Privatizing and Prescribing Identity: How Canadian biotechnology firms capture queer, trans, and neurodivergent movements for profit


Kai Jacobsen, Caleton University; Megan Linton, Carleton University

Contemporary health companies co-opt the rhetoric of identity politics and social movements in their marketing, transforming marginalized communities into profitable niche markets. This co-optation is fueled by Canadian state sponsored neoliberal biocapitalism, which incentivizes privatization through subsidies for biotechnology startups and pharmaceutical multinational corporations. In this landscape, health technology firms are increasingly functioning as primary care providers to fill the growing gaps in care created by contemporary austerity. In particular, the pivot to telehealth through the COVID-19 pandemic spawned numerous private investor-owned virtual care firms. Socialized health care within a capitalist state like Canada is always at risk for privatization and corporatization. These firms are able to capitalize on loopholes and outdated policies in Canada’s healthcare regulatory framework. One such company is PurposeMed, a venture-capital backed start-up that operates private virtual clinics for HIV PrEP medication (Freddie), gender-affirming care (Foria), and ADHD assessment and prescribing (Frida), and a pharmacy (Affirming Care). We analyze PurposeMed as a case study to illustrate broader trends in the creeping privatization of health care and the biomedicalization of everyday life. In this case study, we first describe the historical, political, and economic factors that led to the rise in private virtual clinics like those of PurposeMed. Then, we present the results of corporate mapping of PurposeMed, where we engage power structure research and subsequent social network theory to understand the corporate powers transforming health care in Canada. Finally, we conduct a critical discourse analysis of PurposeMed’s marketing and branding strategies, highlighting their exploitation of the existing digital networks and health information-seeking patterns of queer, trans, and neurodivergent communities to accumulate capital. We argue that PurposeMed exploits gaps in the underfunded and overburdened public health care system to turn marginalized individuals with unmet health care needs into a profitable niche market. The desired outcome for the private health system is the transformation of queer, trans, and neurodivergent bodyminds into productive, paying neoliberal subjects. Our historical and policy analysis demonstrates that healthcare privatization and commercialization in Canada is not an accident; rather, PurposeMed is the inevitable result of deliberate policy choices and austerity politics fueled by ableism, homophobia, and transphobia. While requiring individual private payment for services, PurposeMed also receives public funding. Our corporate mapping exposes a federal investment of $3.5 million of taxpayer money into PurposeMed’s services. Alongside this federal funding, a wide network of venture capital firms and private investors make up both PurposeMed specifically and the broader movement to privatize health care in Canada. Our critical discourse analysis reveals how PurposeMed’s online marketing strategy leverages digitally-networked communities to popularize their services and transform queer, trans, and neurodivergent bodyminds into commodities for harvest. By marketing their services as affirming, anti-oppressive, patient-centered, and holistic, PurposeMed and similar companies capitalize on people’s experiences of discrimination and harm in the public health care system to entice them into private healthcare. In doing so, PurposeMed frames paying out-of-pocket for healthcare as a strategy for empowerment and liberation rather than the result of government austerity and the failing public health care system. We conclude by calling for urgent scholarly attention to the communities targeted by creeping privatization of Canadian health care and the firms profiting from them. Further, we argue that queer, trans, and disabled communities need to turn to the histories of disability, health, and radical social movements to create grassroots community-based solutions to contemporary crises. Moreover, social movements must take seriously the need to dismantle contemporary capital accumulation practices, which manufacture the crises they seek to profiteer from. 

This paper will be presented at the following session: