President Trump’s proclamation that the use of over-the-counter pain medication during pregnancy may cause autism, and that pregnant people, in seeking relief from pain or fever, will harm their fetus stopped us cold. While garbled, the message issued was clear: Trump, Kennedy, and their “experts” will decide whether Tylenol or vaccines are necessary, and women, and all birthing people, are on notice that we are under surveillance.
Peel back the absurdity of this claim and we recognize a deeply familiar and dangerous logic– delegitimization of bodily autonomy. This time, the strategy is Tylenol, vaccines, and autism. Beyond the confusing work to parse through the junk science behind his erroneous claim, this gambit opens up a new pathway for blame, stigma, and potentially prosecution. If autism is preventable, parents/caregivers are the ones at fault: culpable. Trump’s Tylenol-autism comment is not an isolated misstep, rather it is part of a long legacy of family policing. And for those who continue to be criminalized for being poor, Black, disabled, immigrant, or gender nonconforming, the threat is far from hypothetical.
Family Policing
Trump’s press conference reanimates the logic that helped build what organizers and scholars term the family policing system. Many mistakenly assume the state and federal systems and agencies that comprise child protective services or child welfare are inherently in a child’s best interest and neutral in impact. However, decades of government research and analysis by Black feminist scholars document that these systems are rooted in surveillance, punishment, and control. As organizers and networks, including Dorothy Roberts, Andrea James, and the Movement for Family Power and the National Council for Incarcerated and Formerly Incarcerated Women continue to demonstrate, the family policing system targets and punishes Black and brown families, low-income mothers, and people with disabilities.
Today, parents, particularly Black women, are policed and charged for using marijuana and methadone during pregnancy, for “neglect,” which often simply translates to being poor, for the audacity to enroll their child in a school outside the approved school district, for getting additional medical opinions for a newborn’s health condition, for supporting trans and queer youth’s self-determination, and more.
While caregivers/mothers are routinely racially profiled by educators and other care workers and erroneously reported for neglect, emerging new predictive assessment tools are increasingly used to flag and police so-called “high risk” caregivers, which are usually Black, Indigenous, and low-income families. Anonymous tip lines and drug screenings ensure that 53% of all Black children in the US will experience an investigation by the family policing system, with life-long harmful consequences for the adult caregivers, including being placed on a registry for an allegation of child neglect. And the impact on the young people, usually Black or indigenous, is devastating: Children in the family policing systems, in group homes or foster care, have some of the worst life-outcomes.
MAHA and Eugenicist Legacies of Reproductive Control
Reproductive control via criminalizing public health systems is part an old eugenicist story about race and belonging in the US.
The Trump administration’s “Make America Healthy Again” agenda – including the post-truth Tylenol/vaccine comments– paves the way for the rise of what has been called “soft eugenics.”
Eschewing vaccines, demonizing non-white migrants, reviving the sit-up and pull-up physical fitness tests in schools, decrying “fat generals,” “childless cat ladies,” and the white population “crisis,” all reinforce the same hierarchy in which white, wealthy, able-bodied, heterosexual people who reproduce are positioned as the fully human and rightful progenitors of the nation.
Trump’s Tylenol-autism announcement centers suspicion and scrutiny on those who are pregnant, elevates crackpot theories over people’s relationships with health-care providers, and positions punitive state intervention as the logical next step. The Tylenol-autism narrative is another front in the ongoing right-wing attack on reproductive and bodily autonomy: It’s a short road from “bad choices during pregnancy” to “unfit parent,” and an even shorter one to punitive state intervention. Without pushback, this dubious claim linking autism and acetaminophen will weave itself into policy. Will parents face investigations because their child has autism and they took Tylenol while pregnant? It sounds absurd, but we’ve seen worse happen under the banner of “protecting children.”
From Family Policing to Flourishing Families
As organizers, scholars and educators, and as critically, as caregivers who live in loving relation to many who are neurodivergent we know that autism is not a tragedy, or something to criminalize or fear. The suggestion that a parent or caregiver could be at fault for their child’s neurodivergence reinforces a chilling precedent. It pathologizes not just autism, but caregiving itself.
But there’s hope, too. Organizers continue to resist the family policing system. At the policy level contemporary coalitions are pushing for legislative changes that would require health care workers to get informed consent before they drug test pregnant people. Every day more social workers and educators are mobilizing to unlearn mandated reporting, and to push their professions to support not report.
While these campaigns aim to undo punitive policies that have expanded family policing, we also need to change the wildly uneven access to healthcare and affirming services for people who are neurodivergent.
Instead of bankrolling investigations into neglect, why not direct these state dollars to affirming and free healthcare, including mental health services? When research clearly identifies that disability causes poverty and poverty causes disability, why are billions directed at supporting out of house placements rather than alleviating poverty?
Simultaneous to their spurious claims about autism and pregnant people, the Trump administration passed a budget bill that will further restrict access to life-affirming resources, including healthcare and education services that support those navigating pregnancy, disability, or parenting children with disabilities.
The work in this moment when we cannot count on courts or elected officials to be fair or just is also mutual aid: We keep each other safe. Policy and legislative work are sometimes necessary, but never sufficient. Even in states where people risk arrest and other forms of punishment including loss of employment, informal networks build trans-liberation and gender affirming care for young people and ensure that people get access to necessary reproductive justice supports. Grassroots mutual aid collectives try to fill unmet needs that may reduce targeted communities interactions with family policing, including creating childcare collectives or providing free and non-stigmatizing community workshops on everything from tenant’s rights or to how to address medical debt. More tools that enable all of us to build more authentic, non-carceral, forms of safety challenge the family policing system.
Forming coalitions to change harmful policies and laws, in conjunction with creating networks for support and political education and survival, is a strategy that builds on decades of previous organizing, often led by Black women. Networks like Black Women for Wages for Housework and SisterSong continue to demand that people have the right to state support and create tools and opportunities for many, particularly women of color, to make informed choices about their own bodies, pregnancies, and families without fear of criminalization.
Trump’s comments are an opportunity to educate the public about the ways policing and punishment operate in our public health and human service systems. We don’t need a return to familiar scripts that pathologize and criminalize already vulnerable populations, including Black, Indigenous and parents of color, LGBTQ+, and people with disabilities. We need a radical rewrite where care, autonomy, and justice are inseparable. Together, we can halt the logic of family policing from hardening, again, into law and practice.
