At a rambling news conference on Sept. 22, President Donald Trump said acetaminophen use during pregnancy is contributing to the rise in autism, then improvised his own guidance on childhood vaccines. Watching the President do what many leading professional organizations believe inaccurate and dangerous The medical advice brought back painful memories for me of the early days of the COVID-19 pandemic, when I worked on the front lines 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 April 2020 proposal that injection disinfectant can treat COVID.
However, for me it was much worse.
Back in 2020, most Americans instinctively knew that drinking or injecting bleach was dangerous. But at his recent news conference, the president took the podium and spouted a barrage of lies that may not be obvious lies to most Americans: misrepresenting data on autism, misrepresenting vaccine research and offering a host of unscientific medical opinions. As a physician, public health researcher, and parent, I felt not just frustrated, but truly alarmed by the confusion that pregnant women, new mothers, and families now face as they try to make sense of these mixed messages in real time.
Back in April, Robert F. Kennedy Jr., the 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 presented political theater disguised as science. Officials relied on selective citations, selecting studies that matched their findings and ignoring others. They presented the case as closed, although they provided no new data, no reliable evidence, or anything that could really help parents or doctors make more informed decisions.
The problem wasn't just that the president and the nation's top health officials were exaggerating and misrepresenting scientific evidence. The point is that they replaced uncertainty with spectacle, leaving doctors and families to make sense of it all. And the announcement wasn't limited to acetaminophen. The president has made claims that are so easily refuted that they border on the absurd: He insisted that autism does not exist among the Amish or that Cuba does not have access to acetaminophen. Both are completely wrong.
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Of great concern to doctors like me were his instructions regarding vaccines. He urged parents to reject the US Centers for Disease Control and Prevention's vaccination schedule and “detached” vaccinations, a strategy no evidence additional safety, but guaranteeing more injections, more clinic visits and less protection from serious illness. He even suggested dividing the measles, mumps and rubella vaccine into separate doses. impossible in the US because single-dose versions do not exist. And he urged parents to delay hepatitis B vaccination until age 12, mistakenly believing the virus is “only transmitted through sexual contact.” (The virus can also be transmitted at birth and through small drops of blood on surfaces or skin.) There is no evidence to support this. The president even said that his recommendations were “based on how I feel.” It was the reckless leadership of a man without medical training, delivered from the most powerful platform in the country.
Here's what we really know about link between acetaminophen during pregnancy and autism: The evidence is mixed, and many studies show that the association disappears when genetic and other factors are controlled. Some observational studies have found a weak association between frequent acetaminophen use during pregnancy and neurodevelopmental outcomes, including autism and ADHD. Others, including a methodologically sound study of almost 2.5 million children published in Sweden last year, I couldn’t find any references at all.
One study even suggested that short-term use—a week or less—was associated with a lower risk of autism compared to mothers who did not take acetaminophen at all.
The administration ignored this nuance and preferred to rely largely on the recent research review this suggested a possible association. But association is not causation. This is why professional organizations, including obstetricians And experts in high-risk pregnancy management— Continue to recommend acetaminophen during pregnancy when clinically indicated. The dangers of untreated fever and pain are clear and well documented (despite Trump's claims that “nothing bad will happen” if fevers are left untreated). There is no evidence that Tylenol causes autism.
Families seeking answers about autism deserve more than just soundbites. Autism is a complex disorder shaped by genetic, environmental and developmental factors. Pretending otherwise does not clarify science, but insults it. Worse, it places additional stigma on parents, especially mothers who may already be struggling with guilt over decisions made during pregnancy, often following proven medical advice. By placing blame on the only drug considered safe for treating fever and pain during pregnancy, the statement risks pushing pregnant women toward alternatives such as aspirin and ibuprofen—drugs with well-documented risks to the developing baby.
We all want a clearer understanding of the causes of autism. This requires stronger science and sustainable funding. On the very day of the press conference, the National Institutes of Health (NIH) announced the creation Autism Data Science Initiative expand research into this condition. But the administration has cut broader research budgets and weakened the public health agencies best suited to continue this work. The result is an empty contradiction: a narrow expansion of autism research coupled with a systematic dismantling of the infrastructure needed to understand it.
The recent announcement only compounds the harm by confusing parents and diverting attention and resources away from questions that can truly provide answers. And if the purported link between acetaminophen and autism breaks down under scrutiny—as the evidence to date suggests—then we will be wasting valuable time pursuing the wrong target. This would be a profound failure not only of science but of leadership.
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As a physician, I know what it's like in the emergency room. A pregnant patient with a fever, which itself carries risks for both mother and fetus, may now think twice before taking acetaminophen, the only medicine that the American College of Obstetricians and Gynecologists consistently recommends as safe for fever during pregnancy. As a father of two young children, I know how difficult it is to decide what medications and vaccines to give them, and the trust it requires in both science and the system. The President has just made these decisions more difficult and much more dangerous.
Despite the confidence shown on stage (Trump flatly declared that pregnant women should never take Tylenol and “just tough it out,” and the nation's top health officials nodded along), the administration's own agencies almost immediately began backtracking. A few hours later, the US Food and Drug Administration (FDA) published statement acknowledging that there is no conclusive evidence of a cause-and-effect relationship between acetaminophen and autism. However, that same evening on Fox News, FDA Commissioner Dr. Marty Makary said the review of the study they were relying on had proven “causation.” Nothing of the sort happened.
Even the lead author of the study was clear on this issue: speaking that more research is needed “to confirm the link and determine causation.” In other words, the administration is exaggerating the evidence, the FDA is contradicting itself, and the scientists who actually did the research are saying something completely different. This inconsistency does more than just confuse the public. This calls into question the very idea that there is such a thing as credible expertise.
This dissonance—between what senior U.S. health officials have said on stage, which their subsequent statements have avoided, and what professional societies have said that have resisted it—leads patients to ask the most caustic question in medicine: Who should I believe?
This point isn't just about Tylenol or even vaccines; it's about how fragile public trust is and how quickly it can be squandered. Once the idea that health care recommendations are shaped by politics rather than evidence becomes increasingly suspect, everything becomes suspect. Vaccine. Impressions. A treatment 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 influential health authorities in the country, the science on acetaminophen and autism remains unsettled. What is not alarming is the damage that is done when politics masquerades as medicine. Any false confidence undermines the trust that holds the fragile bridge between patients and their doctors. Destroy that trust, and no research, no cure, no vaccine will be able to save lives when the next real crisis comes. When politicians play doctor, families will pay the price.
