23andMe, myself, and I

Here is the new ad from 23andMe that will begin airing shortly on cable TV*:

Genomics is going mainstream and the best news is first that it’s real simple and second that it’s all about me.

Let’s take the most obvious first: the “me” meme. Of course this relates to the company name, but the ad takes me to a new level. It makes “you” your DNA. I give them points for a couple of qualifiers — it “helps” make me who I am, one character says. But the overall message is that you are your genes.

It also exploits the meme of egocentrism. Nearly everything today seems to be all about me. Memoirs are the hottest genre of nonfiction. We have a magazine called “Self.” One of the most common themes on commercial websites is to have a “My [company name]” area, which usually just means they have your personal information to use to sell you more stuff. There’s even a “.me” internet domain, which they advertise “is all about you.” Who isn’t curious about himself? I’m the most interesting topic in the world! And 23andMe will tell me about my true inner nature for just $99.

One element of personalized medicine, then, is narcissism. Another, more noble, element is individuality. No one is more committed to his individuality than I am—but I’m also wary of its dark side: selfishness. I am struck by the single reference to future generations (“what I will pass on to my kids”). Again, this is a two-sided coin. In the Progressive era, the literature on genetic medicine emphasized family and community. There isn’t a hint of that here. On the one hand, then, the ad is free of the eugenic message of controlling human evolution. On the other, it’s relentlessly selfish. Most likely, the reason for staying away from issues such as family, community, and responsibility is that it enables them to steer way wide of abortion. This ad is about me, not my kids and not the future. That’s actually a new and rather radical development in genetics. 

A persistent theme in popular literature from the 19th century to the 21st, is that hereditary information provides certainty. This despite the fact that one of the signal insights from genomics is how uncertain its results are. Genetic medicine today is all about probabilities, and to make informed decisions based on our genetics we have to understand how probability works. The ad works against this principle, promising certainty where there is only chance. “Now, I know” says one woman. No, you don’t. Now, you have a sense of risk—not certainty. This is a dangerous over-simplification.

double helix

Simplified double helix from Watson and Crick’s 1953 paper.

This sense of simplicity is also carried in the graphics. Note how there’s hardly a double helix in it. “Your” DNA is reduced to circles, dots, and lines. They move and whirl entertainingly and there’s just enough suggestion of complexity to carry the message that you can’t understand “you” without them‚ 23andMe. If DNA becomes as central to identity as companies such as 23andMe want to make it, this ad suggests that its iconic image may fade. Even the stripped-down ribbons and bars version is simply too complex for TV.

karyotypedowns

An early karyogram (of Down syndrome) from the 1960s.

A comprehensive chromosome map from UCSF.

Screen shot from 23andMe commercial. Her “DNA” is those two colorful cylinders by her ear.

Most of the genetic “knowledge” promised is simple enough to be carried in the one- and two-syllable words that dominate mass-market media. Genetic medicine, stuffed as it is with Latinate and Greek words, is a tough sell in that market, but the ad pulls it off. At 0:21 we hear the longest word in the ad: “hemochromatosis.” The speaker pauses after the second syllable, to suggest empathy with viewers who get hung up on such terms. According to the Mayo Clinic website, hemochromatosis is indeed usually inherited, is rarely serious, is most common in men, and is the most common genetic disease in Caucasians. The ad script gives this word to a black man. Thus, one of the ad’s subtle messages is to erase racial differences—even differences supported by scientific evidence. It’s a commonplace in TV ads nowadays to feature men and women of many hues, but the 23andMe ad takes it a step further.

Another theme of the commercial is the way it suggests communities based around biological identities of health and disease. Once, our primary identities were with those who lived near us, or shared our work or hobbies or politics. But politics has become personal, our communities are digital, and our identities center around health. The sociologist Nikolas Rose calls this “biological citizenship.” The 23andMe website features forums where members who share particular mutations or risks can discuss diets, lifestyle habits, child-bearing decisions–or their pets, if they wish. They are communities based around health. The ad sends the message that race, class, and gender are no longer our defining social themes: what matters now is health and disability.

We hear so much about the importance of educating the public about their biology as a key component of contemporary personalized medicine, but in this ad that biology is reduced to bumper-sticker-like phrases about this circle “saying” I will have blue eyes and that line segment “saying” I have a risk of this or that disease. Learning about me will be fun, easy, and inexpensive. Thank goodness I can mail off a C-note, spit in a cup, and in a few weeks get a report that simplifies it all in language I can understand. The ad ends with a rainbow of people chanting “Me. Me. Me.” It’s the “Om” of the 21st century.

 

*h/t to Bob Resta for sending the link to the ad, and to Shirley Wu (@shwu) for a tweet that showed me that the hemochromatosis passage was too terse in yesterday’s version. I’d been wanting to add something about biological citizenship and Shirley’s comment suggested a way to do it.

 

 

 

21 thoughts on “23andMe, myself, and I

  1. KW

    This is a fascinating video followed by insightful comments – thanks for sharing! You mentioned that this commercial steers clear of the eugenic message of controlling human evolution. But for me it did conjure images of the so-called “self-styled eugenicist” that you’ve mentioned in some of your previous work. At several points during the ad, it reached far beyond suggesting knowledge for the sake of knowledge, or for the sake of curiosity. It actually proposed a change in behavior to mitigate any notable deviations from the norm. Linking genetic information to good behavior makes the individual “better,” and the dangerous undercurrent of course is that better individuals make better societies. One of the men in the commercial advised viewers to “change what you can. Manage what you can’t.” Other 23andMe clients “do things a little differently now,” “eat better,” and “ask more questions.” These are individuals who have employed self-directed techniques – albeit non-genetic and non-medical ones – based on their DNA circles, dots, and lines. In these ways, genetic information is being utilized to control human behavior. 23andMe may not have a hand in directly managing the collective gene pool, but it is suggesting (or at least popularizing) what is normal and what is not, and furthermore instructing us on how to adjust for identifiable abnormalities. Re-defining norms and correcting deficiencies is eerily reminiscent of the “eugenic impulse” you’ve very clearly characterized elsewhere. I don’t think that this company is necessarily advocating for the expansion of modern “self-styled” eugenicism, but it is almost certainly capitalizing on it.

    Reply
    1. genotopia Post author

      Thanks for your comment. There’s a difference between human improvement and eugenics, but the line has always been fuzzy. Yes, living well and healthy does improve the population, but only in a weak sense can it be construed as the self-direction of human evolution. “Capitalizing on the eugenic impulse” is an apt way to put it.
      You’re absolutely right about using genetic information to control human behavior, and I especially like your point about promoting normalcy. I certainly don’t want to see anyone suffer, but one can suffer by being ostracized as well. I’m wary of a creeping intolerance of abnormality.

      Reply
  2. KW

    Also – I enjoyed your analysis on hemochromatosis, and how the ad strips the disease of its racial prevalence. Just a quick thought: not only does this emphasize that health and disability are the most important social identities, but it also plays to viewer “fear” as well as curiosity (i.e. “fear” of the genetically unknown). According to the ad, diseases are no longer non-threatening to certain populations, just as they are no longer overly threatening to other ones. Anyone can develop any disease at any time. That’s why it’s important to know your DNA map ASAP. It creates a sense of urgency. From the company’s perspective, unsettled consumers are consumers who are more likely to buy into its services.

    Reply
    1. genotopia Post author

      Yes. Urgency is explicit in the ad–and it is a nice example of the convergence of genetics and standard marketing techniques.
      Always good to read your comments.

      Reply
  3. Mindbreaker

    You should ask yourself: if I owned this company and was going to make an ad what would it look like? My simple answer is that it would look quite a bit like this. Why that little mental experiment? Simple; you can’t read into this all the BS you are attributing. No matter what ad they came up with you would have made some bogus deal about it. Biased jury. They have “me” in their name. Bet you believe in horoscopes too. You are finding patterns, because that is what brains do. But intellectually mature people have tests to catch thinking errors like this. Maybe you should too.

    Whose DNA is it? Duh, the person being tested. Very sinister and suspicious to say the result might be about them. Get a grip!

    And black people do care about their DNA. They want to know where their ancestors came from in Africa while most people with European ancestors can just go to a normal genealogy site and find out or ask great aunt Martha. Makes perfect sense to have more in the ad. It is about knowing their audience.

    Knowing your risk of diseases is valuable…somehow contorting that into eugenics…see a shrink.

    I must be a machine I never get those dang CAPTCHA Codes right.

    Reply
    1. genotopia Post author

      Mindbreaker, the crab-bearer (Aug. 12-Aug. 12-1/2):
      You have always been different. Speshal. As a MindBreaker, you have honed your psychic powers and battle skills to a deadly edge. You have spent years training your body to be a fighting machine, and have also honed your psychic abilities to work in unison with your weapons to create the ultimate psionic warrior! Only those Legends who have purchased a 12,000 AdventureCoin package may unleash the force of their mental attacks. Because of their high Intellect, Endurance, Wisdom, and Luck stats, MindBreakers who don themselves in Spellbreaker, Wizard, and Lucky Enhancements tend to break a lot more than just minds!

      However, be wary this morn, Mindy. You may find yourself venturing into foreign lands, where the rules are strange to you and the inhabitants have skills and knowledge beyond your ken. Attempt to deploy your powers in such foreign climes and your sword may slice the air but ought else–and you will play the fool!

      Reply
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  5. Stephen Cobb

    I found this article through my Google Alert on hemochromatosis and have to say you have an interesting perspective on “consumer genomics.” What you don’t have is a clear picture of HH, hereditary hemochromatosis, which can be an extremely painful, disabling condition, with deadly outcomes. The idea that HH is “seldom serious” can only exist within some weird construction of the facts.

    Around 1 in 300 Americans have HH. The condition of iron overloading that it sometimes produces does not occur in every carrier, but the potential is always there, for that person’s entire life. For a carrier to avoid excessive iron intake, and get an annual iron panel to check for overloading, makes a lot of sense and can prevent irreversible damage to heart, lungs, brain, joints, liver kidneys, and other glands. Make no mistake, many people do die of hemochromatosis, and many more suffer terribly from it. Just read some of the posts at .

    For example my wife, who is now disabled after suffering all of those things, could have prevented much of the damage if she had known she was susceptible to HH. But the genetic test, for which 23andMe is now by far the cheapest source, was not around when she entered menopause and her body began loading iron. Like most HH patients it took about 9 years for her to get a diagnosis (that statistic is from a CDC study), by which point a lot of damage had been done, damage that cannot be undone.

    FYI, the idea that men suffer more from HH is out-dated now that more women live longer. While the menstrual cycle acts as a natural defense against iron overload, menopause removes that defense and is often the point at which women begin to succumb to the condition (frequently discounted by doctors as menopause itself).

    I fully understand that there are risks of misinterpretation when reading the results of genetic tests. As someone who has used 23andMe I can attest that the service does a good job of putting results in context and providing a lot of medically reviewed advice around the their findings, far more than you might imagine based on the ad alone.

    Let’s face it, the traditional healthcare industry in America has done a thoroughly abysmal job of identifying and helping HH sufferers. Many doctors miss it. Some doctors who see high iron numbers nevertheless refuse to order genetic testing, As a result, thousands of people die needlessly every year.

    I am contacted on a regular basis by people who have wasted many years and small fortunes dealing with problems that could have been avoided through open and affordable access to genetic tests. Do I think the ad is great? No. But until there is a vast improvement in healthcare delivery in America, then IMHO, the more people who know about 23andMe, the better.

    Reply
    1. genotopia Post author

      Thanks for your comment. The more one learns, the more ignorant one realizes one is. Glad to be set straight.

      I hope you don’t take me as being generally opposed to genomic profiling. I agree that, armed with good, reliable knowledge, genomic results can be extremely powerful as part of one’s healthcare regime. I’m just wary of misplaced risks, hype, and over-reliance on genetics as a guide to health. My claim is that scientific knowledge can be used for greater benefit of patients by providing historical context and cultural analysis.

      Best wishes to you and your wife.

      Reply
  6. Stephen Cobb

    Glad to discover that we are in violent agreement 🙂

    I too am “wary of misplaced risks, hype, and over-reliance on genetics as a guide to health.” In my efforts to raise awareness of hemochromatosis I have struggled to get the right balance, and frankly, HH is an easy one compared to many other conditions. I think every doctor would agree that, if you happen to know you are homozygous C282Y, an annual iron panel makes sense. But what do you say to someone who has a genetically elevated risk of developing Parkinsons?

    Many factors, including education and “comprehension,” come into play. For example, did the patient pass Statistics 101? Do they understand concepts like relative risk? I totally understand doctors who vent about patients Googling their own diagnosis. However, my wife and I are both fortunate to have had plenty of educational opportunities, and we have both used research via the Internet to diagnose things that doctors missed. In that process we learned how to “hack” the current healthcare “system” in America. For example, letting the doctor think it is their discovery works a lot better than saying “But I read on the Internet that…”

    So I definitely agree that “scientific knowledge can be used for greater benefit of patients by providing historical context and cultural analysis.”

    Stephen

    Reply
  7. genotopia Post author

    Bravo! You see, you sound like just the type of people we need more of. I couldn’t agree more: genomic information can be immensely powerful–IF used by informed and thoughtful people who understand probability AND the historical context of this stuff. The latter is my bailiwick.
    Thanks for your comments. Glad to have you reading…

    Reply
    1. genotopia Post author

      Oh yes, by all means! You can “use my ideas” so long as you “put them in quotes.” And “attribute them” to me, with my name and a “link” to my “website.” If I find, however, that my “ideas” are being “plagiarized,” I will “sue your ass.”
      “Thanks!” I’m “glad” you “dropped in!”

      Reply
  8. Pingback: A blow for personal genome testing | Genotopia

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