The Truth About Autism, Tylenol, and Political Fearmongering

I tend to try to keep my blogs apolitical, however, Donald Trump and Robert Kennedy Jr.'s recent announcement has unleashed a wave of dangerous fearmongering about acetaminophen (Tylenol) being a possible cause of autism during pregnancy, and I will not stay silent in this. Now I'm seeing people share these claims across social media, and politicians are amplifying them despite contradicting decades of research. It's frustrating because it completely misses what's actually happening and perpetuates harmful myths about autistic people. Let me break down what the research actually shows, expose the dangerous politics behind these claims, and explain why this conversation is headed in the wrong direction. 

Autism Existed Long Before Tylenol

Here's a fact that should end this debate immediately: autism was first diagnosed in 1943 by Leo Kanner, more than a decade before Tylenol was introduced in 1955. Kanner's original 11 patients, all born in the 1930s, displayed clear autistic traits well before acetaminophen was available. So if Tylenol was a cause for autism, how do we explain all the autistic people who came before it existed?

Looking back through history, we can find many individuals whose documented behaviors and traits align remarkably well with what we now recognize as autism. Nikola Tesla's obsessive routines, intense focus on his inventions, and well-documented social difficulties. Emily Dickinson's preference for solitude, sensory sensitivities, and narrow but intense interests. Henry Cavendish's extreme social awkwardness but brilliant scientific mind. While we can't definitively diagnose historical figures, their documented behaviors suggest autism has been part of human neurodiversity long before modern medicine, or modern pain relievers, existed.

The answer is simple. We don't see older autistic adults in large numbers for two main reasons. First, the ones who were "obviously autistic" were often institutionalized in asylums or care facilities. Second, the ones who could mask their autistic traits went unsupported for their disabilities and suffered mentally and physically as a result. Masked autistics historically had higher rates of suicide and lower life expectancy.

Think about it this way. If your child was blind and never received supports for their disability, would they be likely to grow up, live long enough to have children, and reach old age? Probably not. We have more autistic children today partially because we know more about supporting people with disabilities, so they're living longer and healthier lives.

The Research Picture Is More Complex Than Simple Answers

The research on acetaminophen and autism has produced conflicting results, but the highest-quality studies consistently find no causal link. The largest and most rigorous study to date, published in JAMA in 2024, examined nearly 2.5 million Swedish children and found no association between acetaminophen use during pregnancy and autism when researchers controlled for familial factors by comparing siblings. This suggests that associations observed in other studies were due to shared genetic and environmental factors rather than the medication itself.

While some studies, including a 2025 Mount Sinai meta-analysis, claim that higher-quality studies show a link between prenatal acetaminophen exposure and increased risks of autism and ADHD, these studies have significant methodological limitations. When genetic and environmental factors are properly controlled through sibling comparison studies, the associations disappear. The Swedish study found a very small increase in autism prevalence among children exposed to acetaminophen (0.09 percentage points), but this elevated risk disappeared completely when researchers compared siblings where the mother took acetaminophen during one pregnancy but not the other.

Leading researchers and medical organizations emphasize that association is not causation, and no study has definitively proven that acetaminophen causes autism. Major medical organizations, including the American College of Obstetricians and Gynecologists, maintain that acetaminophen is safe when used as directed during pregnancy, and that "in more than two decades of research on acetaminophen in pregnancy, not a single reputable study has successfully concluded that the use of acetaminophen causes neurodevelopmental disorders".

Why the Correlation Exists

When studies do find correlations, there's likely a logical explanation that doesn't involve causation. Autistic people are more likely to experience chronic pain from conditions like hypermobility. We're also more likely to have compromised immune systems due to the stress of masking in a world that doesn't accommodate disability. This means autistic people, including pregnant autistic people, may need pain and fever relief more often than neurotypical people.

When you're pregnant, doctors advise against most other over-the-counter pain relief options. No aspirin, no ibuprofen. Acetaminophen becomes the safest choice. So of course pregnant autistic people, who may need pain relief more frequently, would use more Tylenol. And autistic parents are more likely to have autistic children due to genetic factors.

It's correlation, not causation. Ice cream sales and drowning deaths both spike in summer, but ice cream doesn't cause drowning. Hot weather causes both more ice cream consumption and more swimming activities. The underlying factor, summer weather, explains both increases.

Why Autism Diagnoses Are Increasing

People often ask why there are so many more autistic people now. There are two main reasons, and neither involves Tylenol.

Until the DSM-5 was published in 2013, doctors didn't realize people could have both ADHD and autism simultaneously. The previous diagnostic criteria prohibited simultaneous diagnosis of both disorders. But they can, and autistic people are actually more likely than others to have ADHD, with studies indicating 15-25% of youth with ADHD meet criteria for ASD, while 50-70% of those with ASD have comorbid ADHD. When the diagnostic criteria changed to reflect this better understanding, many more people suddenly met the criteria for an autism diagnosis. We call this AuDHD, though some people use the umbrella term neurodivergent.

Second, women have been consistently understudied and underrepresented in medical research. Diagnostic tests were always designed around how autism presents in men and boys. Now that doctors are beginning to understand how autism presents in women, girls, and non-gender-conforming people, we're finding autistic people who aren't men. Recent research suggests that nearly 80% of autistic girls and women remain undiagnosed by age 18. Studies show that screening tools commonly used in research consistently exclude women at much higher rates than men, creating a "leaky pipeline" that results in severe underrepresentation. As more women seek and receive autism diagnoses, I expect the numbers to continue rising.

The Dangerous Politics of Autism Fearmongering

The Trump administration's recent announcement linking acetaminophen to autism represents more than just bad science, it's a harmful attack on autistic people and the families who support them. President Trump repeatedly told pregnant women to "tough it out" without Tylenol, claiming there was "no downside" to avoiding safe pain relief during pregnancy, while simultaneously promoting an unproven treatment with concerning financial conflicts of interest.

Treating Autism as a Disease to Cure

The administration framed autism as an "epidemic" that has "surged nearly 400%" and needs to be confronted with "bold action". This language is not just scientifically inaccurate, it's deeply harmful to autistic people. Autism isn't a disease or epidemic. It's a neurological difference that has always existed in human populations. We're seeing more diagnoses because we've gotten better at recognizing autism, especially in women and girls, not because something is suddenly "causing" more autism.

When politicians talk about autism as a crisis to be solved, they're telling autistic people that our existence is a problem. They're telling parents that having an autistic child is a tragedy to prevent rather than a life to support and celebrate.

Vilifying Mothers for Safe Medical Decisions

The American College of Obstetricians and Gynecologists emphasizes that "untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure". Yet the administration is telling pregnant women to avoid one of the safest pain relief options available to them.

This creates a dangerous false choice for pregnant women: risk their health and their baby's health by avoiding safe medication, or feel guilty about potentially "causing" autism by taking medically recommended treatment. As medical experts pointed out, "the biggest risk is that pregnant people might stop treating fevers or severe pain out of fear".

A Troubling Financial Conflict of Interest

The administration's promotion of leucovorin as an autism treatment raises serious ethical concerns. Dr. Mehmet Oz, who now heads the Centers for Medicare and Medicaid Services, is a "global advisor and stakeholder" at iHerb, a supplement company that sells folinic acid (the supplement form of leucovorin). Oz holds up to $25 million in iHerb stock, creating a direct financial incentive to drive demand for these products.

Despite the administration's claims, the evidence for leucovorin helping with autism is extremely limited, only small studies with mixed results and no large-scale trials proving effectiveness. Dr. David Mandell, an autism researcher at the University of Pennsylvania, emphasized that "the evidence we have supporting it is really, really weak". The American Psychiatric Association stated that leucovorin "is not recommended to treat autism" and that "it will require many more years of research before we know if leucovorin is an appropriate treatment".

The Real Harm

This announcement does real damage in several ways:

First, it spreads fear about safe medical treatments that pregnant women may actually need. Second, it gives false hope to desperate families by promoting an unproven treatment as government-approved. Third, it reinforces the harmful narrative that autism is something to be prevented or cured rather than understood and supported.

As autism advocate Alison Singer noted, "We are unsure why this announcement came today and how the conclusions were drawn. No new data or scientific studies were presented or shared".

The real "epidemic" isn't autism, it's the failure to provide adequate support, services, and acceptance for autistic people and their families. Instead of wasting time and resources on debunked theories and unproven treatments, we should focus on what actually helps: early intervention services, educational support, accessible healthcare, employment opportunities, and building communities where autistic people can thrive as ourselves.

In regards to one of the studies that were mentioned: 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 goes to show how the research is still ongoing, and these claims made by Trump and RFK Jr., are jumping the gun on what the research actually says.

What We Should Actually Be Focusing On

Instead of debating whether Tylenol causes autism, we need to recognize there's a difference between being autistic and being severely cognitively disabled. Some people are both autistic and cognitively disabled. Many aren't. Some are just autistic.

Autism doesn't automatically mean someone needs intensive 24-hour care or wants to be "cured" of what they see as a fundamental part of who they are. We don't try to cure other forms of human variation like left-handedness or red hair. I'm autistic and I have ADHD and I have led a fairly successful life. Bill Gates and Steve Jobs have both indicated they qualify as autistic, and I've never seen anyone trying to "cure" them.

The real problems families face aren't caused by autism itself. They're caused by inadequate support systems. Schools are underfunded. Teachers don't know what autism looks like in kids who can speak and make eye contact. Paraprofessionals are undertrained and underpaid. Pediatricians aren't well-trained in spotting autism or providing early interventions.

Our schools demand full-body listening for long periods, which isn't developmentally appropriate for any child but is particularly challenging for kids who learn best while fidgeting and having sensory engagement with their environment. Parents aren't taught what to look for in recognizing sensory processing or communication differences in their children.

Autistic people face discrimination in the workforce, leading to lower-income jobs or unemployment, making families reliant on limited Medicaid services. This restricts access to psychological health services and screenings, particularly in areas where Medicaid has been cut.

The real work lies in building better support systems. Schools need better funding and training so teachers can recognize autism in kids who speak and make eye contact. Paraprofessionals need proper training and fair wages. Pediatricians need education in early autism identification and intervention referrals. Parents need guidance on recognizing sensory processing and communication differences in their children. And workplaces need to understand neurodivergence and create inclusive environments that support autistic employees instead of discriminating against them.

Moving Forward Constructively

Getting an autism diagnosis isn't easy, and it shouldn't be treated as a tragedy to prevent. Autistic people exist. We're not going anywhere. Many of us can communicate for ourselves and want you to learn about us from us, not from politicians with financial conflicts of interest.

Instead of falling for fearmongering about safe medications, focus your energy where it actually matters: advocating for better school funding, improved educator training, accessible healthcare, employment opportunities for autistic adults, and services that help neurodivergent families thrive.

That's where real change happens, not in avoiding medically necessary treatments during pregnancy, but in building communities where autistic people are valued for who we are.

If you're a parent and you are looking for support and help with your children with ADHD and/or Autism, let's talk! I help parents find their way through this maze of information and give you actionable strategies for supporting your kids. Schedule a Free Discovery Call with me today!