When President Donald Trump took the podium at a White House press conference on September 22, 2025, few expected the firestorm that would follow. In a sweeping announcement, Trump declared a new government initiative linking the use of acetaminophen (widely known by its brand name Tylenol) during pregnancy to autism and other neurodevelopmental conditions. Not only did he urge the public to avoid the drug, but he also promoted leucovorin, a vitamin derivative, as a possible treatment for autism symptoms and raised questions about the childhood vaccine schedule. The news, coming just as Congress was embroiled in a budget standoff, ricocheted through the medical community and reignited fierce debates about the intersection of science, politics, and public health.
According to a statement from the U.S. Department of Health and Human Services and the Food and Drug Administration (FDA), recent studies have shown an association between prenatal acetaminophen exposure and later diagnoses of autism or attention-deficit/hyperactivity disorder (ADHD). The FDA, under Commissioner Marty Makary, announced it was beginning the process to change acetaminophen labeling and had notified clinicians about the evidence. "The FDA is taking action to make parents and doctors aware of a considerable body of evidence about potential risks associated with acetaminophen," Makary said in the agency’s news release. But he was quick to add that a causal link had not been established, and that acetaminophen remains the only over-the-counter medication approved to treat fever in pregnancy.
The response from the medical field was swift and nearly unanimous in its caution. The American College of Obstetricians and Gynecologists (ACOG) released a statement calling the White House announcement "highly concerning to clinicians" and "irresponsible when considering the harmful and confusing message they send to pregnant patients, including those who may need to rely on this beneficial medicine during pregnancy." ACOG emphasized that the highest-quality studies to date had not found a significant association between acetaminophen use in pregnancy and autism, and stressed that the drug should remain available for treating fever and pain in expectant mothers.
The Society for Maternal-Fetal Medicine (SMFM) echoed these sentiments, reiterating its recommendation that acetaminophen is an appropriate medication for pain and fever during pregnancy. "Reviews of the research have not established causation," SMFM stated, underscoring the need for measured guidance rather than sweeping pronouncements. Autism researchers and advocacy organizations, including the Autism Science Foundation, were equally critical. Dr. Alycia Halladay, the foundation’s chief science officer, warned, "Any association between acetaminophen and autism is based on limited, conflicting, and inconsistent science and is premature." She further cautioned that the studies available often fail to account for confounding factors such as fever, infection, or underlying maternal health conditions.
So, what does the science actually show? Over the past decade, research has produced mixed findings. Some cohort studies have reported small associations between prenatal acetaminophen use and later neurodevelopmental differences in children. However, higher-quality studies that control for family and genetic factors—such as a large sibling analysis published in JAMA—have found no significant association. Most experts agree that observational studies, by their nature, cannot prove cause and effect, and that confounding variables muddy the waters.
Gregg Gonsalves, a public health correspondent for The Nation and a professor at the Yale School of Public Health, offered a sharp critique of Trump’s claims during a recent episode of the magazine’s podcast, Start Making Sense. "The point is that acetaminophen is the safest fever reducer painkiller you could use in pregnancy. Its associations with autism or any autism spectrum disorder are dubious at best," Gonsalves said. He cited a large Swedish study involving nearly 2.5 million children, which found no association between acetaminophen and autism when sibling controls were used to account for genetic and familial factors. "That’s probably the strongest evidence we have right now," he added, noting that while it’s impossible to rule out any connection entirely, the data is too scant to warrant changing clinical guidance.
Even the studies most often cited by those raising alarms about acetaminophen, including a paper co-authored by Andrea Baccarelli, the dean of Harvard’s School of Public Health, ultimately urge moderation rather than abstention. As Gonsalves pointed out, "The conclusion even of that paper was that Tylenol should be ‘used judiciously in the lowest dose at the least frequent interval.’" He emphasized that these recommendations align with current medical advice and do not support sweeping claims of danger.
The FDA, for its part, has struck a careful balance. While noting that some studies suggest any potential risk may be greater with chronic use, its official guidance remains that acetaminophen can be used in certain scenarios during pregnancy. The agency’s move to review labeling reflects concern about reported associations in observational studies but stops short of endorsing a ban or drastic change in usage recommendations.
For pregnant people and those planning to become pregnant, the message from leading medical organizations is clear: do not make medication decisions based on political statements or single studies. Consult with a trusted healthcare provider about the safest options for your individual circumstances. Both ACOG and SMFM recommend using acetaminophen "as needed, in moderation, and after consultation with a doctor," especially since untreated high fever during pregnancy can itself pose risks to both parent and fetus. Alternatives like ibuprofen and aspirin carry their own dangers in certain trimesters, making acetaminophen the recommended over-the-counter choice for now.
Meanwhile, the broader context of this debate cannot be ignored. As The Nation podcast highlighted, Trump’s comments about Tylenol came alongside other controversial statements about vaccines and public health. The episode, featuring analysis from Gonsalves and commentary from Harold Meyerson of The American Prospect, framed Trump’s press conference as a "double whammy of misinformation." The podcast also touched on the political battles over healthcare, Medicaid, and the ongoing government shutdown, painting a picture of a deeply divided nation where science is often caught in the crossfire of partisan agendas.
Adding to the confusion, Trump’s statements were made as the National Institutes of Health announced $50 million in new research grants for autism, focused on the interplay between genetics and environmental factors. While the administration touted these grants, critics noted that overall funding for biomedical research has been slashed, with cuts disproportionately affecting projects related to women, race, equity, and LGBTQ issues.
In the end, experts and clinicians alike urge caution and context. The evidence linking acetaminophen use in pregnancy to autism is, at best, inconclusive and fraught with methodological challenges. Pregnant individuals should not be frightened into abandoning an essential medicine based on political rhetoric. Instead, they should rely on the guidance of their healthcare providers and the consensus of the medical community, which continues to recommend acetaminophen as the safest option for treating fever and pain during pregnancy.
As the dust settles from the latest controversy, one thing remains clear: in matters of public health, nuance and evidence must prevail over politics and panic.
