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Notes -
Something about this article in The New Yorker, The Billionaires Vagina Club really irks me. As far as I can tell, this doctor is doing God's work in focusing on an under-served area of women's sexual health and promoting the idea that women should be able to have orgasms more frequently and regularly and throughout their later years if they want to. This should be an uncontroversial good, especially if you are a reader of The New Yorker. But I sense the article smacks of condescension and how problematic this all is.
She serves wealthy clients, like the wives of Silicon Valley techbros. She has a concierge practice, because that's the only space doctors are allowed to actually innovate. Oh, she also might be friends with Peter Attia, an allegedly toxic masculinity influencer. Are we sure these are good people? Are we sure they're not doing malpractice? Is this just another way the rich are enhancing their lives somehow at the cost of the rest of us? Are we sure men aren't just demanding their wives continue being interested in sex for their own selfish needs, with good Dr Sally Greenwald as a facilitator for the patriarchy? Really, wouldn't women be happier as lesbians?
Am I hallucinating all of this? Are these widespread concerns held by a real audience? I'm left with the alienating sense this article is trying so hard to snatch defeat from the jaws of victory.
I won't even get into how unfair this article is to Peter Attia, who is cancelled as a toxic masculine Epstein adjacent guy even though he clearly champions women's health. He (e.g.) says repeatedly across many episodes that his favorite videos to watch are of old ladies getting back into shape and quickly working their way up to doing body weight deadlifts. He even had Sally on his podcast last November and she dropped an astonishing amount of women's sexual health knowledge for 2 solid hours, but that's all negated by Attia being surprised that Sally was encouraging even young women to use lubrication and Attia wondered if there wasn't also a risk in too much lubrication reducing men's pleasure. God forbid you ask the sexual health expert if she runs into that concern and how she balances that out. Okay I guess I got into it.
There's something weird going on in it. There's the obvious dislike of the financial side, from the title on down, but if that were the real story, Midi Health (and any other competitors? but I've heard of this sort of thing happening from normal general-practitioner work, just less sexual and less formalized) would be a top-line item, not a footnote, and the BVC would just be scamming the rich people out of what 'everyone' should have.
A lot of it seems like it's borrowing from anti-woo stuff, and there is legitimate history there: a lot of men's sexual health stuff has been snake oil, sometimes literally, and women's isn't much better. But the specific claims here are relatively well-supported in the evidence, and the stuff that isn't (eg, estrogen supplementation post-cancer) is on better ground than the summary suggests.
The Bulverist take is that the writer hates (especially rich) men, sees this as a way for wives of rich men to trade their health to stay sexually desirable to men, and couldn't actually come up with the information to support that position. But that's not very charitable.
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