One of the most recent Instagram posts by Karen Tang features her performing to the ROSÉ and Bruno Mars song “APT.,” a catchy retro single that has spawned a dance craze across social media.

Tang, a Main Line gynecologist, (mostly) doesn’t dance to “APT.” Instead the song plays behind a short, jaunty, graphic video playfully named “Getting ready to snatch out some TUBES for a woman who wants a sterilization.” In it, Tang performs a quick lesson through an actual patient’s tubal ligation; it ends with the camera turned on the patient, post-surgery, giving a thumbs-up to the camera.

The video is unexpectedly fun and joyful. And why shouldn’t it be? As one of the dozens of commenters put it, “Yassss for listening to women when they say what they want!” (This is still a rarity for women who want sterilizations.)

Tang has been making videos of this sort for about six years, as a way to answer for the masses the questions she often fields in her OB-GYN practice. So far, she’s made about 1,000 posts, mostly cross-posted on Instagram and TikTok, ranging from surgery videos to health-related political commentary (“I need to talk about DEI and cabinet nominees. As In Didn’t Earn It,” she says in one. “RFK is as qualified to run Health and Human Services as I am qualified to run the NFL.”) to lessons about everything from endometriosis to cramps, birth control and menopause.

Tang went viral during Covid, along with many other health influencers, and has since amassed a huge following: 205,000 on Instagram, 464,000 on TikTok. Her most popular video, on hysterectomy, has garnered 15 million views and counting. That may be as much about the entertainment factor in Tang’s serious work, as about the fact that it is harder than it needs to be to get the information women need for their health.

“It’s fascinating which videos people will latch on to, like what things people are kind of secretly going through,” says Tang, who has her own practice in Bryn Mawr, Thrive Gynecology. “It’s like they thought they were the only one. But you see thousands of other people are going through the same thing, and don’t feel quite so alone. I think part of the draw is these unspoken things that you know are actually much more common than people realize.”

I caught up with Tang a few weeks into a new presidential administration that has its sights on women’s reproductive health to talk about why social media is the right place for this conversation. This interview has been condensed and edited for clarity.

Roxanne Patel Shepelavy: The idea of a women’s health TikTok account is so … odd to me. What inspired you to take to social media for this work?

Karen Tang: I’m a gynecologist; my training is in minimally invasive gynecological surgery. The specialty goes hand in hand with chronic pain and things like endometriosis, where there’s oftentimes a long delay before people are diagnosed, because a lot of the symptoms — like painful periods, bowel problems, bloating, mood symptoms — get dismissed or very normalized. So, in my day job, I was doing a lot of educating and seeing people at the end of what had been a many years process of just bouncing between doctors and feeling very unheard, and struggling to get care.

I didn’t actually do any social media at all, like even on a personal level until about 2018, when a friend of mine at a conference said she was on Instagram, and that this is how people get their health information now. People aren’t going to their doctor and asking all these questions; they’re scrolling through YouTube, they’re going on Facebook groups. So I started on social media just to educate about these things, and partly just to let people know that I existed as a doctor and where to find me.

 

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A post shared by Karen Tang, MD – Gyn Surgeon (@karentangmd)

And like a lot of health influencers, it really blew up around Covid, when there was kind of a captive audience. People were looking for health information when they were stuck at home, and looking for human connections, so they went to TikTok and things like that in droves. So I amassed a large following, just talking about very basic stuff — like period poops, or symptoms of endometriosis, or what to do if you’re bleeding too much.

My first viral video, though, wasn’t even necessarily about gynecology. It was about gender and biological sex. I was responding to a Marjorie Taylor Greene comment about how there’s only xx and xy people, and “that’s the science.” I tossed off a video explaining about intersex and gender diversity, biological sex diversity, and it really took off. Celebrities, like George Takei, shared it, and that led to a huge social media following.

Were you surprised that that was the video that went viral?

I was definitely not expecting it. I just kind of dashed it off in the moment, because I was so furious at that comment, knowing how medically misinformed it was, but also using the language that “this is the science.” My hair isn’t brushed; I look all crazy because I was not expecting, like, anybody to see it.

Why is this needed — like, why are we not just told these things as we grow up?

For so long, women were either thought to be just so fragile that they overreacted to everything, or that there’s something broken about their body parts, and therefore, you know, we just expect that your body parts are going to be broken, and your period’s going to be horrible, you’ll have pain with periods, menopause. There’s a lot of just cultural normalization of women’s suffering. If this happened to men, nobody would expect them to just deal with debilitating pain and vomiting, several weeks out of every month.

I don’t think people go into becoming an OB-GYN intending to do it badly, but the cultural messages get absorbed. And so if you have a woman who comes in and she’s complaining about fatigue, bloating, vomiting, diarrhea, leg pain, bleeding problems, pain with sex, headaches — these are all endometriosis symptoms. But you get that long laundry list of symptoms, and people are like, wow, that person’s just really overreacting. There’s a kind of dismissal of some of these things, like they’re not that bad.

That also leads to the underfunding of research for women’s health, which was not considered real medicine, like heart attacks or diabetes. There’s much, much, much less funding for women’s health issues than for any of those conditions. And then you end up with fewer options for women.

It’s like we don’t believe science anymore, we don’t believe what health experts or researchers are telling us, we’re going on vibes and acting like we’re making things healthier by taking away these scientific interventions that have actually helped people.

Do you think that’s getting better? Like, I feel like people are talking about menopause a lot these days.

Yeah, menopause is having a moment. Social media has lots of downsides to it, including the spread of misinformation. But one of the goods is people coming together and realizing that we should be speaking out about these things. We’re at a moment where women don’t necessarily feel alone. Even a lot of celebrities have started talking about menopause, for instance, like Halle Berry and Oprah and Drew Barrymore. They have really pushed for funding, they are lobbying Congress, and femtech businesses are realizing there’s a huge market for taking care of women. So I think it is actually an exciting time for women’s health for the first time in human history.

President Biden last year announced a $1 billion women’s health research initiative, which was a first. Are you concerned about the new administration and women’s health?

Yeah. Like a lot of gynecologists who are on social media, I did a lot of video education leading up to the election, trying very, very hard to explain the stakes. It’s not just about abortion. There’s a perspective in many conservative circles that things like IUDs and emergency contraception are abortifacients, when they’re not.

In this current administration, so much of these decisions and leadership positions are given to people who, like RFK Jr., are extremely misinformed in so many different things. One of the things RFK Jr. has been most vocal about has been the HPV [human papillomavirus] vaccine, which has saved countless lives, even, in some countries, eliminated cervical cancer altogether.

It’s like we don’t believe science anymore, we don’t believe what health experts or researchers are telling us, we’re going on vibes and acting like we’re making things healthier by taking away these scientific interventions that have actually helped people. That rhetoric has been used against emergency contraception, IVF, abortion, birth control — people are saying birth control makes you infertile, changes your brain and harms your body. That’s not true. It is very scary.

What’s your most popular video?

That was actually about hysterectomy. It has 15 million views on the dot, 118,000 shares, and like 28,000 comments. And it was literally a little video clip of me doing a hysterectomy. It was like an anatomy lesson, because nothing looks like it does in the drawings. And the reaction was hilarious. People will do something called duets, where they show themselves reacting to a video. So there were men reacting, like, What?! Someone played a guitar and sang a song about it, which was amazing.

I feel like one of the things that has gotten us here is that we don’t have good science communication — which is the fault of both journalists and scientists. How much does that play into your work?

I take that very seriously. I say that I’m like an anthropologist, or like a translator, bridging the languages of the general public and the medical profession. Social media is how people communicate, how they find and absorb information. They take it as fact, and then make their health decisions, so you need to be able to interact with your patients who are doing that.

Watch on TikTok

There’s a couple of different ways to approach it, and one is to use the language and style that people are used to. So on Tiktok, it’s very rapid fire. I talk super fast. It’s lots of graphics. It’s lots of attention-grabbing first sentences, which may seem sensationalistic — though they’re always true — and then breaking down the science.

For instance, something that a lot of us gynecologists and science communicators took on recently was this whole thing about tampons and toxic metals, like arsenic and lead. You probably saw that all over the place. People were like, Oh my God: Everyone’s poisoning us. But when you looked at that particular study, they basically had to heat the tampon material to, like, 400 degrees, and subject it to crazy acid to break it down, and then the amount that came out was less than what’s in bottled water, fruits and stuff. It’s a naturally occurring element.

I was very proud that everyone in the science communication social media community came together, people in the UK, research scientists, gynecologists all kind of jumped in. You can’t just scare people like that.

What are the most important things you’ve talked about?

I’m actually very moved whenever someone messages me and says, You gave me the motivation to keep on searching and then to get an answer. So to get diagnosed with endometriosis, to get treatment for perimenopause, to talk to a doctor who was going to take me seriously.

I have a lot of messages from parents of transgender kids who have been, like, Thank you for speaking up for our kids. In this very broken system where people are really struggling, it gives them a direction and steps to take.

How much time does this take you?

It can be a lot. It depends on the format of the video, like if it’s one that requires a lot of research. I might need to research stuff for an hour beforehand, and then shoot it, edit it, post it, put a caption and then respond to comments — that takes another one to two hours. It’s become, like, my main hobby — that and reading novels.

I have three kids, too, so it’s definitely time intensive. It’s easier now because I have my own practice and set my own hours. There are some people who hire video production teams to do all this, but I like to keep it authentic so it’s actually all me. I like to make it like I’m talking off the cuff. That being said, I’m a perfectionist so I’ll do a million takes and edit it together.

This all led to a book, too, right?

I have a book called It’s Not Hysteria that’s about gynecologic reproductive health — gender diversity, abortion, birth control, endometriosis, perimenopause and menopause, basically everything you need to know about reproductive health, but we’re never told. Again, it’s about trying to bring information that people should have so they can make health decisions for themselves and advocate for themselves, but that, generally, our healthcare system doesn’t provide.

And has it helped your business?

Oh, absolutely, yeah, because people know who I am. I have people coming to me from all different states who find me through social media, or patients who were recommended by doctors or therapists I’ve never met but who saw my posts. It’s helped to get my name out there, and given people the sense that I will listen and believe you, and will help you figure out what’s going on. They’ve heard me talk. They’ve seen my kids.

I think they form that relationship a little bit like they know me. That removes one of those barriers to having a really good doctor-patient relationship, so it feels a little bit less intimidating, especially with vulnerable things like when you’re talking about sex, your periods, your pelvic floor, your bladder … It’s not a natural thing for people to feel comfortable talking about. But with me they’re like, Oh, Dr. Tang. She talks about vaginas all the time on TikTok.

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