By day, Karen Tang, AB’00, is a minimally invasive gynecologic surgeon. By night, she’s the fearless @karentangmd on TikTok. Since she created the account in 2020, Tang’s informative, funny, and nonjudgmental videos on topics including menstruation, sexual health, and transgender rights have been viewed millions of times. She’s even gained a few celebrity followers, among them comedian Margaret Cho and Queer Eye’s Jonathan Van Ness. Her comments have been edited and condensed.

What inspired you to get on TikTok?

A couple years back at a conference, one of my friends was talking about her Instagram account and said something that changed the trajectory of my life. She said we have to get on social media, because that’s how people find health information now. As doctors, we are almost obligated to understand how people are consuming health information and meet them where they are. In 2020 I suddenly had all this time on my hands and, like everyone else in the world, I was trying to figure out something productive but entertaining to do. Instead of making sourdough bread, I decided to try TikTok.

I had this vision of TikTok as a place where people dance and do trends, but other doctors told me, “No, there’s no dancing involved—you can just talk if you want to.” The first video of mine that blew up was in response to Marjorie Taylor Greene’s statement about the gender binary. I have taken care of trans and nonbinary patients in my practice for more than a decade. So I quickly shot a video saying not only is gender nonbinary, but also that biological sex is nonbinary. That’s a well-established fact. Intersex conditions are common and a real, medically acknowledged thing. It’s offensive and narrow-minded to say that it’s a simple binary. That video really resonated with people.

What’s your process for making the videos?

I wish I could say I have a really organized workflow. Usually what happens is that I scroll TikTok for a bit, and I’ll see people are talking about a topic I know about—painful periods, sexual health, COVID-19. And then I’ll respond to it.

Something I learned was that people liked seeing me talk. I originally thought, it’s TikTok, people want some quick, snappy thing. But people actually liked some of the longer explanatory videos, which kind of blew me away.

You post a lot about endometriosis in particular—why?

I see a lot of endometriosis patients in my practice. It is very common—something like one in 10 people assigned female at birth have endometriosis at some point. But it takes on average seven years from when someone starts having symptoms to when they’re diagnosed. And there are many reasons for that. One is that the symptoms are a little bit embarrassing—you know, painful sex, painful periods, irregular bleeding, bowel symptoms. Things that people may not feel comfortable sharing even with their doctors. Sometimes patients are told these symptoms are normal.

Conditions like endometriosis, adenomyosis, pelvic floor muscle issues are what I call “hidden conditions,” because they don’t tend to show up on imaging studies. They are hard to diagnose unless you know what you’re looking for. For all those reasons, people will go years and years with debilitating pain and horrible suffering. It’s something I wanted to talk about from a professional perspective and because people are really hungry for information.

Another theme of your TikToks is your experience as a woman in surgery.

I am excited to show that you can be a woman in surgery and also have kids and a happy home life. I struggled with deciding to do residency in OB-GYN, because I had heard the hours were terrible and it would be hard to balance children with such a difficult schedule. What I didn’t realize back then is that there are so many different ways to construct your career. Right now I have a private practice, so I’m my own boss and I set my own hours.

I wanted to send the message that I wish I’d had when I was worried about my future and whether I could balance all these goals, personal and professional. And I wanted to show that you can do it, that it’s fun, and that it’s not all stress and worry.

What drew you to medicine?

When I started college, I was deciding between medicine and archaeology—I came to the U of C because I could potentially do either of those things. I chose medicine pretty early on. I quickly realized that I love the science part, and I love the ability to connect with patients and make an impact in their life. But once I got my mandatory courses out of the way, I took an English Renaissance poetry class and political science and history classes, and it was wonderful. I feel like I use a little bit of that creativity and flexibility in what I do now.

One of your specialties is providing gender-affirming gynecologic care to transgender patients. What got you interested in that work?

I started caring for transgender patients back in residency. One of our faculty members was doing hysterectomies for transgender men. It wasn’t a formal part of the medical school or residency experience—I just learned from someone who was already doing it.

Now there’s the World Professional Association for Transgender Health, which provides a lot of resources, and there’s definitely more formal teaching at the residency level. But people of my generation, we were just learning as we went and trying to do right by patients.

So much of gender-affirming care has to do with listening to the patient and being respectful of them and their individuality. No two patients are going to have the same perspective or goals. When I started my own private practice, I made sure that my intake forms asked about people’s pronouns and gender identity and included very open-ended questions about sexual partners, fertility, contraception.

You had a fun post about playing music during surgery. What are you listening to in the OR these days?

I usually choose a Pandora station. It used to always be ’80s dance music. I recently have gone through a BTS phase. I joke that I had two midlife crises during the pandemic—one was TikTok and the other was BTS. More recently, I’ve come back to the Backstreet Boys.