracking apps in the wrong hands could result in risks to job prospects, workplace monitoring, health insurance discrimination, and in some countries, limit access to termination of pregnancy. In an ideal world, new digital solutions would become publicly owned, allowing integration into real-life health services, leading to better outcomes for society. However, tech entrepreneurs are not going to wait for Valhalla. As women's healthcare needs are finally validated, it is vital that new technologies are evaluated for potential benefits, and or potential harms. Any likely harms, for example compromise of privacy, require informed consent and regulation, especially when it comes to the retention and use of highly personal data. FemTech is here to stay. We must ensure the hand guiding its use is an ethical one. Dr Suzanne Crowe, consultant in paediatric intensive care, President of the Medical Council Read More A period of life we need to talk about — the stigma that still surrounds menstruation

Psychiatry cannot be allowed to dominate debate on Mental Health Act
Psychiatry cannot be allowed to dominate debate on Mental Health Act

Irish Examiner

time12-06-2025

  • Irish Examiner

Psychiatry cannot be allowed to dominate debate on Mental Health Act

Recent public debate around long-awaited reform of the Mental Health Act, 2001 has predominantly consisted of doctors and commentators creating moral panic over legal changes they claim will erode doctors 'right' to force treat people. Let's be clear: the Mental Health Act, 2001 will continue to allow people to be involuntarily confined and force treated. Let's also have some clarity that under the current system, mental health outcomes are very far from satisfactory. Indeed, despite the now accepted deconstruction of 'mental illness' as simply a diagnostic construct, this system is now largely upheld because of legislative frameworks. It begs the question, should those within the system and seeking to uphold it be allowed to constantly dominate the discourse around reform? Let's get to the heart of the real issue here — psychiatry and its wish to retain its legal powers. Psychiatrists use a legal defence of medical necessity for forced treatment but this is increasingly untenable. As Dr Pat Bracken, the highly respected independent consultant psychiatrist, has written: If psychiatry is going to take away people's liberty and use invasive methods of treatment, then it needs to be 'confident that we can predict outcomes, and happy that we understand how our treatments work and for whom.' His conclusion – and the now widely accepted scientific reality, is that psychiatry cannot reach this efficacy standard. The treatment on offer for people who are severely unwell and distressed is not, as some may erroneously believe, intensive therapy that seeks to get to the root cause of the issue. Rather it is drugs and sometimes electricity. There may be psychological interventions but these are few and far between. Of course there are situations where people need acute care and medication to stabilise them, but traumatising environments that use powerful psychotropic drugs should not be the only answer when someone is in distress. People in this system are guinea pigs, labelled treatment resistant if drugs don't work, lacking insight and branded non-compliant if they don't agree with doctors and do what they are told. Debate in Ireland is regressing as is our move towards a rights-based system. Just this week it has been reported that the Cabinet has signed off on an amendment brought to Cabinet that someone who is involuntarily admitted to an acute psychiatric unit can be detained for up to 42 days, an increase on the 21 days previously proposed under the bill. This is a flagrant move in the wrong direction with no debate and no rationale given. In this paper recently Dr Suzanne Crowe argued that people experiencing psychosis do not know they are ill and have no insight into their psychiatric condition. This contention assumes that viewing people through a psychiatric lens is the legitimate view, ergo if a person does not subscribe to this view 'psychiatric illness', then this means they have no insight and therefore must have their liberty taken away to be sufficiently chemically restrained. People who are struggling, who are different, who are living in a chaotic family or community, who have extraordinary experiences, who are in deep emotional distress may not have 'insight' into the limitations of psychiatric diagnosis but the way to help them and those around them is not to lock them up as second-class citizens, take away their liberty and assault their personhood. Insight is so very important, but it is a two-way concept. In order for these 'psychotic people' to receive the help and human engagement they may need for healing, it is important that those tasked with providing care also develop insight. Insight into the multiple perspectives, experiences and circumstances that cause people to warrant support; insight into the need to provide choices that might be more conducive to people wanting to engage, and insight into the damage the 'medical model' paradigm of care causes. This is about a fundamental right to health. Moving towards a rights-based legal system, as outlined in the UN Convention on the Rights of Persons with Disabilities, to which Ireland is a signatory, means treating people as rights holders, not as mere subjects of legal or state control. Consent Unquestionably, evidence-based care should be at the core of cancer or heart, or any other type of health treatment. Therefore, it cannot be the purview of just one highly contested profession (psychiatry) to impose what is increasingly seen as a dogmatic ideology onto people who are already in a vulnerable state. This is not to say psychiatry should not be part of a suite of measures available to people, but mental health care should be based around consent and choice — a right to choice should be enshrined in legislation, and requisite funding must be put into things like family work, peer support, peer-run grassroots organisations, community development, non-medical crisis houses and open dialogue. Choices should not be viewed through the sole lens of a psychiatric classification system that prescribes meaning to people's struggles, distress, environmental outcomes and extraordinary experiences. These choices have long been mandated as part of the post-psychiatry paradigm for mental health service provision, and the new paradigm is awash with international examples of best practice. In other words, there are examples of how we can do things better. Certainly, things cannot get much worse for people in distress. In 2013, the UN Special Rapporteur on Torture explicitly stated that forced psychiatric treatment may amount to torture or ill-treatment, especially when not evidence-based. Doctors may be offended that their well-intentioned treatment is causing harm, but advocates cannot dampen the quest for change and justice to appease psychiatrists. Because the harsh truth is that while some coercive practices might not always meet the legal threshold for torture, they do often qualify as inhuman or degrading treatment. Surely if there is even a question that 'care' could be considered as something akin to torture, this requires radical debate and reform. Jennifer Hough is a human rights and social justice advocate Dr Líam Mac Gabhann is Associate Professor in Mental Health Practice at Dublin City University Read More Watchdog to create code of practice for using surveillance in mental health services

Watchdog to create code of practice for using surveillance in mental health services
Watchdog to create code of practice for using surveillance in mental health services

Irish Examiner

time09-06-2025

  • Irish Examiner

Watchdog to create code of practice for using surveillance in mental health services

A code of practice is to be drawn up for the use of CCTV, GPS trackers and other surveillance technologies in Ireland's mental health services. A public consultation process is currently underway by the Mental Health Commission, to seek the views of people who use mental health services about how the use of surveillance equipment impacts on them. The views of family members, carers and friends are also being sought, as well as those of people working in the sector. The Director of Regulation at the Mental Health Commission, Gary Kiernan, says surveillance technologies have advanced considerably in recent years, and their use has become 'a complex area' in mental health services. He said: 'The Mental Health Commission wants to develop a code of practice that takes account of these technological advancements while encouraging and promoting good practices and high standards in relation to their use. "This consultation is particularly concerned with how Ireland's mental health services should protect the rights of people who use mental health services, especially their rights to privacy and dignity. I would encourage all interested parties to engage and ensure their voices are heard.' According to the commission, such technology is used to observe or monitor service users to 'inform their care and treatment'. While CCTV is currently the most commonly used form of surveillance, other technologies being used include bodyworn cameras, infrared cameras, sensors, alarms, and GPS trackers. The use of such equipment falls under regulation 25 of the Mental Health Act 2001 (Approved Centres) Regulations 2006. The Mental Health Commission says the purpose of the consultation is to identify key areas that the new code of practice should address. It said: 'The Code of Practice will apply initially to inpatient mental health services. Its scope may be widened in the future to include community mental health services and community residences once the MHC's regulatory remit expands to include these services.' The survey can be accessed online here. PDF versions of the survey may also be requested from standards@ and returned via email or by post. Focus groups and interviews with interested stakeholders will also take place, with interested parties invited to email standards@ The public consultation will close at 5pm on July 16. Read More Suzanne Crowe: People with severe mental illness will be failed by proposed new law

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