Rose Bialk/The Mossy Log
Last week, President Donald Trump held a press conference detailing a “very important medical discovery.” He announced that the over-the-counter painkiller Tylenol, the brand name for acetaminophen, when taken during pregnancy, causes autism in children. He also announced that leucovorin, a form of vitamin B typically used in conjunction with cancer treatment, could be used as a treatment for autism spectrum disorder. This announcement serves as a success story for Health and Human Services Secretary Robert F. Kennedy Jr.’s mission to find a cure to rapidly growing autism diagnoses in less than six months of Trump’s presidency, which he did almost exactly on the dot.
First, let us acknowledge what is definitively not true: taking Tylenol while pregnant does not cause autism. According to the exact study cited by Trump’s team, around 1.42% of the children exposed to acetaminophen during pregnancy were autistic, compared with 1.33% of children who were not exposed, a very small difference. Another extremely telling piece of evidence is that autism was first written about in 1911, well before widespread use of acetaminophen, which was invented in 1950. There has been evidence of autism or autistic behaviors even before 1911 too — there is a mountain of evidence about autism being a deliberately developed trait in thousands of years of evolution. Even if the study does show some overwhelming relationship between the two — which it does not — Tylenol would not be the sole cause of autism or dangerous in the way Trump suggested. One of the researchers from the study, Ann Bauer, an epidemiologist at the University of Massachusetts, has said this announcement feels a little like jumping the gun, and that she would like to see stronger scientific evidence before a presidential announcement, echoing the sentiments of many people who doubt the claims of the Trump administration.
It is obvious that the administration’s goal here is not to present and amplify a particularly significant scientific discovery, but to announce a manufactured victory while villainizing autism further. When presented as something that needs to be and can be cured, autism becomes a negative condition, not a neurodevelopmental difference that deserves a presence in the world. The additional claim that leucovorin is a “cure” for autism furthers this lie. After this announcement from the Trump administration, the Food and Drug Administration declared plans to update the label for leucovorin for use in people with both autistic traits and a rare metabolic disorder called cerebral folate deficiency. This will obviously affect only a small number of people, but this decision bypassed the typical requirement for large-scale clinical trials and might lead some people to believe in a true “cure.” There has only been minimal research into leucovorin and certainly not enough to warrant a presidential snake-oil speech.
It is also no coincidence that the story of pregnant women dooming their children with Tylenol rang so true with the Trump administration, who will take every chance they can get to blame the world’s problems on women, and particularly pregnant women. Conservative values have noticeably gotten more extreme on abortion in particular. Much of the available conservative literature about abortion and pregnancy shifts the blame on to children in the foster system, teen mothers and accidental pregnancies onto the choices of pregnant women instead of away from the real issues like unaffordable birth control and miseducation about sex and rape.
Putting another “bad” thing under the pregnant women’s control, especially framed as something to be prevented by enduring more pain, hides another attempt to blame problems on women. Earlier, more credible studies have even shown that autism and other neurodevelopmental disorders may be more common with fathers who have children when they are older — but of course, this cabinet full of elderly men would never call a sudden medical announcement to get the word out about that. This announcement is also dangerous — Tylenol is the only over-the-counter painkiller that is safe to take during all stages of pregnancy. If someone is scared of taking something that might be “very bad” for their children, they might take other painkillers that were not announced on national television as dangerous — which might actually be more dangerous. The second most common kind of painkillers are ibuprofen variants like Advil, which are anti-inflammatories that, if taken during pregnancy, increase the risk of underdeveloped lung tissue in a baby. Even though any OB-GYN practitioner would warn against taking ibuprofen, it is not wise to underestimate the sway that television has on people’s beliefs, and the impact of President Trump’s words.
Trump and Kennedy’s goal in chasing this white whale — the cure for autism — is because of their belief in an “autism epidemic.” It is true that diagnoses of autism have risen steadily over the last 25 years, according to the CDC. In 2000, there was about one diagnosis for every 50 children, and now that number is closer to one in every 31 children. However, the scientific community asserts that this “epidemic” is caused by increased diagnostic testing, awareness and tools. One of the biggest factors for increased diagnoses is that in 2013, the DSM-IV’s definition of autism was expanded to include diagnoses like Asperger’s and other criteria. Also, as autism awareness has increased, parents feel more comfortable asking questions and getting help, which is aided by the increase in health screenings in babies that can help doctors diagnose autism earlier than before. All the evidence shows there is not an autism epidemic — there is only new autism recognition. By far the biggest obstacle to diagnosis and support for any condition is stigma, which is exactly what the Trump administration is furthering with this announcement.
This speech was misinformation at its finest, misinformation that preys on vulnerable women’s fears about the health and wellbeing of their children. Demonizing autism, and then pretending it is a disease to be prevented, cured or killed off does nothing but hurt the autistic children that will be born anyway. It is important to listen to scientists, but it is important to listen to autistic people too — under a regime that is slowly drifting toward an attitude reminiscent of eugenics, autistic people need to be listened to. Some charities that I recommend are Autism Society of Oregon, a Portland-based community building organization that mostly works in education and research-sharing and Autism Spectrum Disorder Foundation, which helps families access resources they need to improve quality of life for those who need high levels of support. I also recommend checking out the organization Small Steps in Speech, which helps kids get the speech skills they need in order to communicate with their peers. So get involved and have a friendly chat with an autistic person today — do not take it from me, see what they think.
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