Tylenol

It’s not my habit to preface my columns with “trigger alerts,” so this is a first:

If talking about circumcision makes you cringe, feel free to move along.

If, on the other hand, you wish to understand what Robert F. Kennedy Jr. was talking about during a White House meeting Oct. 9 when he tried to connect circumcision with autism, follow along with me.

The offhand reference to circumcision’s possible role in autism by Kennedy, Trump’s secretary of Health and Human Services, is part and parcel of Kennedy’s documented assault on science-based medicine.

His campaign encompasses attacks on COVID-19 vaccines, which have been shown over the years to have saved millions of people from death, hospitalization or long-term disability; his firing members of professional advisory boards at his agency and replacing them with anti-vaccine activists; his promotion of unproven “cures” for vaccine-preventable diseases; and his inaction in the face of a nationwide surge in cases of measles, a disease that was declared eliminated in the U.S. in 2000.

Let’s pause for a few words about the broader consequences of the erosion of our public health infrastructure. It not only exposes Americans to more disease and more serious disease, but has profound economic effects.

That’s true worldwide, but especially in the U.S., which spends much more per capita on healthcare than other developed countries, for lower results. Undermining the existing system for partisan ends won’t make the picture look any lovelier.

“The U.S. health disadvantage threatens the country’s global competitiveness and national security, as well as the hopes and prospects of future generations,” according to a 2021 paper from the Department of Health and Human Services, the agency that Kennedy now leads.

“U.S. employers depend on a healthy workforce to maximize productivity and minimize healthcare costs,” the paper stated. “Population health also affects the consumer market, whereby the demand for nonessential products and services suffers when families are struggling with illnesses and much of their disposable income is required for medical expenses.”

The chaos imposed on our public health system under the Trump administration only intensifies the damage.

On Friday, hundreds of employees at Kennedy’s agency, including the Centers for Disease Control and Prevention, abruptly received layoff notices. Some were hastily informed that their firings were erroneous, but the experience rattled the CDC, an agency tasked with overseeing the national response to seasonal respiratory illnesses at a time when those illnesses typically spike.

“The damage is beyond repair,” Demetre Daskalakis, who resigned as director of the National Center for Immunization and Respiratory Diseases, a unit of the National Institutes of Health, over conflicts with Kennedy, told CNN. “Crippling CDC, even as a ploy to create political pressure to end the government shutdown, means America is even less prepared for outbreaks and infectious disease security threats.”

That brings us back to Kennedy’s preoccupation with autism. He has claimed that the autism rate is on the rise due to “environmental toxins” such as childhood vaccinations and the use of Tylenol — or acetaminophen, its generic name — by mothers during pregnancy.

As I’ve reported, however, the roots of the increase in reported autism rates in recent decades are well understood: They have much to do with a broader definition of autism, which is widely described today as “autism spectrum disorder,” and with improved access to screening and diagnostic services by formerly overlooked groups such as Blacks, Hispanics and other nonwhite cohorts.

Kennedy’s comment about circumcision came during a White House Cabinet meeting. At first, he and Trump traded misconceptions they had previously aired about Tylenol use by pregnant women — Trump asserting that “obviously,” the rise in autism rates is “artificially induced” and adding, “I would say don’t take Tylenol if you’re pregnant, and … when the baby is born don’t give it Tylenol.”

That advice dismayed physicians, who say that fevers during pregnancy are a greater risk for the unborn and that acetaminophen is safer than alternative fever-reducing medicines.

Kennedy then injected circumcision into the discussion. “There’s two studies that show children who were circumcised early have double the rate of autism,” he said. “It’s highly likely because they were given Tylenol.”

Unsurprisingly, Kennedy’s remark got extensive play in the news media, prompting him to try walking it back via a tweet on X. Rather than accept responsibility for his confusing words, he responded with Bondi-esque truculence, writing: “As usual, the mainstream media attacks me for something I didn’t say in order to distract from the truth of what I did say.”

He even took arms against the Murdoch-owned New York Post, which posted its story with the headline, “RFK Jr. says Tylenol after circumcisions linked to autism,” and proceeded to debunk the claim.

In trying to clarify his point, however, Kennedy dug himself a deeper hole. According to his tweet, the two studies he was referring to at the cabinet meeting were a Danish study from 2015 and a non-peer-reviewed preprint posted online in August, which refers to the Danish paper. Kennedy mischaracterizes both.

Contrary to Kennedy’s implication, the Danish study did not address the use of acetaminophen (called “paracetamol” in the paper) in connection with circumcision. The reason, its authors wrote, was that “we had no data available on analgesics or possible local anesthetics used during ritual circumcisions in our cohort, so we were unable to address the paracetamol hypothesis directly.”

They did note, however, that the acetaminophen theory had only “limited empirical support.” In other words, evidence was lacking. Anyway, the Danish study was criticized — in the same journal that had published it — for its reliance on a very small sample of children.

As for the preprint, contrary to Kennedy’s description, it did not identify the Danish paper as offering “the most compelling ‘standalone’ evidence” for an autism-acetaminophen link. That language referred to three studies, one of which was the Danish paper. Of the other papers, one was based on later interviews with parents. The other was a study of the effects of acetaminophen on 10-day-old mice, not human children.

I asked Kennedy’s agency to clarify his claim and to explain the discrepancies between his words and the papers themselves, but received no reply.

To summarize, Robert F. Kennedy Jr., the nation’s top federal healthcare official, conjured up a connection between circumcision and autism via a relationship between circumcision and Tylenol that is unsupported by the research he cited. Indeed, the Danish paper describes the idea that boys undergoing circumcision invariably are given acetaminophen for pain as “a questionable assumption.”

In searching for empirical support for the acetaminophen theory, moreover, the Danish paper cited a 2010 paper funded by NIH that cautioned: “No evidence is presented here that acetaminophen in any way causes autism. … This hypothesis is largely based on multiple lines of often weak evidence.” Anyway, the paper was focused on a possible link between acetaminophen use and asthma, not autism.

Sadly, this sort of mischaracterization of research described as “a rigorous scientific framework” (RFK Jr.’s words) isn’t surprising coming from today’s Department of Health and Human Services. This is the agency, it may be recalled, that in May issued an “assessment” of the health of America’s children that cited at least seven sources that did not exist.

Nothing can stop unwary parents from relying on the judgment of Donald Trump or Robert F. Kennedy Jr. to make healthcare decisions for their infants and children. But they should be warned: They do so at their own and their offsprings’ risk.

During this week’s White House press conference in which President Trump named the over-the-counter drug Tylenol as a possible cause of rising autism rates, he did not mince words, urging pregnant women to “fight like hell” not to take it.

But outside those remarks in the Roosevelt Room — during which Trump himself acknowledged “I’m not so careful with what I say” — the discussion on the common fever and pain reliever’s role during pregnancy is a lot more nuanced.

What the research on Tylenol use during pregnancy actually says

Physicians, researchers on the very studies cited in support of Trump’s position and even other members of the president’s administration are largely united on a few key facts: untreated fevers in pregnancy pose real risks to the fetus, acetaminophen (Tylenol’s active ingredient) remains the safest medication to treat them and any pregnant person seeking advice on the issue should consult their doctor.

“All that we should be asking of the medical profession [is] to actually weigh the risks and benefits for the women, with the women, and be cautious about chronic use of pain medications,” said Dr. Beate Ritz, a UCLA professor of epidemiology who co-authored a paper published last month that the White House cited as evidence for the link between Tylenol and autism.

Ritz said it has been misinterpreted.

The conclusion of the paper, which reviewed existing studies on the topic, was that the association between acetaminophen use in pregnancy and later diagnoses of neurodevelopmental disorders in kids was strong enough to merit doctors’ consideration when determining how to treat fever or pain in pregnancy. The group did not determine a causal relationship between the drug and autism, or suggest barring the drug altogether, she said.

“Looking at all of these studies, yes, there is a risk,” Ritz said. “It’s not very big, but it’s there, but the risk increases are more seen in regular users of Tylenol. This is not a woman who has a fever and takes three Tylenols.”

“There is always a weighing of the risks and the benefits, and fever in women is no good either. … Not having to take any pain medications when you are in severe pain or in chronic pain is also very cruel,” she said. “We all should have an interest in helping out here, making the right decisions without blaming the victim and putting it all on the individual woman.”

Her co-author, University of Massachusetts epidemiologist Ann Bauer, has made similar statements.

“What we recommend is judicious use — the lowest effective dose [for] the shortest duration of time under medical guidance and supervision, tailored to the individual,” Bauer told the news outlet Politico.

The administration’s confusing recommendations

Ultimately, that’s what the administration is recommending as well.

The letter that U.S. Food and Drug Administrator Dr. Marty Makary sent to physicians this week made clear that “a causal relationship” between autism and acetaminophen “has not been established and there are contrary studies in the scientific literature.”

It went on to recommend that clinicians consider limiting their use of acetaminophen for routine low-grade fevers during pregnancy, while noting that medical advice “should also be balanced with the fact that acetaminophen is the safest over-the-counter alternative in pregnancy among all analgesics and antipyretics.” (An analgesic is a pain reliever; an antipyretic reduces fever.)

Untreated fevers during pregnancy are associated with higher rates of birth defects, particularly those of the heart, brain and spinal cord; premature birth; low birth weight; neurodevelopmental disorders including autism; and fetal death, said Dr. E. Nicole Teal, an assistant professor of maternal-fetal medicine at UC San Diego.

“The FDA’s letter, while significantly more nuanced than the president’s comments on the issue, still gives too much weight to findings from poorly designed studies,” she said.

She said she will continue to prescribe acetaminophen to pregnant patients who need to treat fevers or severe pain, as it has the fewest known risks in pregnancy.

Are there other pain-relief and fever-reducing drugs that can be used during pregnancy?

Nonsteroidal anti-inflammatory drugs like ibuprofen (often sold as Advil) or naproxen (often sold as Aleve) are linked to problems with blood vessel and kidney development, as well as oligohydramnios, a condition in which there isn’t enough amniotic fluid to support a healthy pregnancy. Aspirin raises the risk of bleeding complications, and narcotics — which can relieve pain but not fever — pose addiction risks for the mother and infant alike, Teal said.

She referred to a statement from the American College of Obstetricians and Gynecologists noting that two decades of research on the question had failed to find a causal relationship between acetaminophen and autism.

“Acetaminophen is one of the few options available to pregnant patients to treat pain and fever, which can be harmful to pregnant people when left untreated,” American College of Obstetricians and Gynecologists president Dr. Steven J. Fleischman said in the statement.

The group also noted that reviews in 2015 and 2017 from the FDA and the Society for Maternal-Fetal Medicine respectively found no risks associated with appropriate usage of the drug in pregnancy.

How to navigate government communications around Tylenol use

Nonetheless, the mixed messaging from the Trump administration about Tylenol seems likely to continue.

The Department of Health and Human Services this week reposted a 2017 tweet from the Tylenol brand’s account that said, “We actually don’t recommend using any of our products while pregnant.”

A spokesperson for Kenvue, the company that owns Tylenol, said the post was taken out of context and incomplete.

“Consistent with regulations, our label states clearly ‘if pregnant or breast-feeding, ask a health professional before use,’ ” Melissa Witt said in an email. “We do not make recommendations on taking any medications in pregnancy because that is the job of a healthcare provider.”

Vice President JD Vance offered similar guidance this week.

“My guidance to pregnant women would be very simple, which is follow your doctor. Right?” Vance said in an interview with the outlet NewsNation after Trump’s press conference. “Talk to your doctor about these things.”

President Donald Trump has urged pregnant women to avoid taking Tylenol, pointing to an unproven claim that links the painkiller to autism.

Speaking from the Oval Office with Health Secretary Robert F Kennedy Jr, Trump claimed that acetaminophen, the main ingredient in Tylenol – also known as paracetamol in most parts of the world –  was “no good” and should only be used in pregnancy when there’s a high fever.

He then outlined steps his administration would take to restrict the use of the drug during pregnancy, in comments laced with unproven – and, in some cases, false – claims.

Here is what he said, and what the facts say, about the drug, autism and whether Cuba, as Trump claimed at one point, does not have autism.

What did Trump announce?

Trump opened the event by calling autism a “horrible, horrible crisis”.

“The meteoric rise in autism is among the most alarming public health developments in history. There’s never been anything like this,” Trump said, even though experts point out that the data on autism only captures increased diagnoses – not necessarily a rise in the incidence of autism itself.

Trump then laid out his administration’s plans to tackle the “crisis”.

“First, effective immediately, the FDA will be notifying physicians that the use of a – well, let’s see how we say that acetaminophen – is that OK? Which is basically commonly known as Tylenol during pregnancy, can be associated with a very increased risk of autism,” he said.

He went on to warn that Tylenol use during pregnancy should be avoided unless absolutely necessary.

“So taking Tylenol is not good. All right. I’ll say it. It’s not good. For this reason, they are strongly recommending that women limit Tylenol use during pregnancy unless medically necessary. That’s, for instance, in cases of extremely high fever, that you feel you can’t tough it out. You can’t do it. I guess there’s that.”

Trump then shifted to his broader concerns about vaccines, arguing against combination shots – like the MMR vaccine against measles, mumps and rubella – even though they have been proven to be safe in multiple rounds of research.

He also questioned giving newborns the hepatitis B vaccine.

“Hepatitis B is sexually transmitted. There’s no reason to give a baby that’s almost just born, hepatitis B. So I would say, wait till the baby is 12 years old and formed and take hepatitis B.”

Finally, Trump repeated a claim that countries without Tylenol, like Cuba, have little or no autism – framing it as evidence.

“I mean, there’s a rumour, and I don’t know if it’s so or not, that Cuba, they don’t have Tylenol because they don’t have the money for Tylenol. And they have virtually no autism, OK. Tell me about that one.”

President Donald J. Trump, @SecKennedy, @DrOzCMS, @NIHDirector_Jay, & @DrMakaryFDA announce the Autism Action Plan.

Make America Healthy Again. pic.twitter.com/1inEvIecYU

— The White House (@WhiteHouse) September 22, 2025

As with Trump’s other claims at the event, his assertion about Cuba doesn’t stand up to scrutiny – as we’ll get to in a bit.

But first …

What is autism?

Autism, or autism spectrum disorder (ASD), is a developmental condition that’s experienced by people in many different ways. In the United States, it’s recognised as a form of neurodivergence and disability under the Americans with Disabilities Act. According to the Centers for Disease Control and Prevention (CDC), autism can shape how someone communicates, learns, and interacts with the world, often in ways that are simply different from most people.

Children diagnosed with autism can also have difficulties with social, emotional and communication skills. This can develop into traits that can affect interaction with others and difficulty in learning.

What causes autism?

Autism has been linked to a complex mix of genetic and developmental factors, and it looks different for every individual. Scientists have identified hundreds of genes that can play a role, either passed down from parents or appearing as new mutations during early brain development.

According to the US National Institute of Environmental Health Sciences, certain environmental influences may increase autism risk, including:

• Advanced parental age
• Prenatal exposure to air pollution or certain pesticides
• Maternal obesity, diabetes or immune system disorders
• Extreme prematurity or very low birth weight
• Birth complications leading to periods of oxygen deprivation to the baby’s brain.

Is autism on the rise in the US?

At first look, that’s what the numbers would suggest.

Figures from the CDC show that in 2022, 1 in 31 eight-year-old children were identified with autism in the US, up from 1 in 149 in 2000.

According to the CDC, the condition is also about three times more common in boys than in girls.

Globally, estimates vary. The World Health Organization (WHO) reported in 2021 that about 1 in 127 people worldwide were living with autism. Similarly, a 2022 review of 71 studies found an average prevalence of about 1 percent.

These numbers have been cited by some, like supporters of US Health Secretary Robert F Kennedy Jr, to argue that the US faces a particularly acute challenge with autism, and have been used to justify crackdowns on drugs like Tylenol.

But experts warn that the data might not necessarily agree with these assertions and the measures that the Trump administration is taking.

Why are the numbers going up?

First, say experts, comparing autism rates across countries is problematic because of differences in diagnostic practices, awareness and access to healthcare – all of which affect how prevalence is measured and reported.

The increased numbers in the US, they point out, only demonstrate a sharp rise in diagnoses – not necessarily a rise in the incidence of autism itself.

According to experts, there are two main factors behind the rise in autism diagnoses. First, the definition of autism has broadened as scientists have recognised its wide spectrum of traits and symptoms. This has led to updated diagnostic criteria and better screening tools.

At the same time, growing awareness has meant that more parents are seeking evaluations.

What about acetaminophen?

Acetaminophen (also known as paracetamol) is one of the most widely used over-the-counter pain relievers and fever reducers.

For more than a decade, researchers have studied whether acetaminophen use during pregnancy is linked to developmental disorders. Findings have been mixed: Some studies reported associations with autism, while a 2025 Mount Sinai review suggested evidence for broader neurodevelopmental risks.

But association is not the same as causation. The largest and most rigorous study to date, published in 2024, found no link between prenatal acetaminophen use and autism, ADHD, or other learning or developmental disorders. Experts note that the best-quality studies so far show no evidence of harm from acetaminophen.

According to the Autism Science Foundation, claims of a connection remain “limited, conflicting, and inconsistent”.

“The big reveal about autism was a total bust full of misinformation,” Arthur L Caplan, an American ethicist and professor of bioethics at the NYU Grossman School of Medicine, told Al Jazeera.

“There is no data to show Tylenol causes autism and lots of data to show that fever in pregnant women harms the fetus,” he added.

To be sure, even without a Tylenol-autism link, most doctors “will probably tell pregnant women they should always be careful about medication”, Catherine Lord, a professor of psychiatry at UCLA who specialises in autism, told Al Jazeera.

But those doctors will likely also caution women not to avoid taking medicines when they have a fever during pregnancy, she said. “They also need to realise that having a high fever or being in pain is not good for a growing baby, either, so they should consult their doctor,” she added.

Have there been other claims about what causes autism?

Over the years, autism has been wrongly linked to many supposed causes. The most notorious was the false vaccine-autism link from a 1998 study, now fully debunked. That study claimed an association between the MMR vaccine – the same one that Trump targeted on Monday – and autism. The Lancet, the highly respected British journal that published that study, retracted it 12 years later, in 2010.

Other debated factors include prenatal medications or antidepressants, environmental toxins, and diet, but the evidence is weak or inconsistent. Earlier, the discredited “refrigerator mother” theory blamed parents who were perceived to lack adequate emotional warmth with their children for higher risks of autism.

And finally, is it true, as Trump claims, that autism does not exist in Cuba?

It’s untrue – and if anything, Cuba undercuts Trump’s argument.

Cuba officially recognises autism spectrum disorder (ASD). There are multiple specialised schools and paediatric clinics that provide diagnosis and therapy for children with autism.

In Cuba, acetaminophen is generally known as paracetamol and is sold in government pharmacies. In other words, it is very much available and used as in other parts of the world.

According to a 2022 study, Cuba had an autism incidence of about 2 to 4 per 10,000 children in some settings. While research on autism diagnoses in Cuba is much more limited than in the US, the data from the 2022 study shows a far lower rate of recognised cases than in the US – despite the presence of acetaminophen.

United States President Donald Trump has urged pregnant women to avoid Tylenol, the brand name for paracetamol, over the painkiller’s unproven links to autism, prompting a swift backlash from doctors and scientists.

Trump issued the warning on Monday as the US drug regulator announced plans to add a label to paracetamol warning of an increased risk of autism and ADHD in children.

“Don’t take Tylenol. Don’t take it,” Trump said during a news conference at the White House while flanked by top public health officials.

“Fight like hell not to take it,” Trump said.

“There may be a point where you have to, and that you’ll have to work out with yourself.”

Trump also cast doubt on the medical consensus on childhood vaccines, suggesting that inoculations for measles, mumps and rubella should be administered separately instead of in the combined MMR shot.

“This is based on what I feel. The mumps, measles – the three should be taken separately,” Trump said.

“And it seems to be that when you mix them, there could be a problem.”

Trump’s comments drew condemnation from medical bodies, including the American Academy of Pediatrics and the American College of Obstetrics and Gynecology (ACOG), which have long recommended paracetamol as one of the few painkillers that is safe for women during pregnancy.

About half of pregnant women worldwide are estimated to take paracetamol – which is sold in different countries under brand names including Dyman, Panadol and Panamax – for pain relief and to reduce fevers, which can be potentially dangerous to both the foetus and the expectant mother.

ACOG president Steven J Fleischman called the suggestions of a link between paracetamol and autism “irresponsible”.

“When considering the use of medication in pregnancy, it’s important to consider all potential risks along with any benefits,” Fleischman said in a statement.

“The data from numerous studies have shown that acetaminophen plays an important – and safe – role in the well-being of pregnant women,” Fleischman said, using the name for paracetamol in the US.

While some research has found evidence of an association between paracetamol and neurological conditions such as autism, medical experts have cautioned that more robust studies have found no link, and that causation remains unproven.

One of the biggest population-based studies, published by Swedish researchers last year in The Journal of the American Medical Association, found no link when comparing children who had been exposed to the painkiller with siblings who had not.

Arthur Caplan, a bioethicist at the NYU Grossman School of Medicine, described the Trump administration’s moves as “hugely negative” for public health.

“The big reveal about autism was a total bust full of misinformation, a lack of evidence, bad advice and a bogus answer about the cause,” Caplan told Al Jazeera.

“I think mainstream medicine will ignore what he said today,” Caplan said.

“I think patients can’t trust federal science in the USA and must turn to other reputable sources.”

Catherine Lord, a professor of psychiatry at UCLA who specialises in autism, said studies showing a link between paracetamol use and autism were limited by the presence of confounding factors that are difficult to control for.

“I think the medical community will be firm that Tylenol in pregnancy does not cause autism, but will probably tell pregnant women they should always be careful about medication,” Lord told Al Jazeera.

“But they also need to realise that having a high fever or being in pain is not good for a growing baby either, so they should consult their doctor.”

In its updated guidelines announced on Monday, the US Food and Drug Administration cited evidence of a “correlation” between paracetamol use and autism, and noted studies suggesting a heightened risk when the drug is taken “chronically” throughout pregnancy.

Still, the drug regulator was notably less emphatic than Trump, noting that a causal relationship had yet to be established, and the existence of “contrary studies in the scientific literature”.

“It is also noted that acetaminophen is the only over-the-counter drug approved for use to treat fevers during pregnancy, and high fevers in pregnant women can pose a risk to their children,” the regulator said, using the other generic name for paracetamol.

Autism has no known single cause, but is believed to be related to an interplay of genetic and environmental factors, according to the American Academy of Pediatrics.

President Trump blamed the over-the-counter drug acetaminophen, commonly known by the brand name Tylenol, as a significant factor in the rise of U.S. autism diagnoses on Monday, at a news conference in which he offered often inaccurate medical advice for the nation’s children and pregnant women.

“Taking Tylenol is not good. I’ll say it. It’s not good,” Trump said, flanked by Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz.

In a series of rambling, error-filled remarks that touched upon pain relievers, pregnancy, vaccines and the Amish — who he inaccurately said have no autism prevalence in their communities — Trump also said that the mumps, measles and rubella vaccine should be broken up into multiple shots and that children defer until age 12 the hepatitis B vaccine series now started at birth.

• Share via Close extra sharing options

“I’m just making these statements from me, I’m not making them from these doctors,” he said. “It’s too much liquid. Too many different things are going into that baby.”

The announcement was met with dismay from autism researchers and advocates who said that research thus far into causal links between acetaminophen and autism has turned up minimal evidence.

“Researchers have been studying the possible connections between acetaminophen and autism for more than a decade,” said Dr. David Mandell, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine. The Trump administration, he said, “has cherry-picked findings that are not in line with most of the research.”

Physicians and researchers also took issue with Trump’s insistence that there was “no downside” to women avoiding fever-reducing drugs in pregnancy. In fact, studies show that untreated fever in pregnancy is associated with higher risk of heart and facial birth defects, miscarriage and neurodevelopmental disorders — including autism.

The U.S. Food and Drug Administration will initiate a safety-label update for Tylenol and other acetaminophen products and send a letter to physicians about potential links between the drug’s use and autism, Kennedy said.

The actual text of the letter is much milder than Trump’s impassioned critique.

“In the spirit of patient safety and prudent medicine, clinicians should consider minimizing the use of acetaminophen during pregnancy for routine low-grade fevers. This consideration should also be balanced with the fact that acetaminophen is the safest over-the-counter alternative in pregnancy among all analgesics and antipyretics,” states the letter, signed by FDA Commissioner Dr. Marty Makary.

Monday’s announcement followed weeks of speculation that Kennedy planned to publicly link Tylenol usage to autism, which prompted multiple medical associations to release statements clarifying that any evidence of a causal relationship between the two is limited, and that the drug is safe to take during pregnancy with medical advice.

“All of us in the advocacy community, and all of us who have children with autism, had very high hopes that RFK and the President were serious when they said they wanted to find the causes of autism,” said Alison Singer, co-founder and president of the Autism Science Foundation. “The problem is that so far, what we’ve heard has not been gold-standard science.”

The administration also said it would fast-track the labeling of leucovorin, a generic drug currently used to reduce side effects of chemotherapy, as a treatment for autism-related speech deficits. Also known as folinic acid, leucovorin is a form of the B vitamin folate. Research into its effect on autistic children is still in its early stages, researchers said. The few studies that have been published had small sample sizes and found only minimal improvements in symptoms of concern, Mandell said.

“I want to see a large, rigorous, independent trial. In the absence of that, to tout this as a cure is reckless,” he said. “Families deserve better.”

Autism spectrum disorder is a complex neurological and developmental condition. Symptoms cluster around difficulties in communication, social interaction and sensory processing, and the condition can manifest in many different ways based on co-occurring disabilities and other factors.

Diagnoses in the U.S. have risen steadily since the Centers for Disease Control and Prevention began tracking data in 2000, thanks in large part to a broadening definition of the disorder and increased efforts to identify children with ASD.

Today one in 31 U.S. 8-year-olds has been identified as having autism spectrum disorder, according to the most recent CDC data, up from one in 150 in 2000.

Kennedy has long asserted that’s due to an external environmental cause, often using inaccurate statements to describe both the condition and the research around it.

• Share via Close extra sharing options

Most experts believe genetic links and changing diagnostic criteria play a significant role in the trend. In April, Kennedy dismissed such research and arguments as “epidemic denial.” He said he was certain an external factor was to blame.

“We know it’s an environmental exposure. It has to be,” Kennedy said. “Genes do not cause epidemics.” He said at the time that the administration would find an environmental cause by September.

Research into causal links between acetaminophen and autism have not found strong evidence.

Last year, a team of researchers from the U.S. and Europe reviewed records of 2.5 million babies born in Sweden between 1995 and 2019. At first glance, it did seem like children exposed to acetaminophen in the womb were 5% to 7% more likely to be diagnosed with autism than those who weren’t. But when the researchers compared those children to their siblings, they found that kids from the same parents were equally likely to be diagnosed with autism, whether their mother took acetaminophen during pregnancy or not.

“If you actually do an apples to apples comparison, you see absolutely zero effect. The association flatlines. In other words, there’s no real risk that’s attributable to acetaminophen,” said Brian K. Lee, a professor of epidemiology and biostatistics at Drexel University who was on the study team. “A large elephant in the room is being ignored, and that’s genetics.” Hundreds of studies over the years have explored the complex genetics of autism, with both inherited and spontaneous genes contributing to the condition.

The paper also noted that women who took acetaminophen while pregnant were, unsurprisingly, more likely to suffer from the kinds of ailments for which the medication is indicated, like fevers or chronic pain.

They were also more likely to have diagnoses of autism or other neurodevelopmental disorders, to have pre-existing mental health conditions or to be taking other prescribed medications, the team found. Their results were published in the Journal of the American Medical Association.

“People don’t take acetaminophen for fun. They are taking it for a health condition,” Lee said.

He compared the correlation between Tylenol exposure and autism to the correlation between ice cream sales and drownings. Both of those things tend to increase at the same time each year, he said, not because ice cream is deadly but because both rise during hot summer months. In other words, the underlying health causes that women are taking acetaminophen to treat could be more likely linked to autism than the pain reliever itself.

“This is just such a shame when there are so many things we could do to help autistic children and adults, and the negative consequences — making parents feel guilty about taking Tylenol during pregnancy and newly pregnant women afraid — are real,” said Catherine Lord, a clinical psychologist and autism researcher at UCLA. “Just sad all around.”

President Donald Trump said doctors in the US will soon be advised not to prescribe the pain reliever Tylenol to pregnant women, citing a disputed link between the drug and autism.

Trump made the announcement on Monday in the Oval Office along with Health Secretary Robert F Kennedy Jr.

The US president claimed that taking Tylenol, known as paracetamol elsewhere, “is no good” and that pregnant women should only take it in cases of extreme fever.

Some studies have shown a link between pregnant women taking Tylenol and autism, but these findings are inconsistent and inconclusive. Tylenol maker Kenvue has defended the use of the drug in pregnant women.

In a statement to the BBC, it said: “We believe independent, sound science clearly shows that taking acetaminophen does not cause autism. We strongly disagree with any suggestion otherwise and are deeply concerned with the health risk this poses for expecting mothers.”

Aacetaminophen – Tylenol’s active ingredient – is the safest pain reliever option for pregnant women, it added, and without it, women face a dangerous choice between suffering through conditions like fever or use riskier alternatives.

During the announcement on Monday, US Health Secretary RFK Jr said the Food and Drug Administration (FDA) will begin the process of changing labels on the drug’s packaging to note what he said is the risk of use during pregnancy.

He added that the FDA will also begin issuing a public health campaign to spread awareness.

In April, RFK Jr pledged “a massive testing and research effort” to determine the cause of autism in five months.

But experts have cautioned that finding the causes of autism – a complex syndrome that has been researched for decades – would not be simple.

The widely held view of researchers is that there is no single cause of autism, which is thought to be the result of a complex mix of genetic and environmental factors.

The American College of Obstetrics and Gynecology said doctors across the country have consistently identified Tylenol as one of the only safe pain relievers for pregnant women.

“Studies that have been conducted in the past, show no clear evidence that proves a direct relationship between the prudent use of acetaminophen during any trimester and fetal developmental issues,” the group has said.

The drug is recommended by other major medical groups as well as other governments around the world.

In August, a review of research led by the dean of Harvard University’s Chan School of Public Health found that children may be more likely to develop autism and other neurodevelopmental disorders when exposed to Tylenol during pregnancy.

The researchers argued some steps should be taken to limit use of the drug, but said the pain reliever was still important for treating maternal fever and pain, which can also have negative effects for children.

But another study, published in 2024, found no relationship between exposure to Tylenol and autism.

“There is no robust evidence or convincing studies to suggest there is any causal relationship,” said Monique Botha, a professor in social and developmental psychology at Durham University.

Dr Botha added that pain relief for pregnant women was “woefully lacking”, with Tylenol being one of the only safe options for the population.

Autism diagnoses have increased sharply since 2000, and by 2020 the rate among 8-year-olds reached 2.77%, according to the US Centers for Disease Control and Prevention (CDC).

Scientists attribute at least part of the rise to increased awareness of autism and an expanding definition of the disorder. Researchers have also been investigating environmental factors.

In the past, Kennedy has offered debunked theories about the rising rates of autism, blaming vaccines despite a lack of evidence.

Welcome to Screen Gab, the newsletter for everyone who longs for the expansion of dirty soda chain Swig so we can feel better equipped to deal with #MomTok drama (IYKYK).

It’s been a week since the second season of “The Secret Lives of Mormon Wives” dropped on Hulu, but die-hard reality TV watchers have likely already inhaled all nine episodes with the same unwavering commitment as the cast member trying to make us believe that her husband is related to Ben Affleck. (Spoiler alert: He is not. But we sure hope the actor watches while sipping on a 44-ounce iced coffee.) Taylor Frankie Paul, the self-proclaimed founder of #MomTok, the TikTok infuencer group that unites them, stopped by Guest Spot to talk about the new season of friendship and backstabbing.

Also in this week’s Screen Gab, our resident true-crime expert Lorraine Ali tells you why a docuseries about 1982’s unsolved Tylenol murder case is worth watching, and TV critic Robert Lloyd dives into the pleasures of watching professional surfers chase giant waves. Be sure to also find time to take in Lloyd’s tender tribute to “quintessential Regular Guy” George Wendt, who died this week at age 76; it’s linked below.

ICYMI

Must-read stories you might have missed

Actor George Wendt, best known for his role as Norm in NBC’s long-running sitcom “Cheers,” holds a glass of beer in a barroom in Los Angeles on June 13, 1983.

(Wally Fong / Associated Press)

Appreciation: George Wendt, quintessential Regular Guy: George Wendt, who died Tuesday, will be most remembered for his character on ‘Cheers,’ whom he played straight and without affectation.

On his travel show, Conan O’Brien is on a treasure hunt for the unexpected: The comedian and host of ‘Conan O’Brien Must Go’ spoke about the latest season of his Max travel show, his recent Mark Twain Prize and acting in his first feature film.

At this year’s Cannes, bleak is the new black and miserable endings are très chic: On the Croisette, Ari Aster’s ‘Eddington’ with Joaquin Phoenix and Pedro Pascal and a strong directing debut by ‘Babygirl’ star Harris Dickinson grab attention.

Everyone knew Pee-wee Herman. But few knew the man behind the man-child: ‘Pee-wee as Himself,’ a two-part documentary directed by Matt Wolf on HBO, supplies a vivid portrait of Paul Reubens, who receded behind his character.

Turn on

Recommendations from the film and TV experts at The Times

Professional big-wave surfer Garrett McNamara in HBO’s “100 Foot Wave.”

(HBO)

“100 Foot Wave” (Max)

The continuing story of big-wave surfer Garrett McNamara, his family and friends becomes a trilogy with the third season of Chris Smith’s great HBO docuseries, crazy to contemplate yet beautiful to behold. Garrett, a maverick who put the Portuguese town of Nazaré on the map for its massive waves, set a record there, surfing a 78-footer — imagine an eight-story office building coming up behind you. But with the spot well-established and many records having been matched, the series has become less about competition than community and compulsion. (A middle-aged adolescent with a seemingly high tolerance for pain, Garrett, despite age and injury, cannot stop surfing.) Back again, with a cast of top big-wave surfers, are charismatic Nicole McNamara, Garrett’s level-headed wife and manager and mother to their three, one might say, “other children,” and her brother C.J. Macias, suffering from surfing PTSD after breaking his arm at Nazaré. The climax of the season is a surfing safari to Cortes Bank, 100 miles off the coast of Southern California, where an undersea island creates huge waves with no land in sight. — Robert Lloyd

A still showing Tylenol pills from the Netflix documentary “Cold Case: The Tylenol Murders.”

(Netflix)

“Cold Case: The Tylenol Murders” (Netflix)

If you’re not ready to switch to Advil, stop reading here. Netflix’s three-part, true-crime docuseries deftly chronicles one of the largest criminal investigations in U.S. history involving the 1982 murder of seven victims in Chicago who died after ingesting Extra Strength Tylenol tablets laced with cyanide. No one was ever charged with their murders.

Directed by Yotam Guendelman and Ari Pines (“Conversations with a Killer: The Ted Bundy Tapes”), the series includes interviews with family of the victims, investigators, police and prosecutors who were directly involved in the case. Together their accounts recall the bizarre and terrifying nature of the crimes, the national panic caused by the tainted pills and the stunning lack of scrutiny on the medication’s manufacturers, Johnson & Johnson.

Private citizen James W. Lewis eventually emerged as one of two main suspects in the case, and he served 12 years in prison for sending an extortion note to Johnson & Johnson demanding $1 million to “stop the killing.” But authorities couldn’t pin the murders on Lewis. The documentary features an exclusive interview with Lewis before his death in July 2023 in which he proclaims his innocence yet appears to still revel in the media attention. The series also calls into question the culpability of Johnson & Johnson and the possibility that the poisoned capsules may have come straight from the factory before landing on drugstore shelves, where they were purchased by the unwitting victims. The murders ultimately led to an overhaul on the safety packaging we see on today’s over-the-counter medication.

Also worth your time is “This is the Zodiac Speaking,” Netflix’s riveting 2024 docuseries chronicling a family of siblings who were intimately involved with the top suspect in the still unsolved Zodiac killings of the 1960s and ‘70s. Sleep tight. — Lorraine Ali

Guest spot

A weekly chat with actors, writers, directors and more about what they’re working on — and what they’re watching

Mayci Neeley and Taylor Frankie Paul in “The Secret Lives of Mormon Wives.”

(Fred Hayes / Disney)

“The Secret Lives of Mormon Wives” feels like the new wave of soapy reality TV in the way it builds off social media personas to create ridiculously addictive drama. The Hulu reality series follows the lives of a group “momfluencers” who push against traditional Mormon norms — they’re the breadwinners, some are divorced, many drink, and at least one faced the dilemma of promoting a sex toy brand. Taylor Frankie Paul, the founding member of #MomTok, stopped by Guest Spot to discuss what makes great reality TV versus social media content and the scripted show that reminds her of her life. — Yvonne Villarreal

The women spend a lot of the season saying #MomTok has veered away from what it was initially conceived to be about — women supporting women. How do you think the reality show — this additional layer of sharing your personal life with an audience — has both helped its evolution and threatened its survival?

I think it’s threatened the survival because when you share, you get vulnerable and, unfortunately, when doing so it could eventually be used against you. With that being said, it helps the evolution by doing the same thing — being vulnerable can bring people closer together as well.

What have you learned makes great reality TV and how is that different from what makes great social media content?

What makes great reality TV is sharing as much as you can — both pretty and ugly — so they [followers] can see [the] bigger picture. What makes great social media content is leaving some mystery. It’s ironic that it’s opposite!

Viewers had a strong reaction to how your family engaged with you about your relationship with Dakota, particularly at the family BBQ. What struck you in watching it back?

Watching the scene at my family BBQ made us all cry because my family loves me dearly and the approach was maybe not the best (including myself), but everyone’s emotions were heightened. A lot was happening and all I remember is feeling overwhelming pain. But I do know my family has my best interest [in mind] even if that moment doesn’t show that. I know and that’s all that matters. I don’t like seeing the backlash because they are my village and I love them so much.

I notice that I come off intimidating or harsh, however I’m very soft and forgiving. I typically need to feel safe to show more of that. I feel like I’m always on defense, and I need to give people the benefit of the doubt — not everyone is going to cause pain; in other words, [I need to] open my heart more.

What have you watched recently that you’re recommending to everyone you know?

My current go-to watch is “Tell Me Lies” [Hulu]. I’m not a reality TV girl, ironically. I’m obsessed with this show. It’s so toxic and so good. It’s a lot like my life, so it’s entertaining to watch someone else’s life.