Back in April, RFK Jr. committed publicly to firmly knowing the cause of autism by September of this year. In May, Donald Trump himself weighed in with the already baked conclusion that autism doesn’t “occur naturally” and therefore must have some environmental cause. Both statements were absurd at the time. Autism causes have been studied for decades and RFK Jr. has no magic wand to make the answer more knowable to him than the collective medical community. Donald Trump is not a doctor, nor a medical researcher, and unless he has actual evidence and research to back up his claim, it is fit for being ignored and nothing else. Meanwhile, Kennedy also shut down the research that was actually being done to find causes of autism.

But it’s now September and a promise was made, so the Trump administration had to at least pretend to make it a promise kept. To that end, reporting came out last week that Kennedy and HHS would be pointing the finger at prenatal use of Tylenol as a major cause of autism. And just this week, that’s exactly what Trump and Kennedy did.

“Don’t take Tylenol,” Trump instructed pregnant women around a dozen times during the unwieldy White House news conference, also urging mothers not to give their infants the drug, known by the generic name acetaminophen in the U.S. or paracetamol in most other countries. He also fueled long-debunked claims that ingredients in vaccines or timing shots close together could contribute to rising rates of autism in the U.S., without providing any medical evidence.

The rambling announcement, which appeared to rely on existing studies rather than significant new research, comes as the Make America Healthy Again movement has been pushing for answers on the causes of autism. The diverse coalition of supporters of Health Secretary Robert Kennedy Jr. includes several anti-vaccine activists who have long spread debunked claims that immunizations are responsible.

Okay, so where is this coming from, you might be asking? Well, to start, studies do exist that point to correlational data between use of Tylenol and autism rates. That’s just the truth. So, if you hear any opponent of this administration tell you that there is zero data or studies indicating that this might be a concern, that is simply not true. It’s important that we be really precise about this sort of thing.

One such Harvard study, for example, did find that there was an uptick in rates of autism diagnoses among children who’s mothers took Tylenol while pregnant, primarily to reduce a high fever in the mother. The problem is that even those who performed that very study don’t agree with Trump’s message to pregnant women, which was, again, “Don’t take Tylenol.”

One of the researchers on that study was Ann Bauer, an epidemiologist at the University of Massachusetts. Bauer said she thinks pregnant women should be told about a possible risk from acetaminophen. But the researcher also was worried that it might be too soon to have the federal government offering guidance on its use.

“I’m a little concerned about how this message is going to come because I think they may be jumping the gun,” Bauer said before the announcement was made. “I think those of us in the research community would like to see stronger evidence.”

This is how scientists talk when the evidence is, at best, inconclusive. We’re talking about one study, with a relatively small sample size and for which all kinds of externalities that could impact an outcome of autism were not accounted for. “We need more data” is exactly the right conclusion of such a study, as opposed to “Don’t take Tylenol.” Again, precision here matters very much.

Trump and Kennedy didn’t bother being precise. They advised the nation on a health matter that they can’t possibly understand, since the current researchers of it don’t understand it. And they even took it further than studies like the Harvard study would suggest even if we wanted to draw conclusions based on it.

One challenge is that it’s hard to disentangle the effects of Tylenol use from the effects of high fevers during pregnancy. Fevers, especially in the first trimester, can increase the risk for miscarriages, preterm birth and other problems, according to the Society for Maternal-Fetal Medicine.

Trump also urged not giving Tylenol to young children, but scientists say that research indicates autism develops in the fetal brain.

Responding to Trump’s warnings, the Society for Maternal-Fetal Medicine said they still recommend Tylenol as an appropriate option to treat fever and pain during pregnancy. The president of the American College of Obstetricians and Gynecologists said Monday that suggestions that Tylenol use in pregnancy causes autism are “irresponsible when considering the harmful and confusing message they send to pregnant patients.”

Ironically, high fevers in pregnant women have also been suggested as a potential cause of autism diagnoses in children, among many other negative healthcare outcomes for the unborn child. This is the same flavor of medical advice that Kennedy had on COVID vaccines: the cure is worse than the disease. That’s bullshit, of course, but it’s the kind of bullshit you get when you believe that those who suffer negative health outcomes are at fault for those same outcomes.

And, despite the plain advisory language from definitely-not-a-doctor Donald Trump, he also threw out the repeatedly debunked claims about vaccines being linked to autism in the same announcement. Perhaps he did so because he really believes in such a link, but I doubt it. Instead, this was red meat to Kennedy’s base of supporters, because they were fucking furious when the news first broke about the announcement of the link to Tylenol.

“We didn’t wait 20 years for Bobby to finally speak and then get served Tylenol as an answer,” anti-vaccine group Georgia Coalition for Vaccine Choice wrote in an unhinged Facebook post on Monday morning. “If that’s all we hear – is that the end? Not thimerosal. Not aluminum. Not MMR. Not Hep B. Not the insane schedule pushed after pharma got liability protection. Are we supposed to just forget?”

Children’s Health Defense (CHD)—the anti-vaccine group founded by Kennedy—even got in on the backlash, retweeting a post on Monday about parents who falsely blame vaccines for their children’s neurological condition, with the statement: “THIS WAS NOT CAUSED BY TYLENOL.”

And if that’s not good enough for you, here’s Steve Bannon and a guest on the matter.

In an interview on Steve Bannon’s podcast War Room Monday, CHD President Mary Holland downplayed the link, telling Bannon: “Today may be something of a sideshow—Tylenol is not the primary cause. Vaccines are the primary cause [of autism],” Holland said. (The claim that vaccines cause autism has been thoroughly and repeatedly debunked.)

Bannon, for his part, slammed Kennedy’s effectiveness as health secretary, calling his efforts to implement an anti-vaccine agenda unserious and amateurish. “This Tylenol thing stinks to high heaven,” he said.

Again, precision in how we talk about this matters when we’re talking about science and healthcare. I am unwilling to say that vaccines definitely do not cause autism. Instead, I say that there is no scientific evidence that has gone through a rigorous process to suggest that it does, so there’s no reason to operate as if there were. I will not say that there is zero link between Tylenol use in pregnant women and autism. But I can sure as shit say that here too there is certainly no conclusive causal link of significance between them, only correlational data that doesn’t account for a zillion other factors, and therefore we don’t put too much weight on this claim until more studies and data shows otherwise.

Many medical experts, instead, point to a novel 2024 study conducted in Sweden. The study, published in JAMA, used data from a population of 2.5 million children and was also able to compare differences among (full) siblings. This provided a simple way to skirt confounding variables, such as genetics and environmental factors, to which siblings would have similar exposure.

In the entire population, children exposed to acetaminophen during pregnancy were slightly more likely to be diagnosed with autism than those who weren’t—echoing some earlier studies. But, in the sibling analysis, which compared siblings who were exposed to acetaminophen to siblings who were not, the association vanished. In all, the data suggests that acetaminophen was not causing an uptick in autism diagnoses; rather, there were other confounding factors behind the link.

Meanwhile, the President tells the public “Don’t take Tylenol.”

There is so, so much damage being done by these halfwits looking for a headline rather than real answers. It seems obvious to me that some non-zero number of pregnant women out there will adhere to Trump’s message and their unborn children will either suffer the consequences of high fevers in life, or miscarry and never have that life to begin with. Some will even refuse to give their already-born children Tylenol as Trump instructed and some, almost certainly, will die. On who’s ledger will we place those deaths? The answer must be on Kennedy and Trump.

And beyond that, this cavalier attitude towards healthcare pronouncements will do no favors when it comes to getting the public to trust doctors and researchers on matters of health and medicine. And that is of paramount importance, as the American people today trust both their leaders and medical institutions in particular less than perhaps they ever have in the past.

On matters of life and death, that will literally kill people.

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