Towards responsible FemTech

The rise of FemTech and AI

Around the world, more than 50 million women use menstruation or fertility tracking apps. Often based on algorithms, they promise personalised insight into your cycle and your health. “Ultimately, though, it’s still an algorithm, based on averages, patterns and/or probabilities,” says Tamara Thuis, assistant professor at the Kin Center for Digital Innovation. “What happens if your menstruation and personal experiences don’t conform to the algorithmic norm? Or if your situation changes?”

Accurate predictions make an attractive promise. However, a lot of apps use AI as a marketing tool, without saying clearly where and how the technology is used. “App providers promise better results if you provide more data,” adds postdoctoral researcher Maria Carmen Punzi. “But the data they want is intimate and sensitive, and isn’t always properly secured.”

Not just technology that matters

As well as studying the technology, Maria and Tamara are looking into the organisations behind it. What do they tell users about their algorithms? What design choices have they made, and how is the data stored? “It’s not only an algorithm’s performance that matters, but everything that goes with it,” says Tamara. “How are AI-driven functionalities presented? As something that can tell you what you’ll experience? Or as something that can help you understand what’s happening inside your body?”

Loss of privacy isn’t the only risk. Some apps give push notifications in the event of ‘abnormalities’, use words such as ‘abnormal’ and ‘normal’, and base their definitions of normality on data from small populations of healthy, white, heterosexual women. “Users whose background, lifestyle or health doesn’t fit the template aren’t really taken into account,” says Maria. “That can lead to confusion and even anxiety.”

Collaboration with the field

Within the project, the researchers work with various partners, including Yoni.care, the Feminist Generative AI Lab run by Delft University of Technology and Erasmus University, and 28X, an organisation developing a menstruation app based on ethical principles. “We’re following their development process closely,” says Tamara. “What does it actually mean in practice when developers say they want to take a responsible approach?”

Knowledge obtained through partnerships with the field is combined with data from the analysis of existing apps and their public communications, from websites to app stores. “Using the insights gained, we’re working towards 2 toolsets. One is guidelines and pointers for organisations facing design choices and dilemmas involving the AI in FemTech. The other is a decision tree for women to follow when choosing and using an app. What ethical considerations should an organisation address? And, if you’re a user, what really matters for you? What should you be looking out for?”

Support from SIDN Fund

SIDN Fund is supporting the project as part of its Responsible AI in Practice programme. A grant from the Fund is enabling Tamara and Maria to combine their normal work with in-depth research into the social impact of AI. “The Fund has made it possible for us to devote time and attention to this,” says Tamara. “It’s a subject at the very interface of technology, health and social values. As such, it’s a good match with the ideals of SIDN Fund.”

Mieke van Heesewijk, Programme Manager at SIDN Fund, explains what attracted the Fund to the initiative. “At SIDN Fund, we believe that technology should be responsible as well as innovative. FemTech relies on highly personal and sensitive data, making it especially important that the AI involved is fair, transparent and secure. By supporting this project, we’re contributing to guidance and awareness, so that developers and users can count on technology that promotes women’s health without disrespecting their rights or values.”

Impact beyond the bubble

The project is perfectly aligned with SIDN Fund’s goal of helping to make the internet stronger and more secure. “We don’t want our research findings confined to the pages of academic journals,” says Tamara. “We want them read by developers, organisations and the women these apps are aimed at. Our intention isn’t to tell anyone which apps they should or shouldn’t use, but to raise awareness.”

And awareness is badly needed. Although menstruation and fertility are often regarded as taboo subjects, FemTech has become a highly lucrative industry. “People often think of FemTech as a women’s subject,” adds Maria. “But this technology affects everyone. Partners, investors, developers: there are lots of male stakeholders in this sector. And they have a responsibility too.”