Baltimore Sun


Medical experts are exposing the wealth of health disinforma­tion on the social media platform

- By Rina Raphael

“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.’ ”


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