In a rambling press conference on Sept. 22, President Donald Trump claimed that acetaminophen use in pregnancy is driving the rise in autism—and then ad libbed his own guidance on childhood vaccines. Watching the President deliver what is widely considered by leading professional organizations as inaccurate and dangerous medical advice gave me painful flashbacks to the early days of the COVID-19 pandemic, when I was working on the frontlines as an emergency physician in New York City. By the time the press conference ended, people on social media were already comparing it to Trump’s infamous suggestion in April 2020 that injecting disinfectant might treat COVID.
To me, though, this was far worse.
Back in 2020, most Americans instinctively knew that drinking or injecting bleach was dangerous. But at his recent press conference, the President stood at the dais and delivered a barrage of falsehoods that might not be obviously false to most Americans—misrepresenting evidence on autism, distorting research on vaccines, and offering a grab bag of unscientific medical opinions. As a physician, a public-health researcher, and a parent, I felt not just frustration but real worry: for the confusion now facing pregnant women, new mothers, and the families trying to navigate these mixed messages in real time.
Back in April, Robert F. Kennedy Jr., Secretary of Health and Human Services, promised that by September, the administration would finally explain why autism diagnoses have risen in recent decades. Instead, they delivered political theater disguised as science. Officials leaned on selective citations, cherry-picking studies that fit their conclusion and ignoring the rest. They presented the case as closed, even though they offered no new data, no credible evidence, and nothing that would actually help parents or physicians make better decisions.
The problem wasn’t only that the President and the country’s top health officials overstated and misrepresented the science. It’s that they replaced uncertainty with spectacle, leaving clinicians and families to make sense of the whole thing. And this announcement wasn’t limited to acetaminophen. The president riffed on claims so easily disproven that they bordered on absurd: insisting that autism doesn’t exist among the Amish, or that Cuba has no access to acetaminophen. Both are flatly false.
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More troubling to clinicians such as myself were his directives on vaccines. He urged parents to abandon the U.S. Centers for Disease Control and Prevention’s immunization schedule and “space out” shots—a strategy with no evidence of added safety, but one that guarantees more injections, more clinic visits, and less protection against serious diseases. He even suggested splitting the measles, mumps, and rubella vaccine into separate doses, which isn’t possible in the U.S. because single-dose versions don’t exist. And he urged parents to delay the hepatitis B vaccine until age 12, wrongly dismissing the virus as only “sexually transmitted.” (The virus can also be transmitted at birth and through small drops of blood on surfaces or skin.) There is no evidence to support any of this. The President even said his recommendations were “based on what I feel.” It was reckless guidance from a man with no medical training, delivered from the nation’s most powerful podium.
Here’s what we actually know about the association between acetaminophen during pregnancy and autism: the evidence is mixed, and plenty of research shows that the link disappears when controlling for genetic and other factors. Some observational studies have found weak associations between frequent acetaminophen use in pregnancy and neurodevelopmental outcomes, including autism and ADHD. Others, including a methodologically robust study of nearly 2.5 million children in Sweden published last year, found no link at all.
One study even suggested that short-term use—a week or less—was associated with a lower risk of autism compared with mothers who didn’t take acetaminophen at all.
The administration ignored that nuance and chose to lean heavily on a recent research review that suggested a possible association. But association is not causation. That’s why professional organizations—including obstetricians and experts in high-risk pregnancy care—continue to recommend acetaminophen in pregnancy when clinically indicated. The dangers of untreated fever and pain are immediate and well documented (despite Trump’s claims that “nothing bad can happen” if you don’t treat fever). The evidence that Tylenol causes autism is not.
Families searching for answers about autism deserve more than soundbites. Autism is complex, shaped by genetic, environmental, and developmental factors. Pretending otherwise doesn’t clarify the science—it insults it. Worse, it heaps additional stigma onto parents, especially mothers, who may already wrestle with guilt over decisions made in pregnancy, often while following trusted medical guidance. And by casting blame on the one medication considered safe for treating fevers and pain during pregnancy, this announcement risks pushing pregnant women toward alternatives like aspirin and ibuprofen—drugs with well-documented dangers for the developing baby.
We all want a clearer understanding of autism’s causes. That requires stronger science and sustained funding. On the very day of the press conference, the National Institutes of Health (NIH) announced the creation of an Autism Data Science Initiative to expand research into the condition. But the administration has gutted broader research budgets and weakened the public-health institutions best positioned to carry that work forward. The result is a hollow contradiction: a narrow expansion in autism research coupled with a systematic dismantling of the infrastructure needed to make sense of it.
The recent announcement only compounds the harm, confusing parents and diverting attention and resources from questions that could actually bring answers. And if the supposed link between acetaminophen and autism collapses under scrutiny—as the evidence to date suggests—then we will have wasted precious time chasing the wrong target. That would be a profound failure not just of science, but of leadership.
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As a physician, I know how this plays out in the emergency room. A pregnant patient with a fever—which itself carries risks for both the mother and the fetus—may now think twice before taking acetaminophen, the one medication consistently recommended as safe by the American College of Obstetricians and Gynecologists for fever during pregnancy. As a father of two young kids, I know the weight of deciding which medicines and vaccines to give them, and the trust it requires in both the science and the system. The President just made those decisions harder and far more dangerous.
Despite the confidence projected on stage—with Trump flatly declaring that pregnant women should never take Tylenol and “just tough it out,” as the nation’s leading health officials nodded behind him—the administration’s own agencies began retreating almost immediately. Within hours, the U.S. Food and Drug Administration (FDA) issued a statement acknowledging there is no conclusive evidence of causation between acetaminophen and autism. Yet that same evening, on Fox News, FDA Commissioner Dr. Marty Makary doubled down, claiming the research review they are leaning on proved a “causal relationship.” It did no such thing.
Even the study’s lead author has been clear on this point, saying that more research was needed “to confirm the association and determine causality.” In other words, the administration is overstating the evidence, the FDA is contradicting itself, and the scientists who actually did the research are saying something altogether different. This kind of incoherence doesn’t just confuse the public. It casts doubt on the very idea that there is such a thing as trustworthy expertise.
This dissonance—between what senior U.S. health officials said on stage, where their follow-up statements hedge, and what professional societies pushing back are saying—leaves patients asking the most corrosive question in medicine: Who should I believe?
This moment isn’t only about Tylenol or even vaccines; it is about how fragile public trust is, and how quickly it can be squandered. Once the idea takes hold that health guidance is shaped by politics rather than evidence, everything becomes suspect. Vaccines. Screenings. Treatments we’ve relied on for decades. The very foundation of public health is the assumption that leaders will tell the truth about what we know and what we don’t.
Despite what we are now hearing from the most powerful health offices in the nation, the science on acetaminophen and autism remains unsettled. What is not unsettled is the damage done when politics masquerades as medicine. Every false certainty erodes the trust that holds the fragile bridge between patients and their doctors. Break that trust, and no study, no drug, no vaccine will be enough to save lives when the next real crisis comes. When politicians play doctor, it’s families who will pay the price.
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