The GynePunks worked with a lab to develop open-source, downloadable software for a 3D printed speculum.


November 10, 2015

A 3D printed speculum? Do-it-yourself urinalysis? Pushing back against traditional physician-patient roles, members of a European collective – GynePunks – are taking a radical self-help approach to women’s health, combining a feminist sensibility and a hacker’s DIY mentality.
The TransHack Feminist and Pechblenda groups, based in a “postcapitalist” collective just north of Barcelona, bring together radical feminists with engineers and other collaborators who have technical expertise. This loose affiliation works to construct and test tools meant to be used by women who are seeking self-knowledge and empowerment through self-care.
Klau Kinki, one of the founders of the GynePunks movement, explained that the strong social change thread running through the movement has its roots in what they see as some of the exploitative practices in the early history of gynecology. In an interview, Ms. Kinki said her research led her to “dig in the shame alleys of how medicine was built.”

The GynePunks worked with a lab to develop open-source, downloadable software for a 3D printed speculum.
One controversial example is the work of Dr. J. Marion Sims, an Alabama surgeon who pioneered vesicovaginal fistula repair by operating on slave women without anesthesia during the mid-1800s. Though ethicists continue to debate Dr. Sims’ actions in their historical context, Ms. Kinki is seeking to rename the Bartholin’s and Skene’s glands in honor of three of the slave women from Dr. Sims’ experiments whose names are known: Anarcha, Betsey, and Lucy.
The more Ms. Kinki read and learned, she said, the more she felt she needed to use the tools available to take matters into her own hands. Her experience as a Peruvian immigrant in Spain deepened her personal understanding of the impact that outsider status can have on health and well-being, she said.
Using assemblages of spare parts to fashion cell counters, fluid analyzers, and even microscopes, Ms. Kinki and her collaborators in the TransHack Feminist and Pechblenda collectives have put together prototypes that are part steampunk art and part low-tech working prototypes. She describes GynePunks as “a feminist tool developed inside [the] biohacking scene.”

Implications for health
Though the methods are unconventional and the vocabulary of radical “postcapitalist” feminism may be off-putting for
The GynePunks helped develop a do-it-yourself laboratory incubator.
Courtesy Klau Kinki/ Creative Commons License
The GynePunks helped develop a do-it-yourself laboratory incubator.
some, the GynePunks’ work could have serious and practical implications for women and those who care for their health.
Other low-tech, peer-to-peer approaches are already showing promise. For instance, researchers estimate that effective implementation of a low-tech cervical cancer screening program in India could save 22,000 lives annually. Health workers were recruited from the lay population and trained to perform a visual inspection of a woman’s cervix after application of acetic acid. These workers accurately identified those women with dysplastic lesions who needed referral for further care (J Natl Cancer Inst. 2014 Mar;106[3]:dju009).
The GynePunks hacking approach to women’s health, advocates say, also has the potential to help populations that may still experience isolation and barriers to care, even in wealthy, industrialized countries. These groups may include the uninsured and undocumented, LGBT individuals, and sex workers.
To that end, the GynePunks are collaborating with Gaudi Labs, a Lucerne, Switzerland–based group that explores open-source “biohacking” tools and techniques. Founder Urs Gaudenz has helped develop the open-source, downloadable software for a 3D printed speculum. Now, he, Ms. Kinki, and others in the movement are working on a full mobile lab, one that Ms. Kinki said “can be easily reproduced, and with at least the basic tools to perform some diagnoses.”

What it means in the United States
But the movement toward self-diagnosis and self-treatment worries some gynecologists. While acknowledging that barriers still exist for adequate care for many women, Dr. Constance J. Bohon, a gynecologist in Washington, D.C., is concerned that the movement “may do more harm than good.”

For many women’s health disorders, medical science offers the surest path to a cure, said Dr. Bohon. For example, though many herbal remedies exist for menopausal symptoms, “we know that these have been problematic,” and studies have not shown their efficacy when compared to best medical practice.
Real harm can be caused when some procedures are taken into the hands of laypersons, she said, citing the horrors of self-induced and lay abortions in the pre–Roe v. Wade era.
However, Dr. Scott A. Sullivan, an associate professor of ob.gyn. at the Medical University of South Carolina, Charleston, said he sees the innovations and the thrust behind the efforts of Ms. Kinki and her collaborators as both a natural extension of current trends in patient empowerment, and as a wake-up call for women’s health clinicians in the United States.
“This movement may be pushing the envelope, but it follows the trend we’re seeing, where people want more information and more participation in their health,” Dr. Sullivan said.
This is a natural evolution, he said, as patients read articles, do their own research, and talk to each other. In part, this also represents a generational phenomenon, where younger people have a willingness to learn from each other and from online resources, and can figure out how to do things for themselves.
But most importantly, he said, “people need to feel welcome. This is telling us something.”

Dr. Sullivan sees many rural patients who face challenges just getting to the clinic or hospital. And in general he is seeing a trend toward more home care in obstetrics and gynecology – home ovulation tests, home HIV testing, home genetic tests. Especially for underserved rural populations, more patient self-help – with appropriate communication and monitoring – may mean that safe, effective care can be delivered to more women, he said.
“Of course, there are some things that only we should be doing – some procedures and surgery – but this is a wake-up call to our profession,” Dr. Sullivan said.

A historical context
Some of this may seem like old news to those who remember the women’s movement of the 1960s and 1970s, whose leaders promoted female self-awareness and empowerment in health. So how do the GynePunks and their new tools fit in historically?
“This emphasis on women as the agents of their own health is in many ways an extension of the feminist efforts in the 1970s to reclaim women’s bodies and question the authority of experts,” said Terra Ziporyn, Ph.D., a science historian and coauthor of “The New Harvard Guide to Women’s Health.”
Referring to the seminal work produced by the Boston Women’s Health Book Collective, Dr. Ziporyn said, “it’s like an ‘Our Bodies, Ourselves’ updated for a digitalized and globalized world.”
The women’s movement of 40 years ago promoted female self-awareness and empowerment, encouraging women to acquire at least a mirror, and perhaps a speculum, to get comfortable with their own anatomy. Today, a 10-pack of plastic specula can be delivered to your front door – for under $10.
Whether the GynePunks have come full circle to the old ways of self-care, or whether they are creating a new fusion of feminism and technology, the movement has the potential to shake up traditional women’s health. For Dr. Sullivan, that’s not a bad thing. “If women don’t feel welcome in our offices, we need to do something about it,” he said.


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