Trump's Tylenol autism warning draws expert criticism as debate over acetaminophen and autism continues

President Donald Trump on Monday urged pregnant women to avoid Tylenol, saying acetaminophen could raise the risk of autism in children. He framed it as a personal choice for mothers to 'fight like hell not to take it' and suggested avoiding the pain reliever during pregnancy. The remarks drew swift pushback from medical experts who stressed that no causal link between acetaminophen and autism has been established.

Dr. Allen Frances, a leading psychiatrist whose work helped broaden autism definitions in the 1990s, called the president's warning 'absolutely moronic' and warned it could divert attention and resources toward misinformation. Frances led efforts that expanded autism criteria in the DSM over the decades, a change he has since described as misguided and linked in part to rising prevalence and anti-vaccine rhetoric. He has repeatedly cautioned that diagnostic expansion, not medications, explains much of the growth in autism diagnoses. In interviews earlier this year, Frances described the expansion as a 'mea culpa' for well-meaning but unintended consequences and said the links drawn between vaccines and autism are 'absurd.'

Trump and some health officials have pointed to a 2024 Mount Sinai and Harvard study that found an association between acetaminophen exposure during pregnancy and higher odds of a neurodevelopmental diagnosis, including autism. Scientists emphasized that such studies show association, not causation, and the paper’s authors cautioned against drawing definitive conclusions. Co-author Dr Brian K. Lee told the Daily Mail that the best science to date indicates acetaminophen used in pregnancy does not cause autism, noting that several observational studies have found associations but do not prove causation.

Other major studies, including a 2024 Swedish analysis of more than 2.4 million children, found no heightened autism risk among those exposed to acetaminophen. Pediatric neurodevelopmental experts also stress that research in this area carries uncertainties and that findings regarding one medication should not be extrapolated to all contexts. As one pediatric neuropsychologist noted, the uncertainty across several drug classes—including antiseizure medications, SSRIs, benzodiazepines and even antibiotics—means leaders and scientists must share findings with honesty and context so families can make informed decisions without unnecessary fear.

Officials, including the head of the Center for Medicaid and a senior adviser to the administration, have since walked back the comments, urging that pregnant women consult their doctors before taking Tylenol. A Tylenol manufacturer spokeswoman said acetaminophen remains the safest pain reliever for pregnant women when needed throughout pregnancy, citing decades of research that, she argued, shows no credible link to autism. Experts say the evidence to date does not establish causation and stress the importance of weighing benefits and risks in consultation with clinicians.

While the science on acetaminophen and autism remains unsettled, researchers emphasize that autism prevalence has risen in many high-income countries, a trend largely attributed to broadened diagnostic criteria and increased recognition rather than a single medication or exposure. The topic remains a focal point of public health messaging, particularly as policymakers and clinicians seek to balance caution with evidence-based guidance for pregnant patients.