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Spokane, Washington  Est. May 19, 1883

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Dr. Yolanda Evans: Time for Congress to update online protections for young people

Dr. Yolanda Evans

By Dr. Yolanda Evans

The teens I care for these days may not believe it, but there was a time when we had this device called a desktop computer. It stayed in one room of your house – some would even call it the “computer room.” You would turn the computer on and connect to the internet, using something called dial up, to “browse the web.”

When you were finished, you turned it off and walked away – and you were free to go about your day offline. Of course, this is not even remotely true anymore. As a pediatrician specializing in adolescent medicine, my patients do not simply visit the digital public space as we once did; they live in it. Digital platforms permeate all facets of their lives, from their schoolwork and friendships, to their hobbies and interests.

It is as ubiquitous in their daily lives as their classrooms and their bedrooms. Yet these digital spaces were not designed with children’s health in mind. Platforms like TikTok and Instagram employ manipulative practices to keep teens on their devices longer, expose them to harmful content, or get them to give up more personal data – all in the name of maximizing profits. It’s been 25 years since Congress passed online protections for young people, before my patients were born. They need online protections that reflect the digital world they know.

Every single day, I see the impact of this unhealthy digital world on young people in my clinic. I have cared for patients who sought out social media content on reasonable nutritious eating and exercising, only to be recommended videos that encouraged disordered eating and other risky behaviors. Patients of mine who use apps like Instagram and TikTok have told me of instances in which they sought out legitimate health advice and were recommended content on eliminating foods (“clean eating”), purging via laxatives and even “water loading” – a method of tricking scales at medical appointments that is dangerous for young people. These algorithmic recommendations even led one athlete to end up in my office with anorexia, with a heart rate so critically low that I recommended hospitalization.

While algorithms will never replace trusted professionals, we cannot allow them to so easily direct our kids and teens toward harm. Digital platforms have great positive potential for young people, but these same platforms are designed to push teens from innocuous curiosity to self-destruction. With the influence of the digital world no longer confined to the “computer room”, we need to policies to promote a healthier digital ecosystem.

Fortunately, there is bipartisan work underway in Congress to address these challenges by modernizing digital protections for young people.

The Kids Online Safety Act is landmark legislation to hold platforms accountable for the design choices they make that put profit and engagements ahead of the well-being of children by requiring them to avoid certain harms like eating disorders. KOSA advanced out of a key Senate committee in July on a bipartisan basis – a testament to the widespread consensus on this issue.

Congress needs to get the job done by passing KOSA and strong privacy protections for children and teens as soon as possible to support the well-being of young people and future generations that will increasingly live, learn and play online.

Young people deserve a digital ecosystem that lets them engage on their own terms, and meaningful action cannot come soon enough. Our elected leaders must act to bring online protections for children and teens into the year 2023.

Dr. Yolanda Evans is head of the Division of Adolescent Medicine at Seattle Children’s Hospital and associate professor of pediatrics at the University of Washington School of Medicine (opinions expressed are her own and do not represent the positions of UW Medicine). She serves a vast population that includes young people from Eastern Washington.