TransTok - An analysis of surgical gender affirmation content on TikTok

Purpose: Social media platforms are popular sources of medical information but may harbor harmful misinformation. This study aims to evaluate the effect of TikTok on the transgender population, which may be more likely to seek information from non-traditional sources because of high medical mistrust. Methods: Twenty gender affirmation related hashtags were queried, with the top 25 videos per hashtag included for analysis. Videos were categorized based on the content and creator. Variables included likes, comments, shares, and video views. All "educational" videos were analyzed for reliability of information using a modified DISCERN (mDISCERN) score and the Patient Education Materials Assessment Tool (PMAT). Kruskal-Wallis H tests, Mann-Whitney U tests, and simple linear regression models were used in analysis. Results: A total of 429 videos amassed 571,434,231 views, 108,050,498 likes, 2,151,572 comments, and 190,9744 shares. Patients were the majority of content creators (74.88%), with patient experiences being the majority of videos (36.07%). Non-physician creators had significantly higher likes and comments when compared to physicians (6185 vs. 1645, p = 0.028; 108 vs. 47, p = 0.016 respectively). Sixty "educational" videos were included in information reliability analysis. There were no significant differences between video characteristics of different content creators, even after stratifying according to physician status. Significant differences were observed in the reliability of information according to PMAT and mDISCERN scores, with physician created videos being significantly higher rated than non-physician created videos (0.90 vs. 0.84, p < 0.001; 3 vs. 2, p < 0.001, respectively). Conclusion: Lower quality information is associated with non-physician content creators. We encourage physicians to be continuously involved in creating quality information on TikTok. (c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.