On November 8, 2022, the day of the US midterm elections, Martha Dimitratou noticed something alarming. Dimitratou is the media manager for PlanC, a nonprofit that provides information about access to the abortion pill. After PlanC posted a TikTok video encouraging people to vote to protect reproductive rights in elections across the country, its account was suddenly banned.
Dimitratou was confused—nothing in the video seemed to violate TikTok’s community guidelines. “It was really hard to get it back up,” she says. “They are not very responsive when it comes to contacting them, if at all.” Frustrated by the platform’s silence, Dimitratou put out a call on Instagram, tagging TikTok, that was shared widely amongst the organization’s followers. Shortly after, TikTok reinstated PlanC’s account.
Dimitratou is one of many reproductive rights activists who say that they have seen TikTok systemically target content related to abortion, particularly the abortion pill, at a time when right-wing lawmakers are trying to make accurate information about the procedure harder to come by.
TikTok spokesperson Ben Rathe told WIRED that while PlanC’s video did not violate TikTok’s community guidelines for user-generated content, the platform prohibits advertising for abortion services. When PlanC attempted to pay to boost the post’s reach, which included a link to the organization’s website, where pills can be purchased, Rathe said that violated TikTok’s advertising policy. However, he did not address why advertising around abortion is not allowed, while advertising for other medical procedures is.
“In talking with our patients, we know that nearly half of our patients first turn to either friends or family or social media when they find out they’re pregnant,” says Rebecca Davis, head of marketing at Hey Jane, a telemedicine abortion clinic. “Given the capabilities of TikTok, it makes it a really, really important platform and channel for people who are seeking accurate information to be able to get it, especially get it really quickly when we know this is a time-sensitive issue.”
Davis says that even if people are not getting information from TikTok itself, it’s common for them to check a clinic or organization’s social media accounts to verify whether it’s real and reputable. If it doesn’t have an account on TikTok or Instagram, “that could be a potential red flag for someone.”
Davis says that in the days immediately following the US Supreme Court decision to overturn Roe v. Wade, the case that protected the right to an abortion, Hey Jane saw its TikTok account banned three times.
“We noticed pretty much immediately following the Court’s decision that something on the platform shifted and changed,” she says. “It was during this acute moment when people were seeking to understand what was going on and what their options were. It was quite harmful.”
Advocates worry that in order to avoid regulation and sidestep possible legal issues, TikTok may be over-moderating, blocking access to any relevant information, and that this began before 2022. In May 2021, Texas passed Senate Bill 8, which allows private citizens to to sue anyone who assists someone in accessing an abortion. Shireen Rose Shakouri, deputy director at Reproaction, a nonprofit that seeks to increase access to abortion and reproductive health care, says she noticed afterward that TikTok was blocking #mifepristone and #misoprostol, the names of the two drugs used to medically end a pregnancy.
“There was no understanding that [the law] would even be enforced in Texas at the time because it was appealed up to the Supreme Court,” she says. “So even before this law actually had significant teeth, they were banning the two hashtags of the two most commonly used abortion medications.”
Rathe, the TikTok spokesperson, says that TikTok has never restricted these hashtags, even after the Texas law was passed.
And while Shakouri and others worry that accurate reproductive health information is being removed, research from Media Matters for America, a media watchdog group, found that the platform was allowing content encouraging people to physically block access to abortion clinics to remain online. (In September 2022, TikTok released updated community guidelines that forbade medical misinformation about abortions.)
“Our Community Guidelines prohibit content including medical misinformation, hate speech, graphic content, and we will remove any content we identify that violates these policies,” Rathe told WIRED.
TikTok is not the only platform where users have noticed content about the abortion pill being taken down. Last year, WIRED reported that Meta had been removing and suppressing content telling people how to access medical abortions. But Jane Eklund, technology and reproductive rights fellow at Amnesty International, says that TikTok is particularly crucial for younger people, who comprise a significant proportion of the platform’s user base.
“For younger users, sometimes they go to TikTok first before they even go to Google,” she says. “So it’s critically important that we keep up these posts.”
Eklund, who has been documenting instances of abortion-related content takedowns across platforms, says many organizations and creators who focus on providing accurate reproductive health information believe that even if their content isn’t outright removed, it will be “shadowbanned,” or have its reach throttled by the platform’s algorithm. When asked whether TikTok deprioritizes content around the abortion pill, TikTok’s Rathe told WIRED that the company does “not moderate or remove content based on political sensitivities, and nothing in our moderation practices would seek to discriminate against any creator or community on our platform.”
To get around perceived platform censorship, Eklund says that many TikTok creators and organizations that Amnesty partners with have alternate accounts, just in case their main account gets banned. In some videos, creators and activists will tweak the spelling of words like “abortion” by, say, replacing the letter “o” with the number “0,” in an attempt to navigate around any automated moderation.
“It only further stigmatizes the topic when we can’t actually spell the name of a medical procedure correctly,” she says.
This can also mean that abortion-related content becomes harder for users to find, according to Hey Jane’s Davis. “If we’re not able to use best SEO practices, such as reiterating search terms in our videos, those videos aren’t going to be served up to people who are searching and trying to find information about that topic, if we’re changing the spelling or using euphemisms,” she says.
Davis says that little tweaks, like allowing organizations to get verified as legitimate health care providers on platforms, can help users—and hopefully companies—identify which sources are credible. (Hey Jane is verified on TikTok.)
But Reproaction’s Shakouri worries that the platform may further censor content as abortion laws across the country tighten.
“It’s only going to get worse,” she says.
