Every -span is a price tag in disguise

A Stanford gynaecologist sells "sexspan" for $30,000 to $40,000 a year to a waitlisted Silicon Valley elite. The New Yorker profiled the practice in July under a nickname so exclusive the founder had to drop it, because some of her ultra-wealthy patients failed to see the humour in it. And while that story travelled, the longevity vocabulary grew another layer: "peakspan", coined not by a marketer but by Alex Zhavoronkov, CEO of Insilico Medicine, as the period in which you keep at least 90 per cent of your peak functional capacity. The spa industry picked it up within the month.

Follow the ladder down and you get a live map of where the money is moving. Prevention became pro-active care. Pro-active care became healthspan. Healthspan spawned hotspan. Now sexspan, now peakspan. Each coinage steps further from disease and closer to desire: from not dying, to living well, to looking good, to performing sexually, to performing at your peak, full stop. Nobody trademarks "mortality". The sellable layer is always the one just past it.

Every new -span is born at the top of the market as a scarcity product, and the cheap version only inherits the word after the premium buyers have moved on to the next coinage.

What the richest actually buy

Here's the tension that should bother anyone building in this space. The AI-abundance narrative says everyone will soon get billionaire-grade healthcare. Elon Musk made the point around Optimus in July. Partly plausible: the average person today has better healthcare than the richest person of the past had.

But look at what the richest actually buy. It isn't the drugs, and it isn't the protocols. Bryan Johnson's Blueprint protocol is free; his medical team guiding you through it runs about $1M a year. What the waitlist at the $30k practice buys is exclusive access to well-trained humans: appointments that start on time, a quiet room that smells like cedar instead of disinfectant, a doctor who remembers your name, and nobody handing you a printout of your own labs. It's the same reason not many billionaires file their taxes with TurboTax.

Even longevity's most famous body just proved the point in reverse. In late July Bryan Johnson went viral with an autoimmune gastritis diagnosis and the admission he may have taken longevity too far. The protocol was never the product. The hand-holding was.

The software climbs after it

Midi, an AI-powered telehealth platform for the same menopausal and sexual-health care, has raised $250M+ at a $1bn+ valuation: 500 providers across all 50 states, and the average insured visit costs about $50. Rival Alloy deliberately runs lean at $21M, betting against exactly that race. On 1 September WIRED reported that Midi's clinicians now prescribe GLP-1s alongside menopause care, because the golden goose pays for the platform. And the day after the draft of this piece, on 2 September, an NIH-funded team at UC Berkeley reported in Nature that semaglutide extended the median lifespan of older mice by nearly 100 days while improving muscle and cognitive function. The knowledge layer is being democratised in real time; the ageing layer may be next.

The patients say the quiet part out loud. In r/midihealth, women trade notes on symptoms nobody flagged during a decade of religiously attended well-woman exams; one writes that perimenopause was never even mentioned until she found the platform. And Eric Topol, probably the most-read cardiologist in digital medicine, posted in August that he sees the case for AI to deliver concierge medicine. One physician replying loves it when patients use AI, because they arrive so much better informed that the visit finally gets spent on individual treatment.

So both things are true at once. The queue for white-glove humans keeps growing, and the software underneath it keeps getting better. Abundance and scarcity aren't taking turns; they're stacking.

Two speeds, one market

While Silicon Valley buys $30k sexspan, Melinda French Gates pledged $215M to women's health in June, her first major menopause investment, including $10M to train clinicians in the "meno-deserts" where care is scarce. Philanthropy is pushing the floor up at the exact moment luxury pushes the ceiling further away.

The pattern is structural, and it doesn't resolve itself. Language climbs the ladder, software climbs after it, and marketing mints a new step to stay ahead. Musk may be right that the average person will one day have better care than today's richest. That future will still arrive through the cheap step, under a different name, years after the premium buyers have moved up the ladder and left the word behind.

So the real competitive question in longevity isn't whether your product works. It's which step of the ladder you're selling from, and how long before software catches up.

Count the -spans in the next longevity pitch that lands in your inbox. Every one tells you where the seller thinks the money is, and where they think you are on the ladder. Then ask them what they'll call it when it gets cheap. And if you want to see where the longevity market actually lands rather than where it pitches, I track 500+ events a year over on longevents.

💥 May this inspire you to read the vocabulary before you read the claims.