What was once vanishingly rare seems to have become relatively common. Why the sudden increase in people who identify as non-binary or trans, and why are so many people going on to take hormones and undergo surgeries? Could understanding the way Folx use online culture as a marketing tool for selling hormones give us some insight into how the same online culture is operating as a marketing tool for selling an ideology?
I was reading an article on the Folx Health website when I recognised commonplace digital marketing techniques for subscription services. Reading through their website I saw how they picked up the trans ideology embedded within online culture and employed it as part of their marketing strategy. It seems that Folx has founded its business on it. It was shocking for me to see a company selling medical interventions in exactly the same way a streaming service might sell its subscriptions. However, there is nothing special or unusual about this strategy. These are common techniques employed within marketing and widely used simply because they are effective. They draw on a proven body of knowledge created as the result of decades of practical research.
Folx is a company backed by venture capital, led by people who have expertise and depth of experience in big healthcare, big data and social media. They partnered with RedAntler, a marketing agency to build their brand and their launch campaign. They tell us they researched “trans and queer-specific health information” from “Reddit threads, individual blogs, and on the websites of LGBTQ+ centres.” Blogs within the Folx site recommend users search for more information on hormones “in the Folx library,” via social media accounts and Google.
I followed links from the Folx website to “glossy” magazine sites promoting images of men and women who identify as “trans” or “non-binary” after their surgeries and hormone treatments. Folx works with influencers such as Laith Ashley, Isis King, and Brian Michael Smith. I clicked through to pseudo-scientific blogs and Instagram accounts, Wikipedia posts and Reddit subgroups. The language is striking in its consistency: gender is “assigned at birth,” hormone treatment is “Hormone Replacement Therapy.” Anything other than affirmation is “transphobia.” The ultimate aim always seems to be to live one's life as the '”authentic self.” They use words like “hegemony” and “cis heteronormative,” and rail against so-called “TERFs,” even on subreddits for gay women.
An Introduction to Modern Marketing Techniques with Folx Health
Step 1: Identify the Audience
Modern marketing departments now use powerful tools such as Salesforce Cloud or Adobe Analytics, (or any one of multitudes of tools provided by smaller companies) to collect, analyse and visualise data from social media sites, from apps, or collected from their CRM systems. Folx is partnering with the Her dating app. The owners of Her will certainly employ their users' data to help their advertisers micro-target their audience, even if they don't share the data with them, and they probably will share the data if they have been given permission. From all of this information, the company will create a marketing persona, a sketch of a typical prospect. It might list biological sex, age, personality type, interests, income, pains or frustrations (what problems they have that the product could solve) and gains (what they stand to gain from a product) with other information such as which websites they frequent, what time they are most active on the internet, what films they like, what political causes they might follow.
Step 2: Create Personas
It is easy to see the kind of personas Folx has identified as its prospects because this company appears to have linked to them from their website. They seem to be specifically targeting people who identify as “non-binary.” On their page about “microdosing” testosterone, they link to this article from Vice magazine published in April 2019. The target is a woman who identifies as non-binary. She tells her story. She was uncomfortable with gender roles as a child and came out as gay in her teens. She first hears of the terms “non-binary” and “microdosing testosterone” through reading blogs, scrolling through them at night, happy to find images of “people like me.” She now identifies as non-binary and talks about being “terrified” of a full medical transition. She says how she is happy now she is taking so-called “low-dose” testosterone and also how happy she is to have found a community she feels part of. She claims that “cis heteronormative” society excludes “non-binary” identities from its representations of “transness.”
The Folx page on microsdosing oestrogen links to this article in Them, a glossy online magazine. It is written by a man who says he identifies as non-binary - he states that the point of “transitioning' for him is not to get to female. He states that “hegemonic assumptions about gender' wrongly assume that people want to move from one “binary category' to another. He introduces a friend, a man who is a “self-identified lesbian,” who wants to “microdose' oestrogen because he doesn't want to lose the use of his penis or to lose muscle definition. He says he doesn't want to look like “some cis-centric, Eurocentric, fishy ideal.” The use of the misogynist slur against women indicates that this is a gay man speaking whose “self-identified lesbianism' seems to be expressing a preference for transwomen, but this is unclear.
Step 3: Understand Your Customer's Job to Be Done
The job to be done for the customer is usually very different from the service or product you are selling. You may sell hormones, but your customer isn't buying the drugs—they are buying what they perceive those hormones might do for them. And for Folx health they understand the job to be done for their customers is becoming part of a community.
The website looks like an advert for a nightclub, not a clinic. It is decorated with a series of portraits of people and couples lit in pink and blue light. Commarts, their design consultant, claim the portraits “exude confidence” and “hero queer and trans individuals as their authentic selves.” This translates to smiling people with piercings, tattoos and lip fillers as well as evidence of hormone treatment. The implication is that hormone treatment is just another kind of body modification.
Folx recruits staff who identify as trans and non-binary so making them part of the “community.” They've also coded it in their name, taking the term from the trans lexicon in the hope that it will function as a proprietary eponym. They tell us their website, or “library," is intended to be a “universal connector for people in unopened states, the UK, or anywhere on the globe to access medically-vetted trans-first health information." By couching sales copy as “information” and presenting their website as a repository of “knowledge” (by virtue of it being a library) Folx positions itself as an quasi social enterprise working with its customers towards the goal of personal realisation.
The Marketing Funnel
The marketing funnel is a concept that helps marketing and sales teams target the people (or “prospects”) who may want to buy a product. It is visualised as a funnel because the group gets smaller the further down the funnel you go. The basic stages are awareness, consideration, commitment and conversion.
The top stage of the funnel is about awareness of the product, the brand, or the service or subscription. This stage is about getting the word out, whether it is through social media via influencers and bloggers, or through established media organisations who may publish articles written by a company's PR or marketing team. Folx have had articles placed in Forbes, Dazed and Harpers Bazaar. They have gone for glossy, upmarket lifestyle magazines, and their articles are often placed in the “beauty” section. Folx employs the Her app to directly target their audience with advertisements to click through to the website. They may use programmatic advertising to people who match their target personas based on an individual's data profile.
Once the target audience is aware of your service or product they will be considering purchasing it. They may be getting more information via research, looking at blogs or online reviews. They will be checking out competitors. Companies want to keep the prospect aware of their products and services and to learn more about them.
Marketeers try to make their prospects engage with them and respond emotionally to content, for example by liking and sharing social media posts on Twitter and Instagram. Folx invites its users to sign up for its newsletter with the call to action, “plug and play.” Embedded trackers tell the company who has opened and read the mail and whether they clicked through to the website, or follow them around the web thus getting rich data.
Commitment describes the moment when the prospect is ready to purchase. They will perhaps do some more research into competitors, check reviews and weigh up options and prices. The articles and blogs will come into play again. The customer user journey is carefully created to ensure the fewest barriers to purchase. Folx's design consultants, Commarts boast that the customer journey is designed to “build trust and eradicate gatekeeping,” and that the website is designed to simplify “transactional behaviour” from the “product detail pages” to the “onboarding flow.” Designers may use UX techniques to make the offer look more attractive, for example showing the price as monthly when the contract is annual. They may offer discounts. Folx invites people to apply for a year's free hormone treatment, which they call their “scholarship” programme. They do this because once a customer has made a small commitment, such as signing up to a newsletter or asking for information about promotions, they are much more likely to make a big commitment.
Once the sale is made (conversion) the game changes. Now the job is to keep the customer happy, to smooth out their journey. Here Folx offer consultations with their medics over the internet. They have partnered with other companies to make blood tests and picking up prescriptions simpler. Another aim of this stage is to “upsell” to a more expensive subscription or “cross sell” another service. Folx tells the users that they plan to offer other subscriptions such as hormone blockers, viagra, Prep, contraceptives, and treatments to deal with acne and hair loss.
Advocacy is the bottom of the funnel. Here a customer is so happy with their purchase they willingly promote the brand through word of mouth and social media. Articles and hyper-real, hyper-saturated filtered images are published in news outlets and posts on social media. Influencers and bloggers write about how happy they are in their “new” body. So the circle is complete. For children and young people who are unhappy in their bodies and understandably rejecting the constraints of gender roles, Folx presents a seductive image of happiness, dematerialised in shining pixels.
Charities and increasingly companies, news outlets and consumer brands have all appropriated “trans culture” to present an image of society that superficially appears joyful, inclusive and liberal. Together all these platforms promote an ideology that insists on the “gender binary” that it claims to disavow. It insists that medical interventions such as surgery and hormone treatment are the primary treatment for alienation from gender roles in society while actively suppressing other views, vilifying these voices as “transphobic” or “trans hate.” The whole edifice operates as a kind of Escher staircase, a recursive loop.
The traveller may feel they are moving forward but the path is circular. Every step forward returns the same dogma and the only way to progress is down the funnel, down towards medical treatment and surgeries that are being aggressively promoted by US companies that are indifferent to the long term health implications for their patients.