Ahhh the TikTok algorithm: She’s mysterious, all-knowing, chaotic — and perhaps more supremely influential than we realize.
In the time since TikTok first emerged — largely as a platform for quick-turn dance routines to be replicated ad infinitum — the social media platform has aged into a community for just about every niche population in possession of a smartphone. Think of it like Reddit for Gen Z: There are threads, subcategories, canals of information. There are rabbit holes buried inside of rabbit holes, places for nuanced kinks and cultural subgroups. And since the algorithm keeps track of your activity, it submerges you deeper into your own pocket of the internet. Emma Turetsky, an L.A.-based copywriter, even says TikTok “knew” she was gay before she did: “Suddenly, I was being fed videos about Jewish lesbians from Brooklyn moving to L.A. and coming out to their fathers long-distance…all of which was uncannily true of my own life.”
Simply put, the app has the capacity to make us feel “seen.” And when it comes to matters of sexuality, in particular, that validation is key: “As doctors in the sexual wellness space, we have to meet people where they are. And right now, the place to be educating young people about sexual health, or answering their burning questions is not in a doctor’s office. It’s on TikTok,” says Dr. Heather Irobunda, a registered OB/GYN with nearly 40,000 TikTok followers.
What she’s referring to is something of a digital sexual revolution: TikTok is changing the way we approach sex education. In a world where sex ed still consists, alarmingly, of Coach Carr-like diatribes (“Don’t have sex. You will get pregnant. And die.”), we’ve long needed a platform that speaks to the individual nuances of our contemporary sexual landscape — from pleasure to consent to contraception. And right now, it seems that TikTok is the answer.
According to a 2021 reader survey conducted by Refinery29 and VICE Insights, the picture of high school sex education is pretty bleak. Of the 80% of respondents who said they’d received a formalized sex education in middle or high school, only 5% — yes, five — said they felt their curricula actually prepared them for the real world of intimacy. Moreover, 72% said their respective courses never touched on female pleasure, 52% said they hadn’t discussed the topic of consent at all, and 80% said they hadn’t even broached sex as it pertains to the LGBTQ+ community. Which is to say, sex education as it currently stands is — unsurprisingly — thoroughly out of touch.
More broadly speaking, from a policy standpoint, the shortcomings of our school-sanctioned sex education programs are pretty glaring. A 2021 study by the Guttmacher Institute found that only 28 states (plus D.C.) in the U.S. mandate sex ed and HIV education at all — and of those, only 18 require program content to be medically accurate. Moreover, a whopping 28 states require that educators stress abstinence.
This isn’t new information. In fact, for decades, folks have been seeking out alternative ways of learning — and talking — about sex to supplement lacking sex ed lectures delivered in high school gymnasiums. In recent history, queries about sexuality have been posed to glossy magazine columns, YouTube channels, or Google — but none seem to meet Gen Z where they are at this particular stage in time. “At first, I thought I had no place on TikTok because I can’t dance,” says Dr. Jennifer Lincoln, OB/GYN, “But I had other doctor friends encourage me — and it didn’t take long for my first video on consent to go viral — which was pretty tangible proof that this was a place to reach young people, and they wanted to listen.”
A quick scan of Dr. Lincoln’s TikTok profile shows a majority of video thumbnails with written questions from patients (“Can birth control hurt your sex drive?” or “Is period pain normal?”). You’ll find information on everything from the Texas abortion ban, to period tracking, to shower sex. “Orgasms can be really awesome — but when you can’t have one, it can be really stressful,” she explains in a video posted in June with over 360K views. And while the video runs a mere 57 seconds, for many young women — namely, the 72% of teens who made it through sex ed without delving into female pleasure at all — that near-minute could eliminate years of mounting anxiety about the nature of climax.
“In all honesty, I didn’t even understand how to track my own period until I was in medical school,” says Dr. Irobunda. “But so many of the questions I receive from my patients — and in comments on my TikTok page — are things you shouldn’t need access to a doctor or a medical education to find answers to.”
As she sees it, paying a visit to an actual doctor can be a major barrier to entry for most young people — either logistically or financially. So, answers to questions like “How do I track my period?” or “Is silicone lube safe to use?” ought to be available in places where folks can find them without adult assistance or supervision. “Frankly, I get the question, ‘Does my vagina smell weird?’ 10 times a day,” Dr. Irobunda explains. “Thank god there are platforms like TikTok where I can reach millions of women at once to answer that query — and hopefully put some folks at ease.”
Better yet, TikTok’s elusive all-seeing algorithm has the power to deliver content in the sexual wellness space you didn’t yet know you wanted. While you scroll, it saves details about your preferences and your preoccupations so it can tailor videos to you — which is to say, if you’ve watched a couple of videos about sex or relationships, you may find yourself served information about other intimacy-related topics. “The algorithm feeds off your activity on the platform. It measures your engagement with the content that is being served in the ‘For You’ page, then uses that information to show you more content based on your interests,” explains Eric Zhao, CEO and founder of influencer marketing initiative Open Influence. “Over time, it gets smarter and learns what attributes drive your engagement.”
Zhao believes TikTok is a brilliant tool for educators. Beyond the wisdom of the platform’s algorithm itself, he says the nature of the platform — which only allows users a three-minute maximum — pushes creators to find ways of engaging their viewers in supremely succinct, digestible ways. “TikTok is the perfect micro-learning tool,” he explains. “And for young people, we’re already seeing results in that format of learning in math, science, physics, dating, psychology, sexual education, finance, and more.”
Sex education in the TikTok space isn’t purely academic, though. The platform is also key when it comes to normalizing aspects of sexual identity, or helping users work through more personal questions surrounding intimacy, sexuality, and even trauma.
“I felt like I’d been fortunate enough to have a pretty comprehensive sex education growing up, so I wasn’t on TikTok to learn about my biology,” shares Chloe Williams, a New York-based undergraduate student. “But I’d been having a tough time feeling present during sex, and I wasn’t sure what was going on or how to talk to my friends about it until I came across a TikTok video explaining all the ins and outs of sexual dissociation.” The video featured a therapist describing a sexual experience that felt eerily similar to her own, and it explained how performative or self-conscious aspects of sexuality, or the ways in which we derive our behaviors from movies or porn can give way to feelings of dissociation. “When I first saw it, I was shocked. I kind of wanted to cry,” Williams recalls. “Then I read the comments, and I realized so many people were having the same experience as I was, which was really what I needed. I just wanted to feel like I wasn’t the only girl in the world who felt this way.”
For Dr. Clark, that very experience is paramount. In the comments sections on her videos, she says she often encounters notes thanking her for clearing up anxieties about bodily questions, or helping users identify concerns in their sex lives. “Every now and then, someone tells me they had their first orgasm thanks to one of my videos. Or, they learned what they needed to know about safely using contraception. And that is proof that delivering information in this format is so important,” she says.
All of that said, the platform is not without its shortcomings. Unlike in a formalized doctor’s office, content makers don’t need to be registered doctors or authorities in the sexual wellness sector — so there’s ample space for misinformation. Physicians like Dr. Clark and Dr. Irobunda are competing digitally with any number of users to deliver medically sound information. “One of the worst parts about sex education in schools right now is that fact that your curriculum changes so much geographically. What you learn is dictated by where you live — so if you live in Alabama, you may be getting an abstinence-only education,” says Dr. Clark. “TikTok is amazing because it’s available to everyone — it’s where people go to fill in the gaps. But that’s the danger, too: Some of the content does a great job educating, and some of it is terrible and completely false.” And while she’s doing everything in her power to give her audience the tools to tell the difference between medical information and agenda-driven clickbait, there’s simply no way to avoid misinformation entirely.
It’s no secret that our social media platforms lack the tools — and the resources — to properly fact-check content as it’s uploaded. But when it comes to TikTok, those efforts can seem particularly misguided. In the app’s attempts to maintain some level of control over the whirling sphere of rapid-fire information, it would seem it has developed a bit of a reputation for censorship. For any number of doctors and influencers preaching sex-positivity, it can be extraordinarily difficult to broach any topic at all without fear of a video being removed internally. “Almost every video I’ve uploaded about sexuality has been removed by TikTok,” says Emily Sauer, founder and CEO of Pain Perception Project, a patient-founded initiative designed to produce various tools for better understanding — and discussing — pain as it relates to the reproductive system. “It’s incredibly frustrating to make something you feel people are really responding to, especially in the sexual wellness space, and have it removed by the platform.”
Much like the general algorithm, this version of content policing is a bit of a mystery. For most videos removed, the automated message dispatched by the TikTok overlords simply reads, “This video was removed because it violated TikTok’s community guidelines.” For physicians and other sexual wellness figures, most of whom have followed up on multiple counts about video removal, the response from the TikTok team tends to be similarly vague: “Our community guidelines are set up to keep our space safe and welcoming for everyone”.
“Having your videos taken down for totally confusing reasons is actually a huge thing for sex educators on TikTok,” says Dr. Irobunda. “I feel like there are specific words I have to use — like vagina, or vulva — because they feel clinical and I’m a physician. But at the same time, I’m on TikTok to [connect with] people — which means using colloquialisms like ‘blow job’ or even ‘pussy.’ But I can’t tell you how many videos of mine have been removed for using that kind of talk.”
Undoubtedly, there are errors to TikTok’s ways. But whether young people are confronting censorship and misinformation online or in a high school gymnasium seems less significant than the fact that they are exploring personal questions of sexuality and identity. They’re seeking community — and in turn, validation. “Even as a user, I can tell that there are a lot of parts of TikTok that ought to be taken with a grain of salt. It’s not a formal educational space by any means. But still, it gave me the tools to talk about sex with my therapist, and my friends, and my partners — and that’s freeing,” says Williams. “It was the first thing that made me feel like there wasn’t something wrong with me.”
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