Some of TikTok’s biggest stars aren’t teen influencers or adorable pets – they are OB-GYNs posting sex education videos.

Need to know if you can continue to take antidepressants while pregnant? Dr Keith L Riggs, a Houston-based OB-GYN, has got you covered. Want to see how an IUD is inserted into the uterus? Check out a demo on the Dallas physician assistant Shay Blue’s page. Have questions on what sex position is most likely to get you pregnant? Dr Ali Rodriguez – aka the Latina Doc – made a video for that. (Spoiler: it’s whatever position you like the most – no method has emerged as a scientifically proven best choice.)

All kinds of doctors have joined TikTok. There are plastic surgeons and dermatologists who gleefully post videos hypothesizing what work an actor has had done. Dentists film videos – equal parts terrifying and mesmerizing – showing what plaque looks like as it’s scraped from teeth. If you really want to see footage from a colonoscopy, hit up the urology corner of #healthtok.

But those who practice #OBGYN – a hashtag that has over 5bn views on the app – enjoy a particular kind of virality. And some of the most popular have parlayed their online fame into other ventures.

Dr Jennifer Lincoln, who has 2.8 million followers and claims to offer “the health class you wish you had in high school”, published a book on reproductive health in 2021 and hosts a podcast where she answers listeners’ questions about all things sex. (Recent episodes include A Summer Period Survival Guide and Myth-Busting the Morning-After Pill.)

“There’s just a lot of people out there who do not know how to access things,” Lincoln, who lives in Portland, said. “Commenters have asked about anything from birth control to a pregnancy test. These are basic things we would have hoped to have been covered in sex ed, but that’s not the case in the majority of states.”

Americans have been receiving inadequate sex education for decades – but in the last year, things have become even worse. The supreme court’s reversal of Roe v Wade has led to a flood of abortion misinformation online, and Florida’s “don’t say gay” law means that teachers can no longer lead classroom discussions on gender identity or sexuality. As LGBTQ+ students continue to be marginalized across the country, they lack information that can help them understand their bodies and cultivate a sense of autonomy.

A few years ago, people with concerns about their reproductive health might hit up anonymous Reddit boards for help – now, they can take their pick of TikTok experts to follow.

Dr Danielle Jones, who goes by @mamadoctorjones on TikTok, said she had joined the platform because that’s where the kids are. “It’s a good venue to do some sex education and dispel myths about things that impact people who are younger,” she said. “We know that if we can get into their heads early and dispel misinformation before they encounter it, it can keep them from falling down the rabbit hole.”

And there are a lot of myths to dispel. Though Planned Parenthood reports that the vast majority of parents support having sex education taught in middle and high school, the US is pretty terrible at teaching it. Only 30 states and the district of Columbia require sex education classes in schools, and those that do may stress harmful abstinence-only narratives or spread medically inaccurate information.

Since the fall of Roe, Lincoln’s teen viewers have reached out to her after applying to college in states where abortion rights have been gutted, such as Texas, Florida, or Oklahoma. “They’re really scared, and they’re not sure if they’ll be able to access contraception,” she said. “Parents will also message me saying, ‘My daughter is going to college, she has her heart set on the University of Texas, but I’m scared for her. What should I do?’”

Lincoln’s answer: “Let’s talk about birth control and get Plan B and abortion pills ahead of time, just in case. You may not think this is a conversation you have to have with your daughter, but in 2023, you do.”

Jones, who practiced obstetrics in Texas before her family moved to New Zealand in 2021, said many of her followers reach out to her with questions they do not want to ask their primary care physicians.

“In states like Texas, people are concerned about who they can safely ask about contraception,” she said. “If you don’t know how your healthcare provider feels about abortion, you don’t know if you can trust them.”

Tiffany Connolly, a 26-year-old from Grand Rapids, Michigan, has learned helpful information from OB-GYNs on TikTok. “It’s a useful source when it can be difficult to pinpoint certain things within my body,” she said. “I can’t always just call up a doctor or make an appointment right away.”

Connolly, who does not want children, plans to get a tubal ligation after her IUD expires next year. Young people who seek sterilizations often have to visit multiple doctors before finding one who will agree to provide it, but Connolly found a spreadsheet posted by Dr Franziska Haydanek, a Rochester, New York, gynecologist with more than 300,000 followers, that lists the names of doctors across the country who are known to safely and responsibly perform the procedure on unmarried and childless patients.

Haydanek posted the spreadsheet last summer, right as the reversal of Roe v Wade pushed more women to consider the procedure as a means of permanent birth control. Since then, the video has been viewed over 50,000 times.

Krysten Stein, a PhD candidate in media studies, has written about TikTok gynecologists for a communications journal. “I wanted to know why these videos were getting so much traction,” she said. “When people seek these kinds of resources online, it’s often because they don’t have access to health insurance or doctors.”

Stein has polycystic ovary syndrome, which can cause irregular periods and pelvic pain, but often goes undiagnosed by doctors who downplay its symptoms as normal period side effects.

Years ago, Stein found refuge in online forums like Reddit, where she finally engaged with people who took her pain seriously. She suspects that people on TikTok form a similar kind of community on the app. “It’s a platform where you can see other people who might be experiencing the same thing as you are,” she said.

Samantha Broxton lives in southern California and frequents OB-GYN TikTok, where, the 35-year-old mom said, she had learned things she wished her own doctors had told her years ago. It’s been a resource for her, but she also wonders what type of care TikTok OB-GYNs provide their patients offline.

“If they’re talking about inequalities in medicine on TikTok, I want to know if they’re vocal about it too in the workplace,” she said. “Are they working to improve the system, or is it just easy to talk about doing that online?”

The American College of Gynecology and Obstetrics does not give doctors specific rules on how to use TikTok, but some hospitals and institutions have social media policies. For the most part, Stein said, doctors are on their own when it comes to deciding what information is appropriate to include in a TikTok.

They don’t always get it right. Last year, four obstetrics nurses were fired from an Atlanta hospital for making a video mocking expectant mothers. Emory hospital, which employed the nurses, later released a statement saying the video was “disrespectful and unprofessional”.

Should OB-GYN influencers take money from brands? When Stein interviewed some for her paper, there was no general consensus. Certain TikTok OB-GYNs said they would only accept deals with brands that felt aligned with their values – they were not just taking cash from anyone. Others were less judicious.

“Some of them said, ‘I want to be a content creator full time,’” Stein said. “There were a lot of moral questions that came up around that. There are no rules, and right now it’s based upon the specific person’s moral compass.”

And how do you know someone is actually a doctor, and not just playing one on TikTok? Lincoln noted that some creators are misleading in their credentials, calling themselves “hormone experts” in their bio. “That’s a term some people use after reading a book or taking a weekend ‘course’ – so, meaningless,” she said.

There are also chiropractors, anesthesiologists, and generalists who are not reproductive health experts dispensing advice on the subject. “It’s really confusing to people, because they [sometimes] see MD in the handle and think they’re experts, though they’re not experts in the field,” Lincoln said. “This harms the OB-GYN TikTok space because these grifting experts often throw our field under the bus.”

Actual gynecologists worth a 30-second watch, Lincoln says, are ones who cite their sources or at least let their viewers know when something is their opinion rather than a studied fact. “As a rule, when I’m explaining something medical, I always give references,” she said. “We need to be transparent about what we know and what we don’t.”

Jones believes the most urgent part of her job right now is spreading accurate information about abortion rights. She grew up in rural Texas and described herself as pro-life until going to medical school changed her mind. Now, she hopes to help others come to the same conclusion.

“I’ve had people reach out and say that I’ve helped them see abortion rights from a different perspective,” Jones said. “It’s one of the most meaningful things I can hear: ‘Two weeks ago I would have called you a murderer, but now I support the right to choose.’”

Still, she knows the limitations of TikTok activism. “What I do online is valuable, and it’s a great supplement, but it’s not going to fully replace sex education,” she said. “Young people need that, and we know the outcomes are not going to be good when they don’t receive it in schools.”