MBA '24, Stanford Graduate School of Business
Success in Middle East: having babies
I’m 12 years old, sitting in the bathroom all alone, absolutely terrified. “Mom, mom, come help me!” My mom comes rushing in, takes a quick look, and her eyes light up with joy. “Sasha, you just got your period! You’re a woman now!”
As if I didn’t already feel awkward enough, word spreads quickly amongst my big Persian family. Uncles, great uncles, cousins all start calling to congratulate me in their thick Persian accents: “Mazel tov Sasha Joon! Now we find you husband so you can have lots of babies.”
Next thing you know, my grandma barges into my house, runs to my closet, steals my favorite pair of underwear, and starts burning it in a bowl of Persian Esfand seeds. She takes the burning underwear, circles it over my head, and with all her love and passion, prays that I’ll have lots of babies. The pride in her eyes was undeniable.
I realized in that moment that my family doesn’t really do the whole boundaries things.
What I didn’t realize then was that when my grandma was 12 years old living in Iran, she was preparing for an arranged marriage so she could have kids in the next couple years. When my great-grandma was 12, she was already married and pregnant with her first baby.
In their Middle Eastern community, the definition of success for a woman was to have lots of babies. As a result, the focus on investing in women was setting them up for successful pregnancies.
Success in American healthcare too is over-indexed on reproduction
Ok so that was Iran a few generations ago and this is America. It’s different here, right?
But it’s not. In America too, the definition of success for women in our healthcare system has been centered around successful pregnancies. A wide-range of women’s health issues have been neglected because most of our clinical research in women’s health focuses on reproduction. And even on reproduction, America is failing! The U.S. has the highest maternal mortality rate in the developed world. For black American mothers, the death rate more than doubles.
Women are over half the population, make 80% of healthcare buying decisions, and spend 29% more on healthcare than men. So how is it that just 4% of all healthcare R&D focuses on women’s health? 4%!
Modern medicine was developed with male anatomy as the default, shaping how doctors treat patients and resulting in misrepresentation of women in clinical trials.
This has alarming implications for healthcare delivery. For example, even though heart disease is the leading cause of death for women, the standard checklist for heart attack symptoms is based on the male body. Women experience heart attacks differently, and their symptoms are labeled “atypical.” As a result, women are 50% more likely to receive the wrong diagnosis following a heart attack and therefore 50% more likely to die.
It’s time to redefine success in women’s health
But I have some good news: we have a new generation stepping in and demanding change.
For me, growing up in America offered something my great-grandma could only dream of: the opportunity to create my own definition of success in life. I had dreams of going to college, starting my own business, and maybe eventually having lots of babies?
So one day when I was 17 hanging out with my mom, I said as casually as I could, “Hey mom, I’d like to go on birth control.” My moms eyes immediately filled with tears, but instead of the glimmer of pride she had when I got my period, this time, her eyes showed fear. She warned me: “Birth control isn’t natural, it could impact your fertility, I don’t know any Persian woman on birth control.”
Her whole upbringing in Iran was about achieving the success of having children. And now her daughter wanted to put that at risk?
But I knew my definition of success required delaying kids, and I wanted control over my timeline. My mom supported my decision to go on birth control and I felt empowered.
The inevitable rise of Femtech
Now women having control over their bodies is an especially painful topic after the recent overturn of Roe v Wade, dismantling 50 years of abortion access.
But despite this significant setback in our progress, healthcare tools like birth control have been empowering women to increasingly gain more power. American women today have more access to capital, more political influence, and are even more likely than men to have advanced degrees.
So how is it that our healthcare system is still overly indexed on reproduction at the expense of everything else?
The definition of success for women in our healthcare system should be about giving women the tools to stay healthy, thriving, and empowered throughout all stages of their lives. Before, during, and after pregnancy.
There is a huge gap in healthcare needs and healthcare investment. And while this gap is frustrating, it also presents an exciting market opportunity.
Which brings us to “Femtech” – coined in 2016, Femtech covers innovations that improve women’s health and wellness. This includes addressing health conditions that solely, disproportionately, or differentially affect those who identify as women.
Femtech entrepreneurs are redefining success in women’s healthcare by applying technology not only in reproduction, but also in mental health, sexual wellness, menopause, chronic diseases.
As an emerging market riddled with unmet needs, little competition, and high-growth potential, Femtech has started gaining serious traction over the past few years.
According to McKinsey, public awareness of Femtech is skyrocketing, the number of Femtech start-ups is blowing up, and Femtech funding is surging. FemTech Focus and Coyote Ventures estimate that by 2027, the women’s health market will reach $1 trillion globally.
The Femtech Revolution is here.
But Femtech still has an uphill battle to face
But despite the high-growth potential and clear white space opportunities, Femtech has an uphill battle to face. I see three clear challenges:
Raising Capital. 80% of femtech founders are women, but just 2% of venture capital goes to all female founders.
Fighting Taboos. There’s an undeniable cultural stigma around women’s health topics. I’m sure some of you were uncomfortable with me sharing my period story. I was even shy sharing that story! Some platforms are more than shy. For example, Facebook bans menopause ads for representing “adult content,” while condoms and erectile dysfunction ads are allowed and considered “family planning.”
Being Heard. Women are more likely to be dismissed in the healthcare setting and told their pain is in their heads. Going back to the heart attack example, middle-aged women with heart disease symptoms are twice as likely to be misdiagnosed with a mental illness compared to men with the same exact symptoms.
Let’s invest in Femtech and empower the next generation of girls
All of this makes me wonder: if I ever have a daughter, how will she define success? I probably won’t be burning her underwear. But I do want her to feel a connection to the strong Iranian women that came before her and the brave Iranian women today fighting for basic rights.
I want my daughter to live in a country that places a high value on women’s health and gives her healthcare tools to thrive in life.
So, I urge all women to be proactive advocates for their own health. I urge men to be allies by being compassionate listeners and overcoming taboos.
And to investors of all genders, I urge you to recognize that investing in Femtech is not only a huge market opportunity, but also the right thing to do.
The Femtech Revolution has just begun, and there’s so much left to tackle. Let’s continue investing in Femtech and empower the next generation of women to create their own definition of success.