Is TikTok Really the Solution to America's Sex Ed Crisis?
By the time they graduate high school, half of U.S. teens will have had sex, but only a fraction will see a doctor to be screened for sexually transmitted diseases. And although the national rate of teen pregnancy is the lowest it's ever been, it's still the highest in the developed world. The bottom line? American sex education isn't working.
In 2020, you can’t even try to preach about sexual wellness to a broad audience with an after school special a la Degrassi or Beverly Hills, 90210, but there are millions of tweens and teens scrolling through social media platform TikTok. So some doctors are getting creative with the 15-second video vignette format on TikTok because, as Jennifer Lincoln, M.D., a Portland, Oregon OB-GYN, tells us, “sometimes you have to go where the teens are.”
Dr. Lincoln’s TikTok videos stick to basic facts: Yes, you can get pregnant the first time you have sex. No, you don’t have to have sex if your partner wants to hook up. Yes, you should always use a condom even if your teenage boyfriend assures you that you’re the only one with whom he’s getting physical. And these simple concepts have made her go viral with millions of views and messages from teens “hungry” for information they say they’re not getting in school.
“It's been really rewarding,” she says. “But really sad to see the sad state of affairs that is sex ed in America—the fact that a 15-second video has somehow taught them more than an entire high school education health class.”
Teens Want Safe Sex Information
TikTok’s main audience is right in that sweet spot of kids looking for information beyond a textbook anatomical breakdown of how (nearly always heterosexual) intercourse works. “These are 13, 14, 15-year-olds. They want good information, they want to be able to make good choices, and be empowered and in charge of their health care,” says Dr. Lincoln. “If they're not going to get that in their high school class or around the dinner table, then I’m glad that there are other people putting out this stuff.”
She’s far from the only doctor on TikTok. Search #doctor and you’ll find slightly cringey videos of health professionals dancing in scrubs to “Renegade” and “OK Boomer” (a wink to their reception on the platform—38-year-old Dr. Lincoln admits she’s been called a boomer in the comments). And Dr. Lincoln says her direct messages are full of teens’ queries about “normal” period cycles, birth control side effects, and more.
Laurie Combe, R.N., president of the National Association of School Nurses, says kids’ questions in school nurses' offices are often more convoluted. Teens may come into the office for a stomachache, but as a nurse digs deeper, they may reveal worries about being pregnant or having a sexually transmitted disease (STD) but not know where or how to get tested for either.
Dr. Lincoln says she never gives out medical advice through her DMs and, instead, suggests teens talk to their own doctor. But she says she hopes her presence on social media can empower teens to have those conversations with their general practitioner or OB-GYN. And the doc hopes her light and playful videos help younger patients realize “we're not all scary and we're not going to force them to do things that they're not comfortable with.”
Many of Dr. Lincoln’s DMs include teen fears about getting a Pap test, which she says many young girls don’t know a doctor won’t advise until age 21 (unless there are worrying gynecological symptoms that need a closer look). She also stresses that teens should know they can start birth control without getting a Pap, something not often included in even fairly well-rounded sex ed classes.
The State of Sex Ed
The good news is that more teens than ever are using some form of contraception when they have sex. The bad news is that for teens, the “chance of getting pregnant really depends on where you live, where you grew up, or how much you are taught,” explains Dr. Lincoln, because sex ed differs from school to school and state to state.
Fewer than half of the 50 U.S. states require public schools to teach sex ed—and only 20 states have rules that ensure that the information is "medically accurate" and reviewed by the states' departments of health. That means schools in the other 30 states are free to stress abstinence in their sexual education programs, which studies have shown don't reduce teen pregnancies or STDs.
Combe explains that even when kids are getting information about preventing teen pregnancy in sex-ed class, there still might be a lack of classroom information on STDs, gender-diverse sexual relationships, and consent. It's the information that helps teens build healthy sexual boundaries, and exactly what doctors are sharing on TikTok in hokey, myth-busting video formats.
What Parents Can Do
“TikTok should not be the great equalizer of health education,” says Dr. Lincoln. So left to fill the gaps between school and social media, what can a parent do? The answer is simple. Talk about sexual wellness at home.
“This starts well before they're teenagers,” says Dr. Lincoln. “By the time most parents think they need to be talking about it with their teenagers, these teenagers have already had sex or been exposed [to sexual material] or have heard 27 different ways that they can get pregnant or can't.”
Dr. Lincoln suggests parents make a first gynecology appointment for kids with uteruses between the ages of 13 and 15, regardless of a tween or teen’s sex life. “It’s not to say that we're going to start them on birth control, but so that they know: This is what this doctor is, here's what they do, here's what we talk about,” she says. “It doesn't mean that they're going to start having sex, but that they know that there's a doctor that's there for them.”
Combe also recommends parents get involved with sex ed at school. You can ask what information is covered at what ages and whether the curriculum has been vetted by a medical doctor. “You have to decide what kind of information you want them to get,” Dr. Lincoln reminds parents. “If you're not going to do it, your kid is going to get it from somewhere else.”
And in 2020, somewhere else is inevitably the internet. But it’s infinitely better if health information comes from a doctor on TikTok, no matter how cheesy the soundtrack, than a fellow teen polling Reddit.