The U.S. Surgeon General is warning there is not enough evidence to show that social media is safe for children and teens — and is calling on tech companies, parents and caregivers to take “immediate action to protect kids now."

With young people's social media use “near universal” but its true impact on mental health not fully understood, Dr. Vivek Murthy is asking tech companies to share data and increase transparency with researchers and the public and prioritize users' health and safety when designing their products.

“I recognize technology companies have taken steps to try to make their platforms healthier and safer, but it’s simply not enough,” Murthy told The Associated Press in an interview. “You can just look at the age requirements, where platforms have said 13 is the age at which people can start using their platforms. Yet 40% of kids eight through 12 are on social media. How does that happen if you’re actually enforcing your policies?”

To comply with federal regulation, social media companies already ban kids under 13 from signing up to their platforms — but children have been shown to easily get around the bans, both with and without their parents’ consent.

Other measures social platforms have taken to address concerns about children's mental health are also easily circumvented. For instance, TikTok recently introduced a default 60-minute time limit for users under 18. But once the limit is reached, minors can simply enter a passcode to keep watching.

It's not that the companies are unaware of the harms their platforms are causing. Meta, for instance studied the effects of Instagram on teens' mental health years ago and found that the peer pressure generated by the visually focused app led to mental health and body-image problems, and in some cases, eating disorders and suicidal thoughts in teens — especially in girls. One internal study cited 13.5% of teen girls saying Instagram makes thoughts of suicide worse and 17% of teen girls saying it makes eating disorders worse.

The research was revealed in 2021 by whistleblower Frances Haugen. Meta sought to downplay the harmful effects of its platform on teens at the time, but put on hold its work on a kids’ version of Instagram, which the company says is meant mainly for tweens aged 10 to 12.

“The bottom line is we do not have enough evidence to conclude that social media is, in fact, sufficiently safe for our kids. And that’s really important for parents to know,” said Murthy, who's been traveling around the country talking to parents and young people about the youth mental health crisis. “The most common question I get from parents is whether social media is safe for their kids.”

Policymakers need to address the harms of social media the same way they regulate things like car seats, baby formula, medication and other products children use, Murthy said in a report published Tuesday. Parents — and kids — simply can't do it all.

“We’re asking parents to manage a technology that’s rapidly evolving that fundamentally changes how their kids think about themselves, how they build friendships, how they experience the world — and technology, by the way, that prior generations never had to manage,” Murthy said. “And we’re putting all of that on the shoulders of parents, which is just simply not fair.”

While Murthy is calling for more research, he says there is ample evidence now that social media can have a “profound risk of harm" on the mental health and well-being of children and teenagers.

One critical factor is children's brain development. Adults can suffer from the harmful effects of social media. But children and adolescents are at a “fundamentally different stage of brain development, where the pathways in their brains, their social relationships, their self-esteem and identity are all under development," Murthy said. “And in this case, they’re even more prone to be influenced by social cues, social pressure and social comparison — and those three things exist in overwhelming abundance on social media.”

In fact, frequent social media use may be associated with “distinct changes” in the developing brain, and could could increase sensitivity to social rewards and punishments, according to a study cited in the Surgeon General's report.

How and how often they use social media, as well as extreme, inappropriate and harmful content they see could have profound effects on kids' and teens' mental health.

And research shows they are using it a lot. al. Up to 95% of youth ages 13 to 17 report using a social media platform, with more than a third saying they use social media “almost constantly,” according to the Pew Research Center.

A systematic review of 42 studies found a “consistent relationship between social media use and poor sleep quality, reduced sleep duration, sleep difficulties, and depression among youth." On a typical weekday, nearly one in three adolescents report using screen media until midnight or later.

What they see on social media also matters. From being bombarded unrealistic body images to a culture of “hyper-comparison” to bullying, hate and abuse, Murthy said he's worried that its effects on young people's mental health is showing up in the “disturbing mental health statistics that we are seeing in our country, which are telling us that depression, anxiety, suicide, loneliness are all going up.”

Murthy's report doesn't tell young people to stop using social media altogether. There are benefits, too. It's where teens can find a community and have a space for self-expression. LGBTQ+ youth, in particular, has been shown to benefit from social media through connecting with peers, developing an identity and finding social support.

“For every family, it may not be feasible to stop your child from using social media or there may be benefit,” Murthy said. “But drawing boundaries around the use of social media in your child’s life so there are times and spaces that are protected, that are tech free, that can be really helpful.”

Murthy's own children are 5 and 6, but like many parents he's already thinking about their future on social media.

“We are planning to delay the use of social media for our kids until after middle school,” he said. “And you know, that’s not going to be easy. But we’re hoping to find other parents and families that we can partner with to make this a little easier, because we know there’s strength in numbers and sometimes making changes on your own is hard.”