From menopause to microbiomes - how Femtech is fighting health inequality

This is the second interview in Giant Leap's Femtech Series, featuring leading founders, investors and thought leaders in the femtech space. Check out Part 1 with ModiBody’s Kristy Chong here and stay tuned for more to come! 

We don’t all have access to the same healthcare system – at least not in terms of outcomes. In Australia, as in the US and the majority of other countries around the world, your health, wellbeing and ability to obtain high quality, affordable care are directly influenced by your gender, race, socioeconomic status, age, sexual and gender identities, cultural heritage and linguistic background. The social gradient in health, income, wealth and workforce participation continues to increase, driven by overburdened health systems and continually rising costs. 

While fixing these broken systems requires wide-reaching reform, we see huge opportunities for positive impact in solutions that decrease the cost of care, combat systemic biases, and enable the delivery of high quality care for underserved populations. 

We sat down with Jessica Karr, founder and Managing Director of Coyote Ventures, a San-Francisco based VC fund backing founders solving problems that disproportionately affect overlooked populations, to discuss where she sees both the greatest problems and opportunities. 

Coyote Ventures invests in seed-stage startups, with a focus on digital health. They ensure that the founders they invest in have expertise in their domain and lived experiences with the populations they are designing for – centering the voices that matter most. 

You define digital health very broadly, to include far more than just physical and mental health. Why have you chosen to define it in this way? 

Our definition of health encompasses physical, financial, mental, emotional, occupational, developmental, interpersonal, community, and environmental health. This recognises that our circumstances and environment play a major role in our physical health. We are typically looking for digital platforms, primarily in the digital health category, that are able to measure their improvements in health outcomes. 

What do you see as the most underserved areas in femtech and women’s health?

Fertility and maternal health are currently the most funded areas in this space, though they only represent a small portion of the total market opportunity for women’s health. 

There are many chronic conditions, including endometriosis, that are debilitating conditions and are massively underfunded – both in basic research and innovation. Other conditions including menopause are massively lacking in true innovation, but are starting to gain traction particularly in the startup landscape. 

I’m most excited about specifically overlooked areas that sit outside the traditional women’s health category, but that disproportionately affect women. One such example is bereavement care. At Coyote, we have invested in a platform that provides care for every phase of bereavement (Betterleave). We’re also interested in holistic health and wellness, including functional medicine, sleep, and microbiome health. 

You’ve spoken about why women’s health needs to be at the heart of the climate solution, particularly given that empowering women and girls is the most impactful solution to the climate crisis. What kinds of tech solutions do you think will make the biggest impact here? 

Globally, this is a very large topic that requires coordination of private investment, government, and philanthropy work. It really needs a global lens. 

One impactful area is ensuring menstrual products are affordable and available. Period poverty is a global crisis, with estimates showing that 1 out of every 10 menstruating young people miss school during their menstrual cycle because of lack of access to products and health services (Penn Live). This estimate could be as much as 1 in 5 in the US (Asan Cup). 

Another highly impactful outcome is preventing unplanned pregnancies through family planning, contraceptive access, and reproductive rights. While these solutions aren't necessarily tech-forward solutions, many of the most impactful investments don't necessarily require heavy tech. 

In the private investment space in the US where we focus at Coyote Ventures, many tech-enabled opportunities lie within some of the more debilitating conditions that women and people with uteruses face including endometriosis and autoimmune disorders. These poorly understood conditions are historically difficult to diagnose and treat, causing enormous pain to individuals and costing the economy trillions in lost productivity.

‍You’ve also written about the deep inequities in maternal health in the US, particularly for Black, American Indian, Alaska Native and LGBTQIA+ birthing parents. Are you seeing companies being founded to tackle these problems?

Yes, there are several exciting companies addressing these populations! Companies doing amazing work include Baby Live Advice (maternal and infant telehealth support), BabyScripts (best-in-class risk detection for birthing parents),  Candlelit Care (perinatal mental health care for pregnant and postpartum Black women), Mae (pregnancy tracker for Black women), Wolomi (companion app for Black mothers), and more. 

I'm glad to say that we've also seen some of them go on to raise additional capital to scale since we published our original blog post on this, including Mae Health's seed round. 

Over the past few years, we’ve seen people become increasingly concerned with transparency on data privacy in femtech space – particularly in the US following the overturning of Roe v Wade. Have you seen this lead to consumers being more reluctant to use digital health products, and how should founders adapt? 

Founders need to implement strong data security systems from the start. Importantly, they must also have a strong revenue model that doesn't require the selling of any data. 

A general concern with direct to consumer (D2C) apps is that they rely on paid subscribers for revenue – a particularly tough sell when there are tons of cycle-tracking apps to choose from. If a consumer isn't paying for the app, the company may likely be selling their data. We don’t back companies with a B2B2C approach that don't rely on subscriptions, as we don’t support companies relying on selling data for revenue. Many of them are not tracking menstrual-cycle specific data as well. 

What advice do you have for Australian digital health founders looking to expand to the US? 

The US presents a huge market to scale within, and is therefore a great opportunity. However, it’s also a difficult and often very slow process to gain traction with US-based healthcare systems – including with providers, payers, and employers. You’re more likely to be able to build solid traction if you can show robust data (including positive health outcomes) and significant cost savings. You can also accelerate the process by recruiting a team and advisors with expertise and a strong network within these systems in the US. 
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Jessica is passionate about innovation that drives positive change in human health, equality, and our relationship to the earth. She worked for 6+ years designing and launching the Impossible burger as the 12th employee. Jessica has advised and consulted over a dozen companies internationally on product strategies. Jessica is an angel investor, LP, and formerly worked as Principal at a celebrity’s venture fund. She launched Coyote Ventures in 2021 to address the opportunities in health and wellness that has been historically marginalised. She can often be found swimming in the SF Bay and walking her Pom rescue.

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