Direct-to-Consumer Telehealth and the Ambivalence of Self-Care

Abstract

Direct-to-consumer (DTC) telehealth is presented by marketers as a mere conduit for self-care capable of circumventing the frustrations and injustices of existing healthcare systems. If self-care is both lauded as a key tool of resistance for the marginalized and rejected as a hollow marketing tactic, how should we respond to technologies seeking to promote self-care? What can they tell us about where self-care is a valuable pursuit and where it becomes a social threat? I pursue these questions by examining the tensions between ethically meaningful care for the self and pernicious self-responsibilization in two different uses of DTC telehealth: ‘men's health’ services for the treatment of erectile dysfunction and gender-affirming care services for queer and trans people. Drawing on opposing views of self-care, I argue that particular self-care projects like DTC telehealth are ethically viable where they resist, rather than bolster, projects of domination and where they support, rather than undermine, caring relationships.