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  • Parents, make sure your kids understand that a TikTok video is not authoritative, even it has 10 million likes.  Tweet This
  • Girls who post videos on TikTok soon discover that their online popularity is linked to their sexuality. Tweet This
  • Screen time controls and parental monitoring apps may be a lot of extra work for parents, says Dr. Sax, but if this decreases the risk of more teens becoming anxious and/or depressed, I think it's worth it. Tweet This

How much do you know about TikTok? Maybe you’ve heard of it but haven’t used it. Or if you have used TikTok, you may think of it as an app for sharing videos of teens doing funny dances or cute pets doing tricks, which it is. But it is more than that. 

For starters, TikTok is now the world’s most downloaded app and the world's #1 most visited website, ahead of Google (#2) and Facebook (#3). Every day, more than one billion different videos are viewed on TikTok. Experts agree that the key to its success is its unique algorithm. When you join TikTok, you are asked some questions about your interests and what sort of things you’d like to see. TikTok then offers you some of the most popular videos that match your interests and starts monitoring what you do. It takes note of which videos you watch and—crucially—how much time you spend watching them, and which videos you watch more than once. The algorithm then hones your preferences. Within hours, or even minutes, your videos become more specific, more customized to your interests.

The results are uncanny. "TikTok can read my mind" is a common refrain among young people, as the app soon starts serving up videos that are precisely what the viewer was hoping to see: whether it’s a funny cat video, or a video of synchronized swimming, or one about applying glitter make-up, or a video of a pretty girl dancing in a way that appeals to a particular teen boy and wearing precisely the outfit that boy finds most arousing, doing exactly the moves that the boy finds most irresistible. And the same is true of sexual variations. "TikTok knew I was bisexual (or gay, or trans) before I did" is a common trope online. 

Is TikTok Harmful?

TikTok is customized. It can be addictive. But is it truly harmful to teens? 

That depends on how a teen uses it. 

Adolescence can be confusing. Young people are struggling to figure out who they are. Increasingly, they are looking online for clues and for guidance. Doctors at Texas Children’s Hospital used to see one, maybe two teenagers a year presenting with new-onset Tourette syndrome. Between spring 2020 and autumn 2021, that number skyrocketed to about 60. Psychiatrists worldwide—from the South Atlantic island of St Helena, to New Caledonia in the South Pacific, to almost anywhere on the planet where kids have access to the Internet—began reporting a surge of teenage girls self-diagnosing with Tourette syndrome. Many of these girls are shouting out "beans!" at unpredictable intervals. Psychiatrists in England call these girls "Evies" because their behavior resembles that of Evie Meg Field, whose TikTok videos have earned her more than 14 million followers and more than 500 million likes. In a characteristic video, Evie shouts out "beans" uncontrollably. In an earlier era, the sudden appearance of myriad teenage girls shouting out "beans" might have been called mass hysteria. Today, the preferred term is "social media induced illness." 

Other issues can lead quickly down a rabbit hole. Go to TikTok and type "how can I lose weight?" and it will offer many options. The TikTok hashtag #diet has had over 11 billion views. There, you will find videos encouraging viewers that simply doing some planks and leg lifts will result in becoming slim in just 16 days (that particular video has had over 32 million views). Scrolling through the videos, it’s easy to be drawn into a spiral of more videos that speak directly to an individual situation. Alyssa Moukheiber, a dietitian at a residential treatment center for eating disorders in northern Illinois, says, “The TikTok algorithm is just too freaking strong." The algorithm sucks girls into a world that promises physical perfection for just trying a little harder. 

Girls who post videos on TikTok soon discover that their online popularity is linked to their sexuality. Newport Academy is an Atlanta-based treatment center for eating disorders. Crystal Burwell, the program’s director of outpatient services, recently noted that 60% of the girls treated since last summer have posted "sexually inappropriate" videos on TikTok. A similar observation comes from Paul Sunseri, director of the New Horizons Child and Family Institute in El Dorado Hills, California, who is concerned about the growing number of girls who are posting sexualized videos on TikTok. “For a young girl who’s developing her identity, to be swept up into a sexual world like that is hugely destructive,” he says. “When teen girls are rewarded for their sexuality, they come to believe that their value is in how they look.” Sunseri estimates that about one-quarter of the girls at his clinic have posted sexualized content on TikTok.

Boys are not immune. A growing number of teen boys are getting sucked into TikTok’s algorithm, which often means they are seeing TikTok videos of young men who are bigger, more muscular, than they are. That can lead to “bigorexia,” boys becoming obsessed with acquiring the muscle-bound look exemplified by The Rock and the entire cinematic Marvel universe of he-men. 

Advice For Parents

So, what’s a parent to do about TikTok?

The first step is for parents to have a frank conversation with their daughters—and their sons—about the dangers of TikTok. I have heard teen girls say, “I saw it on TikTok” with the same air of authority as a middle-aged woman a few years back might have said, “I heard it on Dr. Oz.” In both cases, the speaker is citing an authority they believe to be unchallengeable. Parents, make sure your kids understand that a TikTok video is not authoritative, even it has 10 million likes. 

At what age should a child be allowed to be on TikTok? Jean Twenge, our nation’s leading researcher on how social media impacts child and adolescent development, recommends that no child under 13 should be on any social media, including TikTok. And I would add that many 13-year-olds aren’t ready. TikTok offers a curated version of their app for under-13s. Don’t use it. That watered-down version is designed to fuel interest in the grown-up version. Twelve-year-olds don’t like to be on the kiddie version of anything. And tweens quickly figure out that if they lie about their age, they can easily access the full version. 

As with any social media, the parent must limit, govern, and guide their teen’s use. At this time, we don’t have evidence that 10 or 15 minutes a day on TikTok, or social media in general, is harmful. One study of more than 220,000 teens found that the risk of bad outcomes began to increase after more than 30 minutes of social media a day, on average (see, for example, Figure 3). However, that study was published in 2019, based on data gathered before TikTok became the most-viewed social media for teens. An hour a day on TikTok is definitely too much. Kids have better things to do with their time than spending an hour a day on TikTok. So I advise parents to install parental monitoring apps to limit how much time kids are spending on TikTok. 

That’s where many parents push back. One parent told me: “I think it’s important to show my daughter that I trust her. Installing a monitoring app implies that I don’t trust her. Besides, I already use the TikTok Family Pairing option, so that I can see what my daughter is doing in the app.” I remind parents that I see many teens who have created two TikTok accounts. One is the “clean” account which they show to their parents and which their parents follow on the Family Pairing option. The other is the real account, where the daughter is watching, or posting, the videos she doesn’t want her parents to see. 

Then the parent says: “My daughter would never create a secret account just to deceive me.” I explain that if all the girl’s friends are doing it and advising her to do it, what is that girl supposed to say to her friends? It’s not reasonable to expect a modern American girl to say, “I know all you guys are doing it, but I won’t do it because I don’t want to deceive my parents.” The parent needs to allow the daughter to tell her friends, “I can’t do that, because my parents have installed this evil monitoring app that sees everything I do!” 

Anne Sena is Director of Technology at St David’s School in Raleigh, North Carolina. She recently told me that she uses the Bark parental monitoring app to monitor and limit her teen’s online activities across social media, email, web browsers, and YouTube. She likes that Bark installs a VPN so that the controls are in place when her teen is outside of the home network, for example at a friend’s house or using a network provided by a cell phone. In Sena’s own home, she uses the Circle Home Plus device as well as the Apple’s screen time controls and Microsoft Family Safety to enforce time limits and provide an added layer of search protection on the family’s home computers. There are other similar monitoring and filtering programs out there, including the Canopy app, for parents to choose from. 

“That sounds like a lot of work,” one mother told me the other day when I suggested that she follow Sena’s example. And it may be, especially for those of us who are not as knowledgeable about VPNs and screen time controls. But if taking these steps decreases the risk of more teens becoming anxious and/or depressed, I think the extra effort is worth it. 

I recently spoke with a young woman who is a senior in college. She admits that she used to spend up to four hours a day on TikTok. But one of her professors inspired her to take control of her time, and she now spends 5 minutes a day, or less, on the app. She says she has reconfigured TikTok to show her only those videos that are closely related to her professional interests. She gives her professor the credit for inspiring her to cut back. I am inclined to give her the credit for finding the courage to govern herself—even when many of her peers can’t, or won’t.  

Leonard Sax MD PhD is a practicing family physician and the author of four books for parents, including The Collapse of Parenting, which was a New York Times bestseller. 

Editor’s Note: The opinions expressed in this article are those of the author and do not necessarily reflect the official policy or views of the Institute for Family Studies.