DEBUNKING TIKTOK MYTHS
Medical experts are exposing the wealth of health disinformation on the social media platform
“I’m willing to bet you know at least one girl that’s using steroids every single day,” starts a young man in a TikTok video.
He continues his big, yet notably false, reveal: “One in three girls these days is taking the birth control pill, and believe it or not, the birth control pill is actually an analog of the bodybuilding steroid nandrolone.”
Another face swiftly crowds the screen. Dressed in a white lab coat, debunker Mustafa Dhahir, a practicing pharmacist and medical student based in Australia, interrupts the video with his own commentary: “One of the most annoying things when it comes to busting misinformation is that the people who spread the misinformation use hints of truth to spread their lies.”
Dhahir explains what a steroid is and then goes point by point to illustrate why the original video — which claims oral contraception causes a medley of symptoms, including changes in sexual attraction — is inaccurate.
Dhahir is part of a growing cohort of scientists, physicians, health care professionals and academics who debunk health misinformation on TikTok by “stitching” videos, which involves clipping existing videos into new ones and then offering one’s own input. While social media platforms including TikTok have developed systems to flag vaccine misinformation, an ocean of other dubious health claims often go unscrutinized — except when individual users like him, who have actual medical knowledge, push back.
“Misinformation impacts medical decisions and health,” said Dhahir, who began responding to false claims on TikTok at the start of the pandemic and has since amassed 9.5 million likes on his videos. He has debunked claims that contraception makes women infertile, that only “natural” medicine can be trusted and that Tylenol is linked to autism.
The work is often draining. Unqualified influencers posting misinformation far outnumber the experts debunking it, who are often harassed by other users for their efforts.
“For every large creator who is genuinely evidence-based, you’ve got 50 or 60 big creators who spread misinformation,” said Dr. Idrees Mughal, a Britain-based physician with an additional masters in nutritional research, whose account, @dr_ idz, has 1 million followers. He debunks fad diets, unsupported claims that food ingredients are “cancer-causing” and the myth that certain vegetables contain harmful “toxic” chemicals.
Misinformation is widespread on all of the major social media platforms, but TikTok’s audio capabilities can give false claims particular longevity.
Bits of misinformation clipped and saved as what TikTok calls sounds “operate like viral chain messages,” according to a 2021 blog post from the Institute for Strategic Dialogue, a Londonbased center that researches disinformation and extremism online.
TikTok has enacted policies to flag such content, including adding informational banners to COVID-19 vaccine content, but one ISD study of more than 6,000 videos related to the vaccines found that 58% lacked banners. In a statement, TikTok wrote, “We work diligently to take action on content and accounts that spread misinformation, while also promoting authoritative content about vaccines through our COVID-19 information hub.”
When asked if TikTok was addressing general health misinformation, the company replied that it both removes violations of the platform’s policies and works “with credible voices to elevate authoritative content on topics related to public health.”
In TikTok’s beauty circles, Michelle Wong, a cosmetic chemist who runs Lab Muffin Beauty Science, a blog and social media accounts that explain the science behind skin care and cosmetic products, has made a new career out of fighting misinformation. She often encounters creators who take ingredients out of context. Wong also sees pseudoscience creators who back up false, fearmongering claims about sunscreen with white papers the creators either do not have full access to or do not understand. “That in itself is quite convincing, because very few people are actually going to look up every single paper listed,” she said.
The lack of science literacy online was partly what inspired Katrine Wallace, a public health researcher and a professor at the University of Illinois at Chicago, to start debunking inaccurate content on TikTok. At the start of the pandemic, she noticed that users were debating whether COVID-19 was even real, and she has since debunked videos stating that COVID-19 vaccines cause death within six months, for example, and that microscopic worms or parasites are found in surgical face masks.
In refuting claims, debunkers try to engage respectfully with other creators. Mughal said he refrained from insulting or attacking creators who disseminated misinformation and instead focused on addressing the health claims. Wallace takes a different approach. She said she would first reach out privately to the original poster to explain why the video is problematic and urge them to take it down or publicly address the misinformation. “And if they block me or delete my comments,” she said, “then I’m like, ‘OK, it’s on.’ ”
The business of debunking is time-consuming. Scripting, filming and editing, not to mention managing comments — which also breed misinformation when users share counterarguments — can take hours each day. To attract an audience, each video must accurately convey the science but also must be entertaining and approach the topic with nuance and sensitivity, all while grabbing the viewer’s attention within 15 seconds.
When Wong was a full-time science educator, she found herself working an extra 30 hours a week creating content for social media and her blog. “It was just destroying my personal life,” she recalled, adding that her relationship with her partner had ended partly because she was spending so much time on content creation.
Once a debunker has an audience, the work of maintaining and building an account can also lead to burnout. Like most influencers, they put pressure on themselves to excel. As Dr. Austin Chiang, a gastroenterologist with more than 500,000 TikTok followers, explained, they often blame themselves if their content underperforms.
Wallace said the most exhausting element, though, was the harassment. Commenters repeatedly insult her, and when she posts in favor of vaccination, they accuse her of being a “shill for Big Pharma.” She also received threatening and sexually violent messages through her university email account — a situation that she said had required the university police to become involved early this year.
For health care professionals, harassment can also lead to professional consequences or the fear of them. Dhahir considered quitting TikTok after users found the address of his pharmacy and spread rumors about his professional and personal lives. He also had to meet with the dean of medicine at the University of Sydney and explain why the university had received complaints.
Despite the hurdles, debunkers do see their efforts paying off. Followers have told Wallace that they got vaccinated after watching her videos. Chiang heard from viewers who got screened for medical conditions they might have otherwise ignored. And Dhahir’s fans sometimes reach out to say thank you.
“They’ll say, ‘I appreciate everything,’ or, ‘You’ve inspired me,’ ” Dhahir said. “Then I’ll be like, ‘You know what? This is actually worth it.’ ”