Binary Comfort, Broken Trust
The Aftermath of the Tylenol–Autism Scare
The debate over acetaminophen use in pregnancy and its alleged connection to autism has reignited — this time with an incredibly reckless White House guideline that doesn't even live in the same zip code as any form of common sense. Needless to say, the science remains unsettled and confusion has skyrocketed. Psychology Today recently broke down how epistemic trust — the trust we place in institutions to tell us the truth about science we can’t parse ourselves — is being eroded not by evidence itself, but by the way authorities talk about it politically.
Binary Comfort, Fragile Truth
A Harvard team’s meta-analysis earlier this year suggested higher rates of neurodevelopmental differences when pregnant women used acetaminophen. Other studies show no clear link. The field is messy, full of confounders and contradictions. That’s the nature of complex population health research. Yet instead of acknowledging the ambiguity, major medical authorities went binary. The Autism Science Foundation declared there was “no new evidence.” The UK’s regulator flatly stated, “There is no evidence paracetamol in pregnancy causes autism.”
These lines are meant to reassure. But anyone who can Google knows there are dozens of published studies raising questions. Denying that reality doesn’t protect trust — it shatters it. Binary comfort is fragile truth.
TikTok Science, YouTube Conspiracies
In the absence of careful nuance, the vacuum fills itself. On TikTok, pregnant women film themselves defiantly swallowing Tylenol to “own the administration.” On YouTube, conspiracy theorists fold the story into their favorite bioweapon plots. What started as a modest precautionary guideline has become a culture-war prop. Autism is the object once again, but the real casualty is trust.
Epistemic trust matters because none of us can master every field. We rely on institutions to tell us when evidence is strong, when it’s weak, when it’s evolving. When those institutions pretend uncertainty doesn’t exist, they cede the field to influencers who thrive on certainty — even if it’s fake.
The Problem With Persuasion
The deeper issue is not the data itself but the communication strategy. By insisting “no evidence,” authorities are trying to counteract the political attack on women and their babies, and trying to persuade the public toward calm. But persuasion is not the same as information. Information admits complexity. Persuasion edits it out. For autistic people, that distinction is not abstract. Families trying to navigate medical choices need trust, not spin. When spin collapses trust, everyone loses.
This is why epistemic trust is more than a philosophical concept. It’s a survival need. Autistic communities already live under the shadow of contested science — from the vaccine panic to the genetic silver-bullet chase. Each time, institutions tried to manage panic with simple lines. Each time, that trust was frayed. Each time, autistic people have borne the cost.
What Nuance Could Look Like
Imagine if medical authorities had said this instead: “The evidence on acetaminophen and autism is mixed. Some studies show possible associations, others do not. The overall risk, if real, appears small. Because fever itself can also harm pregnancy, acetaminophen remains the safest option we have — but we recommend using the lowest effective dose.”
It’s less crisp. It won’t fit on a billboard. But it is closer to the truth — and truth is the only thing that builds durable trust. Nuance sounds weak in a sound-bite world. In reality, nuance is stronger because it doesn’t break when challenged.
Questions That Should Have Been Asked
If autistic people had been in the room, the framing would have shifted. We might have asked: Why is autism once again the scarecrow, the feared outcome to mobilize public opinion? Why is maternal pain relief reduced to a political wedge rather than a health equity issue? Who benefits when autism is portrayed as the worst-case scenario?
These are the questions missing from binary statements. These are the questions that protect not only trust in science but the dignity of autistic lives.
Closing Beat
The Tylenol–autism panic is not really about Tylenol or autism. It’s about whether our institutions are capable of telling the truth when the truth is complicated. Binary lines may win the news cycle. But they lose the long game — the game where autistic people, parents and the public need institutions that inform rather than persuade. Trust can’t be demanded. It has to be earned, one honest sentence at a time.