In 2009, West began working as the film editor for Seattle's alternative weekly newspaper, The Stranger. In 2011, she moved to Los Angeles, but continued to write for The Stranger until September 2012.

She was a staff writer for Jezebel where she wrote on racism, sexism, and fat shaming.] West's work has been published in The Daily Telegraph, GQ, the New York Daily News, Vulture.com, Deadspin, Cracked.com, MSNBC and The Guardian. In 2013 West won the Social Media Award from the Women's Media Center, presented by Jane Fonda in New York City. Accepting the award, West said, "I hear a lot these days about the lazy, aimless 'millennials' – about how all we want to do is sit around twerking our iPods and Tweedling our Kardashians – and I also hear people asking, 'Where is the next generation of the social justice movement? Where are all the young feminists and womanists and activists?' Dude, they're on the internet."

On September 19, 2015, West co-founded Shout Your Abortion, a social media campaign on Twitter where women share their abortion experiences online without "sadness, shame or regret" for the purpose of "destigmatization, normalization, and putting an end to shame". The social media campaign was initiated in response to efforts by the United States House of Representatives to defund Planned Parenthood following the Planned Parenthood 2015 undercover videos controversy.

In 2016, West won The Stranger's Genius Award in Literature for her book Shrill: Notes from a Loud Woman.

On July 1, 2017, West became a contributing opinion writer for The New York Times, after having written two op-ed columns for the Times in 2016. Her feminism and popular culture column appears weekly.

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