TikTok in Transgender Health: Is it Really Useful for Plastic Surgeons?

Purpose: In 2020, videos with the hashtag #trans had over 6 billion views on the video-sharing application "TikTok." We aim to analyze TikTok users' engagement with gender-affirming surgery (GAS) content by transgender and nonbinary (TGNB) patients and plastic surgeons.Methods: Between August 23 through September 11, 2021, we analyzed the top 14 hashtags for GAS and the top 10 most viewed videos for each hashtag using the TikTok application. We extracted the number of shares, likes, comments, and analyzed the quality of video comments, content, and creator.Results: Transmasculine top surgery (n=53, 37.9%) was the most featured GAS. Most videos were posted by patients (n=104, 74.3%). Videos posted by the patients' significant other (PSO) had a significantly higher number of shares (median [interquartile range (IQR)] 17,850 [18882.5]) and lower rate of negative comments per video (Median [IQR] 0% [0%]) compared with those posted by Patients (median [IQR] 214 [868.25], p=0.045; median [IQR] 0% [5%], p=0.006) or Plastic surgeon (median [IQR] 226.5 [297.25], p=0.02; median [IQR] 5% [10%], p=0.043). Most videos presented postoperative care/results (n=45, 32.1%) and had a significantly higher number of likes (median [IQR] 116,500 [212,700]) compared with educational videos (median [IQR] 20,700 [66,939], p=0.044) and those on TGNB awareness/pride (median [IQR] 31,050 [84226.5], p=0.034).Conclusion: TikTok users mostly engage with videos by the PSO on postoperative outcomes compared with educational and TGNB awareness/pride content posted by patients and surgeons. Adapting TikTok content may increase engagement with future patients and family members.