Facebook Blocks Women's Health Ads, an Investigation Reveals

You're scrolling through Facebook (now Meta) and see an ad. It's an image of two partially nude individuals intertwined and reads, "Get hard or your money back." Facebook accepted this ad as permissible content.

Another ad shows a fully clothed woman running and reads, "Reclaim your freedom. Run, dance, play, love, don't let intimate health concerns get in the way." The copy is from an ad for pelvic health by Joylux, a brand that caters to menopausal women. Facebook barred this ad for adult content.

The Center for Intimacy Justice recently released a report surveying 60 health businesses for women and people of diverse gender identities whose startups regard sex education, menopause, menstruation, pelvic health, and fertility. The report found that 100 percent of participants experienced a blocked ad. Further, half of the businesses faced suspended accounts.

Why does Facebook block sexual health ads?

Facebook's Adult Products & Services advertising policy reads, "Ads must not promote the sale or use of adult products or services. Ads promoting sexual and reproductive health products or services, like contraception and family planning must be targeted to people 18 years or older and must not focus on sexual pleasure."

Unfortunately, for many companies and organizations focused on sexual health, their advertisements can fall into the category of adult products. As organic post reach has declined over time, more business pages are having to rely on paid advertising that goes through a more rigorous policy check.

A 2020 study titled "Facebook Bias Against Sexual and Reproductive Health and Rights Advertisements? A Case Study of the Love Matters Global Network," looked at the nonprofit Love Matters and their experience with Facebook ads. From 2015 to 2020, almost 1,800 ads from Love Matters were rejected, categorized by Facebook as "adult content" and "sex toys."

This policy does not seem to be evenly applied. Ads focused on sexual and reproductive health and rights are rejected, while some men's health ads that focus specifically on pleasure are allowed to remain on the platform. The aforementioned study further noted that "several studies suggest that Facebook regulations on sexual and adult content disproportionately affect women and result in censorship of marginalized populations," but the impact may vary by country.

How are women's health ads further targeted?

While sexual health organizations across the board are finding their posts affected by Facebook's policy, women's organizations appear to be especially affected.

"Facebook's algorithms and policies are being applied in sexist and unequal ways," said Jackie Rotman, founder and CEO of The Intimacy Project.

"Ads for menopause, fertility, pregnancy, sexual wellness for people with vaginas, menstruation, and vulvovaginal pain all have been systematically rejected by Facebook—while ads for erectile dysfunction, and topics like 'ball hair manscaping' are allowed," Rotman said. "Ads explicitly emphasizing and discussing men's sexual pleasure are allowed, while ads for the pleasure—let alone pain relief—for women and groups who are not cisgender men are silenced."

Rotman specified that the censorship these startups face impacts girls and women of all ages—whether that's a brand showing a Gen Z menstruation ad or an ad for menopause.

'Content moderation has a disproportionate effect on silencing the voices of already marginalized groups, including women.'

A recent UNESCO study found that the second most common way for young people to find information on sexual and reproductive health, aside from their peers, is on the internet. Twenty-nine percent of respondents said this is the most common way they access this information. When pertinent health information is blocked, it prevents access for people who might not otherwise have it.

"Content moderation has a disproportionate effect on silencing the voices of already marginalized groups, including women," said Charlotte Petty, a human rights expert at RNW Media, an NGO based in the Netherlands that builds digital communities for social change.

Love Matters, the sexual and reproductive health organization mentioned above, had an ad blocked about consent that reads, "In this day and age, you'd think that everyone knows what consent is, but from the multiple assault cases reported daily, that's definitely not the case."

"The overwhelming majority of the Love Matters ad content that is disallowed is focused on women's and LGBTQI+ health," Petty explained, noting that during the pandemic, when most young people have inconsistent access to sexual and reproductive health at school, finding this information is more important than ever.

A sexist double standard?

The issue of Facebook blocking ads pertaining to women's health but not men's is two-sided: On one hand, the tech platform censors material that adheres to advertising guidelines, while on the other hand, it permits ads that explicitly break guidelines.

"Our ads comply with Facebook's ad policy, given that we're a device and not a sex toy," said Emily Sauer, founder and CEO of Ohnut, a wearable device designed to alleviate vaginal pain during sex. "We promote education, communication, and self-advocacy regarding pelvic health, so when our ads get rejected—it's like a punch to the uterus."

Meanwhile, some penile-related ads skip through the algorithm unscathed. Why? These aren't just ads about men's health, they are ads that "explicitly objectify women's bodies for the sake of commercialism," Sauer said.

Some penile-related ads skip through the algorithm unscathed.

One reason for the seemingly targeted rejection could lie in Facebook's bulk review system. The 2020 Love Matters study noted that "although Facebook's Advertising Policy seems to suggest that every advertisement is reviewed individually, our data suggests otherwise. We see on a regular basis that once one advertisement is flagged, other ads will be turned down automatically for the same reason, without being reviewed."

So, if a menopause ad is unfairly flagged by the algorithm once—it may snowball into further automatic rejection, tipping the scales against women's health products.

A spokesperson from Meta told The New York Times, "We welcome ads for sexual wellness products but we prohibit nudity and have specific rules about how these products can be marketed on our platform." Sometimes, the spokesperson added, Facebook makes mistakes with advertisement review.

Rotman explained this isn't a new issue Facebook recently discovered—women's health businesses and entrepreneurs have been reaching out with concerns about advertisement review for years.

The need for more equitable ad classification

Holding the largest social media platform accountable is no easy task. But it's a necessary one. If words like "menopause," "menstruation" or "breastfeeding" flag the system, the system needs a rewrite.

Rotman calls on platforms to classify ads fairly and work with sexual health experts when designing policies. Rotman also suggested Facebook expand the nuance of its algorithms to avoid further misclassifications. For the businesses whose accounts face suspension, it's necessary to improve the appeals process.

"There is a need for more transparency around Advertising Policy—specifically, why advertisements are rejected and the role certain tools, such as user reporting, algorithms, and human content moderation, play in this process," Petty added.

"While we acknowledge that a balance needs to be struck between public safety and freedom of expression," Petty continued, "measures taken by tech companies such as Facebook risk excessive censorship of content and thus reduce young people's access to diverse viewpoints and nuanced educational information, especially in relation to their SRHR [sexual and reproductive health and rights]."

For the millions of young people in countries RNW Media works with, information and education on sexual and reproductive health accessed on social media could save their lives, Petty said.

"In the end, Facebook would make more money by allowing women's health ads," Rotman added. "Facebook is currently turning away money from women and nonbinary entrepreneurs who are eager to advertise on Facebook's platform, which would help others in their health."

Rotman said she's willing to work directly with Facebook "to help them rectify this systemic failure and to create a more positive platform that allows women's health ads."