Reflections on Ten Issues for The XX Factor

This began as a creative experiment. You turned it into something more.

A few months ago, I started The XX Factor as a passion project—an outlet to channel my recently rediscovered creativity, and to share hard won lessons with the next generation of builders in women’s health.

But most of all, it’s been a personal experiment in rewiring.

I’ve been a goal-obsessed person for most of my life. And while that mindset has served me well, it’s also been a double-edged sword.

A few months ago, I started asking:

What would it look like—and feel like—to create just to create?

Not to hit a certain KPI. Not to optimize for growth. Not to convert readers into subscribers. But simply, because it feels good. Because something is stirring. Because quality writing, like a long exhale or belly laugh, can be its own, nurturing reward.

The XX Factor became a sandbox for that idea: What happens when I create without a finish line? When I write not to “perform,” but to think in public? When I follow that energy… might others benefit too?

Ten issues in, I’m taking a beat to reflect on those foundational questions—on what I’ve learned, and what’s felt most rewarding as I consider where to take this next.

As I explore a few potential evolutions, I want to hear from you, too: What’s resonating? What’s not? What would you love to see more (or less) of?

This post is a check-in, a peek behind the scenes, and an invitation to co-create what comes next.

Going back to go forward

Step one of learning to create without a goal line meant stepping off the treadmill entirely.

Last year, I made the difficult decision to step back from Tia after eight years at the helm as founder and CEO. Looking back, it was absolutely the right decision for me personally—and I hope the company, too, though the Tia story is still being written. Like many founders passing the torch, I underestimated just how emotionally difficult the transition would be. Learning to let go while staying a committed champion of the company I founded and poured my blood, sweat and tears into was (and is) hard to this day.

I needed space. From Silicon Valley. From the startup grind. Even from women’s health—the very problem space I’d devoted my career to. So I forced myself to do something I’d never done before: I took a full year off to decompress and recalibrate.

I am not a natural sabbatical-er.

For someone who’s wired for productivity and achievement, unstructured time is deeply uncomfortable. For months, I flailed. I was grateful for more sleep, but missed the structure, the momentum, the dopamine hits of building and leading a company. I felt aimless.

But, slowly—with time and nature and allowing myself to get bored—came peace. I learned to go on silent hikes. To sit with my thoughts. To embrace the nonlinear process of reflection and growth.

Eventually, space gave way to a newfound curiosity and creativity that I hadn’t felt since the early days of Tia.

I found myself voice-noting ideas while hiking, brain-dumping half-baked product concepts on chair lifts, and dropping into that rare, magical flow state during my early morning journaling. My brain was rebooting.

one of my many inspiring silent hikes!

Writing as a tool for sense-making

Writing has always been my most powerful tool for sense-making. It’s been my through-line before, during and after Tia. It’s how I process the world, synthesize ideas, and find clarity in the chaos.

At first, my sabbatical writing was mostly retrospective—unpacking what I got right and wrong with Tia, what fueled me and haunted me. But eventually, it turned toward the future: Where is healthcare going? How has the world changed since I first started in this space? What do women—and the people building for them—want and need?

That’s when The XX Factor began to take shape, and I decided to turn my private writing practice into a public one.

I’ll admit, it felt a bit scary at first. Could I actually create without a goal line? Would anyone care what I had to say?

Ten issues in, and I can say the rewiring is working. This writing practice has been more healing, energizing and clarifying than I ever could have imagined. And quite unexpectedly, it’s made me optimistic about women’s health again (yes, even amidst everything happening in the world). It’s reignited my desire to build again—and to help others build, too.

Evolving together

As I look to evolve this practice to serve my shifting needs, I want to better understand yours, too. I want to know: What’s resonating? What’s not? What would you love to see more (or less) of?

Below are a few thought starters about how I’m thinking about the next chapter of The XX Factor with opportunities to vote on ideas I’m exploring. Beyond a quick vote, I’d love to hear any and all feedback or ideas—in the comments, via Substack message or email. You can reach me, always, at carolyn@carolynwitte.com.

1. Women’s health as a lens, not a niche.

If you’ve been reading my work, you’re probably sick of hearing me say that nearly every healthcare company is a women’s health company in some way shape or form. I’ve always believed this, but through this writing, that thesis has crystallized.

Yes, this informs how I think about the so-called “market opportunity.” But, more importantly, it influences what I want to write about here. Sometimes, I want to go deep on women’s health-specific topics—from maternal health policy to menopause science to funding dynamics. But other times, I find myself wanting to explore broader themes in healthcare, technology and company-building: GTM strategy, AI vs. humans in care delivery, patience experience, and new payment models.

Food for thought: all of these topics are essential to building great women’s health products and companies—maybe even more so than women’s health “content” alone?

As I continue to use writing as a playground for my own thesis development, I don’t want to be artificially boxed in, but I also don’t want to lose the lens that makes The XX Factor distinct.

My aim is to use women’s health as a lens—not a limit—through which I view the rapidly evolving future of healthcare. But, I’d love your take:

2. Leaning into long-form (with occasional spice)

From the beginning, I told myself that The XX Factor was not another news digest. Nothing against those—they’re valuable, but there are plenty of great ones out there. I don’t intend to reinvent the wheel. This space is meant to do something different—to give you nonconventional takes and insights, span product to policy, and to equip you with tactical frameworks to help you build better.

I’ve experimented with a range of formats in service of this goal—from interviews and co-authored pieces to data deep dives and long-form essays.

I’ve found that it’s the deeply researched, slower-burn pieces that feel the most fulfilling to write, and seem to resonate most with you, too.

Still, I’d love to hear from you directly: What kinds of pieces do you most enjoy reading — and realistically have time to absorb?

3. Cadence: releasing the calendar

To get myself into a rhythm, I initially committed to publishing every Tuesday. It was helpful early on—especially in keeping my perfectionism in check. But over time, I’ve found the arbitrary “publish weekly” goal to be more limiting than motivating. Some weeks, I’m overflowing with ideas. Other weeks, I’m marinating—and the words need more time to come together.

While I would love to grow my readership, The XX Factor is not a growth marketing engine (remember, no KPIs!). I am firmly against producing content just to “keep up”—there’s enough noise out there as is. I want to write when a topic or idea speaks to me, not because it’s Tuesday.

I also know that my writing isn’t exactly “bite-sized.” Per my love of long-form, many of my pieces are dense. They’re designed to be digested slowly, and spark a conversation or debate. And from anecdotal feedback, it seems like some of you need a breather now and then as much as I do!

4. Sharing the mic

One of the most energizing parts of this project has been connecting with other builders and thought leaders, and experimenting with ways to bring more voices into the fold. From interviews with experts like McKinsey’s Lucy Perez and United States of Care’s Natalie Davis, to co-authored deep dives with Leslie Schrock and Halle Tecco, it’s been a joy to co-create and spotlight perspectives beyond my own.

I want to do more of that—and broaden the scope while I’m at it.

One idea I’ve been toying with is a new Operator Series—an opportunity to “pass the mic” to those in the trenches building the future of women’s health. Consider this part of my personal mission to help more women’s health builders build—not just fundraise—by sharing more hard won lessons, best practices, and innovative frameworks that don’t make it into press stories. Think: zero-to-one product development, cracking your first payor deal, managing clinical quality at scale, and more.

If you have ideas for who I should feature (or want to nominate yourself), I’d love to hear from you!

5. Potential higher touch offerings

Writing done right is a tool—not the outcome. And its best, writing is a catalyst for conversation, connection and community.

Lately, I’ve been thinking about how to create more intentional opportunities to connect, learn, and build together—and how to further support camaraderie over competition in this space (something I care deeply about!).

Here are a few ideas I’ve been toying with. I’d love your take!

Thanks for being here—for reading, reflecting, and building alongside me. This project has been a personal experiment, but your support and engagement has made it something much bigger.

I can’t wait to see where we take it next.

xx. Carolyn