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Influencers need to stop encouraging people to get off hormonal birth control, say critics of an upsurge of TikToks (of varying levels of scientific accuracy) that discuss the contraception’s downsides and promote using “natural birth control” methods instead. After all, an unwanted pregnancy, which might be more likely depending on the contraception method, is a risk in the United States, where abortion rights are tenuous and there’s a maternal mortality crisis. Some say women disparaging hormonal birth control on TikTok are “fearmongering”; they’re “playing into the hands of the right.” The timing of viral videos about the downsides of birth control is simply not ideal. Don’t these creators understand the danger?

The opportunity to capitalize on this moment, propelled by the sometimes shady ethics of social media, doesn’t help. There is money to be made from all the uncertainty; influencers with promo codes, for example, endorse alternative contraception options without discussing the downsides. And the false familiarity derived from the parasocial relationships that make social media platforms so engaging can make it difficult to decipher what’s sincere and what’s a sell. With the ease of finding bad information, it’s only natural to ask how we can convince people not to use TikTok for birth control advice or content creators to fact-check their endorsements.

These concerns are fair. But what these critiques miss is the more important question of why people are turning to social media for this in the first place. Sexually active people who want to avoid pregnancy may have a healthcare provider who is transparent about the pros and cons of their contraceptive options—or they may be medically gaslit and told that the side effects aren’t a big deal and can’t be linked to birth control. The reality is that many people are pursuing answers in a system rife with implicit biases against women’s health concerns and a history of prioritizing reproductive ability over personal preferences.

That may lead people to the internet. There, they can encounter sincere testimonies that make them feel finally seen. Many of these TikTokers detail never being told about side effects and doctors uninterested in discussing other options. As a result, they express doubt over contraception choices that are, in essence, pharmaceutical interventions—these creators and their viewers seem to reject the medical establishment because they feel rejected by it. And while critics have characterized antihormonal birth control conversations as irresponsible, people will continue to encounter misinformation or make intensely personal choices based on less than altruistic framing as long as their concerns are dismissed by professionals. Distrust of hormonal birth control may be most obvious online, but it reasonably began in a doctor’s office.

The arguments against hormonal birth control that are now flooding TikTok have been around for a long time, says Kathryn Clancy, a professor at the University of Illinois Urbana-Champaign and author of Period: The Real Story of Menstruation. Birth control side effects—such as acne, weight gain, loss of libido, and mood changes—are documented in numerous studies, though there’s disagreement over the validity of some results. One complication is that the scientific understanding of the underlying mechanisms, particularly of libido and mental health, is limited. “So many life factors can alter them and often birth control takes the blame,” says Aparna Sridhar, an obstetrician-gynecologist and associate clinical professor at UCLA. At the same time, some larger studies have found, for example, a correlation between hormonal birth control and an increased risk for depression and a lower sense of well-being.

Still, side effects are one of the main reasons why people who menstruate don’t use contraception. In a 2021 study, the highest proportion of people who wanted a different method of birth control were those using hormonal birth control; people using nonhormonal methods were six times as likely to be satisfied with their contraception than the opposing group. But because hormonal birth control is considered safe and effective, there’s little effort to create new methods that circumnavigate patient concerns. Women’s contraception preferences are “simply under-studied and under-funded, and unmet needs are ignored and misunderstood by those who could work to address these issues,” reports a 2020 article published in Nature.