The recent claims from the Trump administration regarding the absent link between acetaminophen and autism spectrum disorder (ASD) reflect a growing mistrust toward scientific authority from the right.
On Sept. 22, The White House published a news release urging pregnant women to stop using acetaminophen — the drug used in Tylenol with the purpose of treating fevers and pain — claiming that the drug could cause their unborn child to have an increased likelihood of developing autism spectrum disorder (ASD).
The U.S. Food and Drug Administration published their own statement echoing Trump’s claims, saying that the administration plans to conduct a safety label change for acetaminophen products while notifying doctors of the “possible link” between acetaminophen and ASD.
However, a paragraph at the end of the FDA’s statement points to inconsistencies in Trump’s claims and scientific findings:
“It is important to note that while an association between acetaminophen and neurological conditions has been described in many studies, a causal relationship [emphasis mine] has not been established and there are contrary studies in the scientific literature,” the statement reads.
An association and causal relationship are not the same; an association implies that acetaminophen use and ASD diagnoses happened to appear alongside each other across the literature, while a causal relationship would require evidence to demonstrate that acetaminophen use causes ASD.
Thus, the statement reveals that there is no adequate evidence to deduct that acetaminophen use leads to ASD; despite Trump’s claims, the drug is not found to cause the disorder.
In fact, the FDA’s statement also reminds readers that acetaminophen is the only drug that has been approved to treat fevers during pregnancy, noting that high fevers in pregnant mothers can be dangerous for themselves and their unborn child.
This situation led the Government of Canada to issue a public advisory speaking against the Trump administration’s claims, writing that there is “no conclusive evidence that using acetaminophen as directed during pregnancy causes autism or other neurodevelopmental disorders.”
Evidently, the Trump administration’s claims surrounding acetaminophen use and ASD are fueled by ableism, othering those with ASD and using medical misinformation to convince Americans of their claims. This discussion ultimately functions to instill a sense of suspicion in citizens when interacting with medical professionals — which is indicative of a broader trend in right-wing politics to mistrust scientific authority.
If you experienced the COVID-19 pandemic first-hand, you’ll remember that this is not the first instance of right-wing politicians spreading misleading health information.
Alongside the COVID-19 pandemic sprung a “misinfodemic” (misinformation pandemic) — a term used by Wen-Ying Sylvia Chou and colleagues in their study to describe the floods of misinformation relating to COVID-19 that circulated throughout the pandemic.
This rampant misinformation was fueled by a “politicization of science,” wherein political ideology began to influence one’s willingness to follow the suggestions of health professionals and scientists, according to researchers Toby Bolsen and Risa Palm.
As reflected in Bolsen and Palm’s study, those expressing right-wing ideology showed more of a hesitancy to trust medical authority and less of a willingness to follow their directions on vaccine use. This hesitancy is largely fueled from the unfounded suspicions surrounding the trustworthiness of medical authority voiced by Trump early in the pandemic. Thus, the association between republicanism and medical suspicion was born, as was the opposite end of the dichotomy tying democratic voters to trust in scientific authority.
Though this dichotomy is far too universal to account for the diversity in views across the political spectrum, it is indicative of a general ideological split between those who trust in medical research and those who do not.
The politicization of science is much to blame for fueling such ideological polarization surrounding health narratives, making it a large contributor to the strength of the Trump administration’s “Make America Healthy Again” (MAHA) movement.
Though the White House says that the MAHA movement is “pursuing truth” and “embracing science,” they unfortunately seem to only use biased science that confirms their misled “truth” on health matters.
As the Autistic Self Advocacy Network (ASAN) describes, the MAHA movement does not demonstrate that they are working to make citizens healthier but instead spend their time “identifying problems that do not exist and proposing solutions that will not work.”
ASAN justifies this sentiment by noting MAHA’s plans to revise childhood vaccine schedules, misled approaches to ASD and fearmongering towards psychiatric drug prescriptions, among others. The network also expressed valid concern regarding Robert Francis Kennedy Jr. — the U.S. Secretary of Health and Human Services, leader of the MAHA movement and newly passionate anti-vaxxer — being in a position of authority over childhood vaccinations.
Much of the anti-vaccine movement is built upon suspicions that there are serious side effects caused by vaccines that health providers are not communicating to patients, hence widespread sharing of unfounded claims that vaccines contribute to a slew of health conditions or disorders, including ASD — which speaks to an underlying theme of ableism in this movement as well.
More than concerns regarding side effects, the anti-vaccine movement and the MAHA movement share the ideological preoccupation involving the untrustworthiness of medical professionals and scientists — a preoccupation further echoed by the Trump administration in the recent discussions surrounding acetaminophen.
Though some instances of medical mistrust, like the ones listed above, can lead to the spread of harmful misinformation that threatens public health, medical mistrust can have genuine roots outside of polarizing ideological motivations. For example, over-prescription of intensely addictive opioids is a major contributor to the widespread opioid crisis faced by many nations today. Watching a loved one fall into opioid use disorder (OUD) — or experiencing OUD yourself — after unnecessary prescription of the strong drugs would make anyone second-guess a doctor’s orders.
However, the largely medical-led opioid crisis should not be conflated with misinformation-fueled medical skepticism. The suspicion of medical practitioners that roots from this epidemic does not have ideological roots, but experience-based empathetic roots that do not serve to demonstrate a political stance.
The core difference here is that the opioid crisis is largely born from insufficient regulatory practices on behalf of the FDA, leading controlled substances (drugs that have highly addictive properties) to get into the hands of too many patients. However, the instances of medical skepticism discussed above are born from ideologically motivated spreading of misinformation. The opioid crisis is not an ideological issue nor a misinformed one; it is a continual tragedy impacting millions of lives.
Ultimately, the medical research surrounding acetaminophen use and ASD exemplifies the important reminder that correlation does not equal causation; just because two things are found alongside each other, it is not always true that one thing caused the other to exist.
Correlation equalling causation is an approach that dominates mistrust in science and healthcare professionals. Though I agree that nobody should blindly believe authority figures in general, it is crucial that the skepticism widely applied to healthcare professionals is applied to political figures as well.
It is safe to say that choosing to follow either the words of healthcare researchers or politicians have unequal consequences for democracy and public health.