In It’s Not Hysteria, Dr. Karen Tang Translates Her TikTok Ethos To The Page

In a TikTok video posted on May 2, Jonathan Van Ness does a sort-of call-and-response with Dr. Karen Tang. He and the gynecologist go back and forth saying “vagina,” each time louder and more animated. Vagina. Vaginas. All the Vaginas. Tang, who’s being interviewed for Van Ness’ podcast, Getting Curious, then summarizes one of the overarching goals of her work: “Say the word. It’s OK. It’s not embarrassing.” Her followers — more than 600,000 across TikTok and Instagram — seem to agree.

Earlier this month, she released her new book, It’s Not Hysteria: Everything You Need to Know About Your Reproductive Health (But Were Never Told). The frank, trans-inclusive health guide is enlightening, to say the least. It feels as formative as, say, discovering Our Bodies, Ourselves was for earlier generations. In it, she lifts the veil on problematic periods, pelvic pain, endometriosis, PMS, menopause, fibroids, and more — issues that, she emphasizes, are incredibly widespread, yet still pretty hush-hush.

“There’s an interesting perception that women’s health is not real medicine, like, say, studying cancer or strokes, that periods and menopause are not as worthy of medical attention or research funding,” says Tang, who’s based in Pennsylvania. “Even in terms of insurance coverage, women’s health has always been some of the poorest among all of the different types of medical treatments.”

The book is dedicated to anyone whose health has been harmed by the patriarchy. And its title refutes the ancient notion that women’s pain was, as Tang writes, “a combination of physical, emotional, and psychological distress somehow tied to the uterus or womanhood.” The legacy of hysteria persists today, Tang says, every time a person with a uterus inquires about a reproductive issue and has their concerns or their pain dismissed, minimized, misdiagnosed, or told it’s all in their head.

It’s Not Hysteria is an expansion of the presence she’s carved out online. Tang, who’s in her mid-40s, entered the social media arena during the pandemic, when she began crafting pithy TikTok responses to the widening spread of health misinformation online. (One of her initial irritants was Rep. Marjorie Taylor Greene, who had been spewing transphobic hate.) Wryly billing herself as a “geriatric TikToker,” she relays reproductive health information and advice in a fun, savvy way — like pairing a query about sexual satisfaction after hysterectomy with a Black Panther meme.

“I’ve always reacted on social media to current events or things I see on TikTok that are myths about sex or reproductive health,” she says. “And as things come out, like the really strict abortion bans, this takes on extra urgency. It’s not just theoretical. It’s what people are struggling with in real life.”

Below, she discusses how to get the most out of your gyno visit, the war on women’s health, and Ali Wong.

“If it seems like the doctor isn’t open to your perspective and questions, that might be a sign to get a second opinion.”

How do you keep your head from exploding when you hear male politicians talk about banning abortion while knowing absolutely nothing about women’s anatomy?

People do want the truth, and you see a lot of doctors active on social media now. If someone is saying that you’re murdering children if you discard embryos, and therefore that IVF is murder, we’re just getting out there being like, “No.” So many of us are getting people to try and understand the medical facts, to try and cut through some of the misinformation, and make whatever positive influence we can. And I think it is making a difference.

The issue of menopause seems to be getting more visibility and attention in recent years. Are there other women’s conditions, like endometriosis and PMS, that you see more commonly discussed, too?

Yeah, there are different advocacy communities doing great work, one of which is focused on endometriosis. There’s a great documentary called Below the Belt, which had screenings with government leaders and at universities. Several celebrities who have endometriosis, like Amy Schumer, Lena Dunham, and Padma Lakshmi, have spoken out, and that’s helped raise awareness.

In the book, you advise readers to come to their gynecologist appointments prepared to ask questions. How does a patient find a balance between pushing for more information and inadvertently annoying the doctor?

A good doctor-patient relationship should feel collaborative. We have a concept now in medicine called patient-centered care, also called shared decision-making, where it’s less of doctors bestowing the answer on you, and more asking you what your thoughts are, what your goals are, what are your thoughts on medicine versus surgery. The patient should feel empowered to find the solution that’s right for them. If it seems like the doctor isn’t open to your perspective and questions, that might be a sign to get a second opinion.

You include care for trans, nonbinary, and intersex people in your book, with a passionate defense of gender-affirming care. Why was it so important to you to be inclusive of these groups?

It’s very important to acknowledge that there are millions of people who are trans and nonbinary and intersex. It’s not like a small subset of the population. I was very purposeful about having experts and sensitivity readers for chapters on trans and nonbinary and intersex communities, because they just haven’t been included when people talk about women and cisgender women.

Among the many alarming facts you bring to light, you cite one study in which many of the medical students polled believed that Black people had less sensitive nerve endings — in 2016? How is this possible?

Yeah. Many medical trainees thought that it was a biological fact, and this has been borne out with actual findings of Black patients with overtly painful things like broken bones and appendicitis being offered less pain medication. It’s not that anybody is out there being like, “I’m just going to overtly perpetuate racist tropes,” but people are absorbing this information somehow. They’re internalizing it and treating it as fact. And it obviously influences how people listen to Black patients who are complaining of pain, or have problems with their periods.

You mention in the book that you’re a big fan of Ali Wong, whose comedy specials have explored sex, pregnancy, and cultural misogyny. Why is she such a good reproductive health spokesperson, in your opinion?

She shows that it’s not shameful to talk about your body, about sex, about yourself as a person who has sex. We should all feel that free and comfortable talking about these issues, and part of the problem with not having enough research and funding is because sexual health has been considered dirty or shameful. Having freedom to discuss issues openly is super critical. That’s why I hope this book gets out there and gets people talking.

This interview has been edited and condensed for clarity.