One of the fun technical details is that, when enabled on a machine (tailscale up --ssh), the userspace tailscaled process takes over all TCP port 22 packets after the WireGuard decryption and doesn't even feed them into the kernel over TUN. We use gVisor's netstack to handle the TCP connections in-process.
So it doesn't matter whether you have other processes (or iptables rules, etc) that would prevent the Tailscale SSH server from binding to port 22. This lets people gradually use Tailscale SSH over time without messing with their system one.
The Tailscale SSH server currently only runs on Linux but there's support in git main for macOS too but it's not super well tested yet and not included in the sandboxed GUI builds currently.