In the play Pygmalion (and later, in the movie My Fair Lady), there’s a quote that has come to mean an awful lot to me.
“Oh! if I only COULD go back to my flower basket! I should be independent of both you and father and all the world! Why did you take my independence from me? Why did I give it up? I’m a slave now, for all my fine clothes.” – Eliza Doolittle, Act V, Pygmalion
When I grew up, I lived in a house that was not political. It was a lot of things… abusive, alcoholic, nasty, obsessively clean… but it was not political. I learned nothing of politics from my parents. I don’t know that either of them ever voted. When I met Chris, I met someone who had an interest in politics, and who talked about it from time to time. I began to learn, both by talking to him and by talking to other people. I learned that I leaned Left, and over time I came to see myself as a “big el” Libertarian. I also learned that almost all of my friends were what would now be considered “far Left.”
I tried to listen to as many different viewpoints as I could. I listened to Chris, and people he suggested. I read about the Libertarian party’s platform. I listened to Gary Johnson speak, and was impressed (and sadly, it was the last time I was impressed by the Libertarian Party). I found out where Aleppo was before most other people. I educated myself.
When I lived on my own, way back when, I was a flower girl like Eliza Doolittle. I was not educated. I was independent. I didn’t have to look at the news and get that sinking feeling in the pit of my stomach. I didn’t have to face backlash from the Left, and concern over the Right. I just blithely lived my life, ignorant and free. And I ask you, why did I give it up? Because I am a slave to it now. And I often wish I could go back to my metaphorical flower basket. But I know too much, and you can never put the knowledge genie back into its bottle.
I don’t have to list the ways that the Left is imploding. It’s all over the news, every day. We’re all aware of it.
But Monday night, I ran into Trump’s announcement about Tylenol. According to Trump, “There is mounting evidence finding a connection between acetaminophen use during pregnancy and autism — and that’s why the Administration is courageously issuing this new health guidance.” Being the person I am, the first thing I did was go and look up the cited studies, because I’ve been watching this stuff (as a parent to a handful of kids with autism). What Trump said is … while it’s not an outright lie, it is definitely stretching the truth beyond belief.
The studies cited (you can find them all on the WH site) mention correlation. They do NOT speak of causation. That’s because causation hasn’t been proven. And WE ALL KNOW THAT CORRELATION DOESN’T MEAN SHIT.
Let’s start here: “Frequent maternal use of acetaminophen in pregnancy has been linked to attention-deficit/hyperactivity disorder (ADHD) in children, but concerns regarding uncontrolled confounding remain.” (Nurse’s Health Study) This study uses historical data (ie what nurses wrote down) of self-reported incidences of ADHD. If you won’t accept self-reported incidences of flu, covid, or anything else, then you really can’t be considering it definitive in this study. I don’t even really consider this a study. It’s a collection of data, and it is most definitely not indicative of causation. The best they got was, “Our findings corroborate those of prior reports suggesting that prenatal acetaminophen exposure may influence neurodevelopment.”
Slightly better was the Boston Birth Cohort: “Of 996 participants (mean [SD] age, 9.8 [3.9] years; 548 [55.0%] male), the final sample included 257 children (25.8%) with ADHD only, 66 (6.6%) with ASD only, 42 (4.2%) with both ADHD and ASD, 304 (30.5%) with other DDs, and 327 (32.8%) who were neurotypical. Unchanged acetaminophen levels were detectable in all cord plasma samples.” At least here we have some correlation. But again, we’re lacking causation. It was a tiny study, though at least it didn’t rely on self-reporting. While I find it at least plausible, I have to ask myself why the study had so many kids with ADHD, ASD, or both, because that’s wildly different from the current percentage of people with those diseases in the population. I believe we’re between 1 in 9 for ASD alone and 1 in 31 having both diagnoses. That’s considerably less, statistically significantly less than the study.
On top of all of the rest, NONE of these studies factored in some important information: whether the risk of ASD or ADHD with acetaminophen use was higher than the risk of other health issues to the mother by not using acetaminophen or drugs containing it. There also doesn’t appear to be any information on what “frequent maternal use” means. I’m extremely mindful of the “study” (and I use that term lightly) that told us that saccharine was bad for us. The study in 1902 by Dr. Harvey Washington Wiley, where he said saccharine was essentially a poison. Turns out he was wrong, and his “study” wasn’t actually a study.
I’m trying to be open to new information. I read everything. But the very source information given to us by Trump does not back up his announcement!
I want to go back to being a flower girl, because then I wouldn’t care. It wouldn’t matter to me. But I can’t, and it does matter. It bothers me that the Left will take this, read it, and point to the vast errors and throw ALL of it out… and the Right may stand up and use cherry picked parts of it to “prove” their stance that autism is caused by some outside source without giving a good look at genetics and environmental factors.
I want scientists to study ALL of it, because right now, there is no definitive answer of where autism comes from. We know damn well it doesn’t come from thimersol because that was removed from vaccines ages ago over yet another botched and disproven “study.” I want studies into commonly used OTC meds, yes. I also want studies into genetics, because I saw some very compelling information that talked about how humans evolve, and that autism may be humanity moving toward the next level of evolution of our brains and bodies (the “bad” autistic traits are the ones we’re breeding out, and the “good” ones like hyperfocus and attention to detail we’re breeding for). The information isn’t a study, but I’d love to see it become one. And let’s look at environmental factors that impact pregnant women, as well. That’s what science does.
I’m gutted over this. This is one of those “it’s really fucking important” things and I’m so very disappointed. I know I shouldn’t care so much, and I know I don’t have to agree with Trump on everything. This isn’t an opinion thing, though. Those studies do not say what he says they say. It’s disingenuous, and I’m left wondering whether he read and understood them and chose to misinform the American people, or if he read it and didn’t understand it and just said what his experts told him to say, or if someone (maybe Kennedy, maybe someone else) just played it up and he punted it to us without even bothering. All of those possibilities make me ill.
I want to go back to being an ignorant flower girl, where I didn’t wake up in dread every day.
From Book of Faces, but fairly good and balanced information (IMO, of course):
Tylenol and Autism
Let’s Talk About Today’s Announcement
Today the Trump government announced that they found a link between Tylenol (acetaminophen) use during pregnancy and autism.
The FDA is even moving toward changing the safety label.
At first glance, this might sound alarming, but here’s why we need to pause, look at the science carefully, and avoid unnecessary fear, guilt, or blame.
The US government claims that observational studies show an association between frequent acetaminophen use during pregnancy and a higher risk of neurodevelopmental conditions like autism and ADHD.
The FDA has even started a process to change labeling and advising caution.
Importantly, experts in their own public statements emphasize that:
1. These are associations, not proof of causation.
2. Some studies show small increases in risk, others are inconclusive, and some show no effect at all.
3. Most of these studies are observational, which means they cannot rule out confounding factors like underlying illness, genetics, or the reason acetaminophen was used in the first place.
The evidence does say that there is no definitive proof that acetaminophen causes autism.
Causality has not been established.
There is no evidence that short-term or occasional use (such as treating a fever or relieving pain) is harmful. The potential signal, if real, seems linked to frequent or prolonged use.
The data do not support avoiding acetaminophen completely.
In fact, untreated high fever in pregnancy is dangerous and has been linked to serious risks: neural tube defects, congenital heart defects, oral clefts, stillbirth, and pre-term birth.
Telling a pregnant woman to “tough it out” through a high fever is not only irresponsible, it could directly harm both her and her baby.
Do autism rates appear higher today? Yes.
Some people use this news to reinforce the narrative that “something new” must be causing autism.
But what is often overlooked is that more than 100 different genes are involved in autism’s development, alongside multiple environmental factors.
Autism spectrum disorder (ASD) is not a single disease but a broad neurodevelopmental variation with many presentations and rates of autism have risen partly because of better diagnostic tools, broader criteria, and greater awareness.
Conditions that were once diagnosed as separate are now recognized under one unified spectrum.
Wide-reaching announcements like today’s can cause more harm than good.
They create unnecessary anxiety and guilt in mothers who used Tylenol in past pregnancies.
They also discourage women from using a medication that may, in many cases, be the safest choice available.
Then, they confuse the public about what an “association” means compared with what actual cause-and-effect means.
They add to stigma by implying that a parent’s actions are solely to blame for their child’s condition, when in truth autism reflects complex biology and genetics far beyond any single exposure.
Autism is not a disease to be “cured.” It is a neurodevelopmental difference.
People with autism experience the world, relationships, and sensory input in ways that are different, not lesser.
When we reduce autism to something to blame on a single medication, we diminish the dignity and lived experience of autistic individuals and their families.
First, conspiracy theorists falsely linked autism to vaccines.
When that narrative was scientifically dismantled, attention shifted to other well-established, safe medications like Tylenol.
This cycle repeats: whenever one myth falls, another rises.
But the result is always the same: fear, guilt, and misinformation that harm more than they help.
Here’s where we agree: more research is needed.
Some higher-quality studies suggest associations, but when designs improve (such as sibling comparison studies), the signal gets weaker.
Medical organizations around the world still consider acetaminophen one of the safest over-the-counter options for pregnant women, especially compared with the risks of untreated fever or pain.
If you are pregnant, do not panic if you used Tylenol in the past.
If you need it now, use it at the lowest effective dose, for the shortest duration possible.
Discuss with your healthcare provider when medication is necessary and when alternatives might help.
Remember: untreated severe fever in pregnancy is far riskier than occasional, medically guided use of Tylenol.
Autism is far too complex to blame on a single medication.
Making sweeping announcements without clear causation risks doing irreversible damage to public trust and maternal health.
Let’s use this moment to promote awareness and compassion, not shame and fear.
Dr. Jules
“And WE ALL KNOW THAT CORRELATION DOESN’T MEAN SHIT.”.
Actually, correlation means you have an unanswered question, and a place to start your investigation. And, if the correlation is strong enough, it may warrant precautionary action. If 10 people get food poisoning and they all ate at the same restaurant sometime in the last 24 hours, precautionary steps are taken. Even if that restaurant served thousands, there is that one common factor.
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“NONE of these studies factored in some important information: whether the risk of ASD or ADHD with acetaminophen use was higher than the risk of other health issues to the mother by not using acetaminophen or drugs containing it. There also doesn’t appear to be any information on what “frequent maternal use” means.”
And, that is why correlation is a place to start your investigation. No study, no matter how comprehensive, will take into account all factors. That is why the 95% confidence standard is so important, and so misunderstood. (And, no… the 95% confidence level does not mean the researchers are 95% sure their conclusions are correct.)
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“I want to go back to being an ignorant flower girl, where I didn’t wake up in dread every day.”
You are still in the learning curve. This is the part of learning to ride a bike where you fall down more often than not. You will get through this. Do not give up.
You’re right about correlation, but you also ignored what I meant. I know, I should write “what I mean” and not couch it. I still struggle with it, especially when I’m upset. So in this case, the correlations that were found were so tenuous that the studies themselves downplayed them. That says something right there. It doesn’t mean we should ignore it, and I don’t care if we suggest pregnant women avoid Tylenol (or anything else for that matter). However, I refuse to give those studies more weight than they themselves claimed. In one case, I give it less weight than they gave themselves.
I’m with you. I want these things studied, ESPECIALLY if there’s a link between ANY drugs and autism. Not just acetaminophen/paracetamol or vaccines (but those are good places to start), but all drugs, from antibiotics on down.
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I’d also want to know about the underlying conditions that are causing expectant mothers to take Tylenol in the first place; that’s an important point because, as many folks have pointed out, the list of approved drugs during pregnancy is EXTREMELY short. Ergo, it’s fully possible that Tylenol is NOT the problem, the underlying condition is, and the ladies who would normally treat it another way, are instead taking Tylenol because they can’t take anything else.
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(Personally, I don’t think I’ve ever met a mother who DIDN’T take Tylenol for something or other, at some point during pregnancy. Its use is so darn-near universal that we could just as credibly claim that breathing oxygen and using toilets during pregnancy is linked to autism and ADHD.)
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That Boston Birth Cohort “study” … I’m curious about the high numbers, too. I wonder if the participants self-selected because it was known to be a ASD/ADHD study; parents of ASD/ADHD kids would be more likely to opt in while parents of neuro-typical kids would be much more likely to opt out. And I’d be doing genetic tests (looking for a MTHFR gene abnormality, among others) and querying vaccination records, antibiotic prescriptions, other illnesses, whether tobacco or alcohol or other recreational substance is used in the home (even if not by the kids directly), etc.
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At this point, I doubt there’s any one thing that definitively “causes” autism or ADHD; the histories and medical backgrounds are far too diverse for there to be a single root cause. I think it’s more likely a sizeable set of independent and interdependent risk factors. Tylenol may or may not be part of it (I rather doubt it) but we won’t know unless and until it’s thoroughly studied.
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But saying that expectant mothers should cease using Tylenol and re-writing FDA recommendations — when there are SO VERY FEW drugs they CAN use safely, not to mention that leaving migraines and fevers untreated is so much more immediately dangerous — is going too far, too soon. Okay, so they have one study that suggests a link; that doesn’t prove causality, and there are so many other concurrent and confounding factors that it would just as easily (if not more easily) be unrelated, or be something for which Tylenol is used to alleviate symptoms but Tylenol itself doesn’t factor in.
Funny enough, I didn’t use Tylenol or ibuprofin when pregnant. I have an autistic kid. *shrug* I was seeing a lot of study on the genetic passing on of autism, and that seems to run true (correlation, not causation) in our family and many of the families I know. But this thing about tylenol has stopped those studies. And that’s where I get my panties in a bunch.
I have an autistic kiddo, too. We didn’t vaccinate him or his brothers because we did the genetic test for the MTHFR gene mutation and it came back positive, and the link between that gene mutation and some vaccinations (particularly the MMR) has been studied more thoroughly than a lot of other possible factors for autism, and while still not conclusively proven as a cause, it remains one of the stronger correlations.
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It didn’t matter; he’s on the spectrum anyway. (He’s had a number of other medical issues that could easily explain his autistic behaviors, too, but that’s outside the scope of this conversation.) We tried to control for factors we knew about, but something else came along and triggered it despite our best efforts.
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I agree with you on the “other studies” thing. People so desperately want to find one single cause for ASD/ADHD — as if ASD is like Fetal Alcohol Syndrome and can be that easily prevented — that when one is presented, tunnel vision kicks in and they stop looking at others. Federal money will now be used to fund studies into this “suggested link” between Tylenol and autism that could have gone to further our understanding of other, more strongly correlated links — or find other correlated possible factors that haven’t been researched yet — and in the meantime expectant mothers will lose one of the safest and most effective pain-reliever/fever-reducer drugs on the planet, with no OTC options to replace it.
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That’s a poorly-thought-out move, in my non-medical-expert (but statistically-trained) opinion. *shrug*
As an aside, I characterize myself as a reluctant Trump supporter. Which is to say, I didn’t support his candidacy in 2015-16 (he wasn’t bottom of my list, but he wasn’t anywhere near the top, either) but was pleasantly surprised by his first term. I supported him in 2020 and 2024 and for the most part have been pretty happy with how he’s running things.
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That is, until the last couple months. His statements about removing guns from trans-identified people because they’re “mentally ill” (even when they’re not a danger to themselves or others), or pressuring broadcasters into removing shows that criticize him or other Republicans and conservatives, or his endless string of half-informed and/or half-true but fully incendiary Tweets (which I’ve always had a problem with, but which seem to have ramped up recently) … have really soured my feelings toward him.
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I understand that it is who he is, but surely he has more important things to do as President of the United States of America than post Tweets attacking comedians’ free speech rights, the mental health of a small subset of the population, and an OTC drug that’s been approved as safe for well over a century — among other things — and even worse, leverage the power of his office to pressure all of these to stop doing whatever they’re doing.
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That doesn’t sit well with me. No, I don’t believe he’s a “fascist” or likely to become one, and I know that accusation has been around since his first term. But his critics already have enough ammunition; he doesn’t need to give them more.
Correlation = abundance of caution. Given the current state of the medical industrial complex these days; we need to exercise caution and initiate further analysis.
Obviously that would involve indirect data collection; it just n be abhorrent to dose pregnant women with acetaminophen and observe for autism in their childern.