'I Teach Sex Ed to Millions on Tik Tok—People Ask About Sex Hurting, Periods and Libido'

I always wanted to be a doctor, there was nothing else I really considered. But it wasn't until I started my rotations during medical school that I really fell in love with obstetrics and gynecology. I specifically loved helping other women and people with uteruses. Historically, and even now, women are regularly marginalized and more so in the doctor's office where they don't always feel empowered to speak up.

I have been an obstetrician-gynecologist (OB-GYN) for 10 years, and so often when somebody comes in to see me for an annual exam and talks about their periods, it's like opening Pandora's Box. When I ask about sex, there is often a pause, so I ask if sex hurts, and they tell me that it's miserable experience. I feel like there is a culture where people don't know how to access information and are typically only taught how not to get pregnant. There is a lack of education and a lot of shame. People say things like, "I know I'm not supposed to have sex, but..." or, "I actually like having anal sex, is that OK?"

When I see women in labor with a catheter in their bladder, so many have said, "how does the baby get out if that's there?" They don't know that the urethra and the vagina are separate. It's not because they're not smart. It's because we so often put these topics in a box where they are not supposed to be talked about. Especially in the U.S. where abstinence only sex education is often taught.

I don't just see these questions from 16 year olds, this spans all ages, and it's sad. I see it from women in their 30s and 40s, people who have had children, or even women in their 50s and 60s who are supporting their daughters giving birth. They hear me talking about a certain topic and ask why no-one ever gave them that information.

Being a female health physician can also be really isolating and lonely. You carry so many people's stories and in OB-GYN everyone thinks the stories you have are happy— sadly they are not. I began following other doctor moms on my personal Instagram account and we just related to each other. Then I saw how they were using their platforms in a professional way and a spark went off.

I can only do so much with people in front of me, but everyone is spending so much time on their phones, so I began to wonder if I could use social media to educate people in a relatable way. There is an idea out there that doctors are scary, we don't listen, or we're condescending. I wanted to show people that I'm just like them. And, because of my advocacy training I can speak out and advocate for access to birth control or abortion services.

I made the jump to TikTok in 2019 very reluctantly, and only because colleagues suggested it. But it's become another way to use my medical degree to educate. It allows me to explain things and show people that there is no shame in saying the words vagina and vulva on social media. We have commercials for viagra and erectile dysfunction so why can't we talk about vaginismus and vulvodynia?

My first video on TikTok was me pointing to questions about sex and sexual health and answering yes or no. It got a million views overnight, and now has 6.4million views, so I thought maybe I had something. The response was mostly thanking me, and people saying they needed and wanted this information.

The videos that get the most views tend to be ones where I am busting myths related to birth control or talking about products that I think are good or bad. I also post videos around things you may not know about going to an OB-GYN like me. I think to many, seeing an OB-GYN feels like a scary secret experience and people are eager to know what it's going to be like.

The most common questions I get from women about sex are, "Why does it hurt so much?" or "What am I doing wrong?" and that makes me sad—there is an internalized idea in women that if sex hurts, it's our fault. The second most common questions are around libido. I get a lot of messages from women who are really desperate, saying their libido is low and nobody is listening to them. They ask if they are allowed to talk about this with their OB-GYN. People don't know where to go for help. The third common question around sex is people who want to know if they're pregnant. I have to say, "friend, I can't tell online if you're pregnant."

The ideas for videos can come from people tagging me in a video about a topic or I may get the same question over and over, say about C-sections. Other times I may wonder why no one has talked about a subject openly—like period poverty or pubic hair care. Recently, I was tagged in a video where a woman talked about how period pain isn't normal and that your periods shouldn't be terrible. I thought everybody knew that if you're dying in pain from your period, that's not normal. So I made a video response saying this woman was right and that you should see your doctor if you're in pain. I've already had more than 390,000 views and 1,400 comments on that post, with people asking questions, saying that they thought it was normal to have pain, and that their doctor isn't listening to them. To me, that is insane. Why are we normalizing period pain?

Sometimes I get comments from men asking, "Why is this on my 'For You' page?" My response is, "welcome to vagina Tok!" Some men are truly confused, but a lot think it's cool. I do create some content specifically for non-uterus owners, explaining what they need to know about periods and what is normal. But in my mind, the content I make is for everybody. Sex education access should not be based on your gender. I'm a mom to boys and if they end up being with a female partner I want them to know what's normal and what isn't.

But I do think it's really dangerous to just get your information from social media. It's hard to get into the nuance of science on these platforms. And, it's crucial to remember that just because someone is wearing a white coat or has a "Dr" in their social media handle does not mean they are a medical physician. If someone is trying to sell you something, it's important to take that information with a grain of salt. For example, if someone is telling you that birth control is making your period horrible and they're trying to sell you a supplement to make that better, they have skin in the game and they are not objective. When people question me, I welcome it. I tell them not to take my word for it and to look at the medical references I have listed. I also suggest they take the information and talk about it with their doctor. Social media should never replace an actual doctor-patient relationship.

I do get paid as a creator from TikTok's #LearnonTikTok educational fund, but I don't get told what to post, it is up to me what to share. I occasionally do directly sponsored posts for products, but I turned down 9/10 companies that approach me, because they are sketchy. I clearly disclose any sponsored posts and only promote something I believe in. As a physician, I hold myself to a higher standard than an "influencer" might. I have taken the Hippocratic Oath.

People have asked me where I see myself in 10 years time. My hope is that by then, I'm not on social media because sex education is taught in a comprehensive, medically accurate way in schools. I hope that parents are taught how to have these conversations and understand that it's not a shameful thing when your daughter asks about her period. I would love to be irrelevant. My dream is that everyone in the U.S.—where we don't currently have universal healthcare—has access to an OB-GYN or reproductive physician with whom they can have conversations about sexual health whenever they like.

Jennifer Lincoln, MD, IBCLC is an Obstetrician-Gynecologist based in Portland, Oregon. Her book Let's Talk About Down There: An OB-GYN Answers All Your Burning Questions without Making You Feel Embarrassed for Asking is available to pre-order here. You can follow Dr. Lincoln on TikTok @drjenniferlincoln.

All views expressed in this article are the author's own.

As told to Jenny Haward.