“Can I get pregnant from this?”
“Am I normal?”
Those are the most common questions teens on TikTok ask Tess Vanderhaeghe, a self-described sex-positive health educator. One of her videos, which breaks down female anatomy, has received more than 2 million views.
“We talk a lot about sex,” Vanderhaeghe said. “But we don’t talk about sexual health.”
Curious young adults struggle to find answers to their questions about changes in their bodies, she said. They might Google a question only to get inundated with information that might — or might not — help.
That’s when many turn to TikTok.
Like Vanderhaeghe, pediatricians, obstetrician-gynecologists, and sex and relationship therapists are becoming influencers by sharing traditionally taboo-for-teens talk. They’re also addressing viewers’ concerns, including whether they need to shave their private parts before going to the doctor, a video watched over 7 million times. The hashtag #sexualhealth has over 250 million views on the platform.
“Every generation is curious,” Vanderhaeghe said. “Any teenager going through puberty is curious about sexual health. Gen Z just has access to platforms like TikTok and Instagram and a place to ask those questions in a different way.”
The need for answers comes in large part from the failures of sex education curriculums, advocates say. Thirty U.S. states and the District of Columbia require it be taught in public schools, of which 22 require it to be medically accurate.
Even when it is taught, disparities remain significant. The Centers for Disease Control and Prevention identified 19 topics as critical to the subject, and only 38 percent of U.S. high schools teach all of them, according to the Sexuality Information and Education Council of the United States. Research has shown that fewer teens are receiving formal sex education in school today than they were 14 years ago.
Research published by the Journal of Adolescent Health found that between 2006 and 2013, there were “sharp declines in receipt of formal instruction” for both girls and boys on the topic of birth control alone. While the federal government has spent over $2 billion on abstinence-only programs, no federal funding has ever been dedicated to comprehensive sex education, according to SIECUS.
“We live in a sex-saturated society, and we’re told not to talk about it,” said Helen Wyatt, a licensed marriage and family therapist in Chicago. “Then it’s put in front of our faces all the time —— advertisements, how we’re socialized, what we’re taught we ‘should’ be.”
TikTok, for some, is filling that education gap. But like anything else, the platform has its limitations: Anyone can create an account and share content, regardless of whether the information is reliable. TikTok does have community guidelines regarding what content will be taken down if the topic discussed is inappropriate — a category many sex-ed videos fall into despite their educational basis. Plus, there are many videos sharing false information.
Vanderhaeghe noticed lower views, likes, shares and overall engagement with two of her more instructional videos, both demonstrating how to use a condom safely and correctly. They were both restricted by the app and not sent to the “For You Page,” where videos get the most interaction, even though she was careful not to violate any community guidelines.
TikTok did not respond to a request for comment on this story.
Christine Elgersma, a social media editor at Common Sense Media, a nonprofit that provides guidance to families on engaging with media, said that for parents, there’s a “constant anxiety” around digital media.
Though TikTok offers “robust parent controls” compared with other platforms, parents still worry about how age-appropriate content is. With sexual education content, those worries grow.
“I think there are pros and cons to it depending on the source of the information,” she said. “Kids might get some helpful information, but who’s to say that it’s going to be entirely accurate or age-appropriate?”
As young adults seek more extracurricular sex education online, the need grows for increased media literacy, according to a 2020 report from the American College of Obstetricians and Gynecologists. Danielle Bezalel, host of the podcast “Sex Ed With DB,” called the sex-ed TikToks a double-edged sword.
“If it’s so accessible to people, then anyone is an expert, right?” she said. “So now there’s this problem of young people having to differentiate between valid, credible sources and noncredible sources.”
Seattle-based pediatrician Tessa Commers said it’s “uncomfortable but understandable” that so many young people turn to the Internet. That’s the reason she started trying to reach the adolescent population, first on Instagram, then on YouTube and ultimately on TikTok. She said it’s an underserved population.
“I started out thinking teenagers want to know about acne and crushes, so I started out making videos about that stuff, but the questions people really had were about their bodies, about what’s ‘normal,’” she said.
Some 1.5 million people follow Commers, who goes by “Ask Doctor T” on social media. In her most-liked video, she answered a user-submitted question asking about genital size. It generated a staggering 1.6 million likes.
“They have this mind-set of, I’d never ask this of someone I know, but I will to this stranger who presents themselves as an authority,” she said. “I’ve gotten some really open and honest questions, and narratives of changes that bodies are going through, and I’m honored that they’re reaching out to me, but I’m sad. They say, ‘You’re the only person I can ask about this.’”
During college in Scotland, Marlena Segar volunteered to teach sex ed to teens and then managed a London-based sex shop before she was laid off during the pandemic. That’s when she turned her focus to social media.
The 24-year-old, who goes by “WeNudetoTalk,” said TikTok reminds her how abnormal conversations around sex are, even though they’re commonplace in her industry.
“I didn’t think the things I’d say would have so much of an impact,” Segar said. “I don’t feel like I’ve done anything major by sharing these things. It’s just information I’ve learned from other people that I want to pass along.”
In one video, she walks through the steps of a sexually transmitted infection test, while taking one herself on camera, to destigmatize the process.
“I really value [social media] as a tool for talking to people about topics that we’re not allowed to talk about but everyone wants to talk about,” she said.
Commers said she creates most of her videos in response to falsehoods she sees on the app.
“I personally feel grossly outnumbered by the number of people spewing misinformation,” she said. “It’s an uphill battle. It’s this increasing obstacle that I think the medical profession just has to address.”
Educating young adults to realize they aren’t alone in what they’re feeling is what makes a difference, Wyatt said.
“What’s missing from our sex ed is what is considered ‘normal,’” she said. “Because most of us come from homes that don’t talk about sexuality openly, we’re never taught how to get through that vulnerability or to put words to it.”
On TikTok, people can choose to be anonymous and invisible listeners and learners. Commers said she hopes research can be conducted to give some “validity” to the impact of sex ed on these platforms.
In one of her most popular videos, liked by over 400,000 people, she dispels common misconceptions that she’s seen perpetuated on the app.
One user commented: “Wait, that’s normal? I’ve been thinking something’s wrong with me.” 29,000 people liked it.
Commers replied: “Yes, it IS normal.”
The video has been viewed over 1.8 million times. With the power to reach so many people and show them they aren’t alone in how they feel, she said she hopes she is filling a gap.
“Social media is changing every component of life,” she said. “Now, it’s even changing sex ed.”