This is not a conversation about science alone; it includes politics, litigation, public health policy, and the complex relationship between large drug companies and consumers. Here's an in-depth examination of what's transpired, what's fact, and what's yet to be known.
A Landmark Lawsuit: Texas vs. Johnson & Johnson
In an unexpected move, Texas Attorney General Ken Paxton has just filed a lawsuit against Johnson & Johnson. The state charges that the company neglected to warn consumers of potential dangers in taking Tylenol while pregnant. It's the first suit filed by a state government on the subject, and it has the potential to set a strong legal precedent.Paxton's complaint centers on the notion that Johnson & Johnson "willfully ignored and tried to muffle the science" regarding the possible connection between acetaminophen and autism. The lawsuit includes Kenvue, Johnson & Johnson's consumer health spinoff that now manages Tylenol, as a central defendant. The Texas Attorney General's office contends that Kenvue was set up to insulate Johnson & Johnson's core assets from damages—a damning charge if true.
Assisting Paxton in this case with high stakes is attorney Ashley Keller with Keller Postman, a Chicago-based firm specializing in high-profile consumer protection lawsuits. Keller has experience representing Texas before, having represented the state in suits against tech giants Google and Meta. His appointment is indicative of the state's commitment to going up against one of the globe's biggest drug companies.
In unveiling the lawsuit, Paxton used a defiant tone: "By holding Big Pharma accountable for poisoning our people, we will help Make America Healthy Again." For him, this isn't about mere legal grievances—it's part of a larger political refrain as he runs in the Republican primary to defeat U.S. Senator John Cornyn.
The Federal Backdrop: New Guidance from Washington
The suit was filed one month after President Donald Trump and U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. released new national policy that discourages pregnant women from using acetaminophen. Based on preliminary scientific reports, they cautioned that prenatal use of Tylenol may be linked with higher risk of autism.The action elicited instant controversy in the scientific and medical community. Some physicians lambasted the statement as hasty and possibly alarming pregnant women with no firm scientific basis. Others welcomed it as a caution in case more is one day discovered.
The new advice has left many pregnant women bewildered—uncertain how to treat pain, fever, or headaches safely during pregnancy without endangering their babies.
What the Science Does (and Doesn't) Say
At the center of this controversy are opposing results of research studies.
Certain research, for example, that Harvard School of Public Health and Mount Sinai Hospital conducted in August 2025, indicates a minor risk for autism in children whose mothers took acetaminophen during pregnancy. Those results were consistent with previous findings of possible links between exposure to acetaminophen during pregnancy and neurodevelopmental problems such as ADHD and autism.
But other research indicates otherwise. In one of the largest studies, done in Sweden and using health records of 2.5 million children spanning 25 years, researchers found that when they looked at siblings—those exposed in utero to acetaminophen and those not exposed—the supposed connection vanished. This implies other environmental or genetic variables, not the drug itself, might be responsible for the link.
Dr. Brian Lee, an epidemiologist at Drexel University and senior author of the Swedish study, clarified it for us: "It's difficult to get a 100% conclusive answer in epidemiology. It would be wrong to expose pregnant women to Tylenol just to see if it causes autism, so we use indirect techniques.
His takeaway? The data so far indicates no direct causal link between the use of acetaminophen during pregnancy and autism. But he concurs that more research is paramount, considering how widespread the use of acetaminophen among pregnant women is.
The Broader Medical Perspective
Large medical groups—such as the American College of Obstetricians and Gynecologists—haven't altered their guidelines. They continue that acetaminophen is still the safest medication for pain and fever in pregnancy when taken in proper doses and for limited periods. They also advise avoiding the use of ibuprofen or aspirin in some trimesters since those medicines lead to complications.
Nonetheless, critics such as Ashley Keller contend that even uncertainty warrants greater caution. "It is mind boggling to me that major medical organizations say, 'We aren't sure, and therefore we should say nothing,'" Keller stated. "The opposite is true: We are not sure, and therefore we should sound the alarm."
That attitude mirrors a broader argument over whether public health regulators tip into fear over caution. Should drugs and medical devices stay on the shelves with more dire warnings until absolute evidence of danger emerges—or should they be limited while studies continue?
Johnson & Johnson's Response
In response to Paxton's lawsuit, Kenvue and Johnson & Johnson released a forceful statement standing behind the safety of Tylenol. "We strongly align with the worldwide medical community that recognizes the safety of acetaminophen and are confident that we will succeed in court again as these complaints have no legal basis and no scientific foundation," the company stated.Johnson & Johnson has had legal challenges from Texas before. The state had earlier settled multimillion-dollar cases with the company in relation to fraudulent promotion of drugs such as Risperdal and its involvement in the opioid epidemic. However, the Tylenol case is distinctive since it revolves not around claims of personal injury but around state consumer protection law violations such as the Deceptive Trade Practices Act and the Uniform Fraudulent Transfer Act. These legislatures provide the state with an alternative legal avenue, in this case, focusing on purported corporate wrongdoing instead of direct evidence that the drug harmed people.
The National Context: Autism and Public Health
Autism affects about one in every 31 American children today—a rate that has risen dramatically over the past two decades. Many researchers attribute this increase to better detection, broader diagnostic definitions, and growing awareness among parents and doctors. But Secretary Kennedy has long sought environmental or chemical explanations for autism, investing $50 million in new research under his Autism Data Science Initiative.
Other critics see his move as a bid to supplant his previous, widely discredited emphasis on child vaccines. His advocacy of labeling Tylenol as a potential risk, however, has reignited public debate about popular drugs.
For autism-affected families, these advances pose hard emotional questions. Parents wonder whether their reliance on common over-the-counter treatments may have inadvertently put their children at risk. Others fear the Tylenol spotlight could further stigmatize autism or take away from more useful areas of study and assistance.
What Pregnant Women Should Know Now
For expectant mothers now, this whirlwind of headlines and research can be overwhelming. The best course, doctors say, is to stick with professional medical opinion instead of political declarations or initial research.Obstetricians in general suggest the following:
Take acetaminophen sparingly. Limited, short-term use for occasional pain or fever is safe for most doctors.
Steer clear of over-dosing. Never take more than the prescribed daily allowance.
Talk to your doctor about all medications. That includes over-the-counter medication, supplements, and herbal remedies.
Prioritize pain relief without drugs. Rest, fluids, gentle movement, and other comfort strategies can sometimes ease minor discomfort.
Stay educated, but avoid alarm. Present evidence does not convincingly establish that Tylenol leads to autism, but additional research is under way to learn more about any potential link.
Finally, it is always best to consult a healthcare provider familiar with your medical history and risk factors of pregnancy before taking Tylenol during pregnancy.
The Legal and Scientific Future
The resolution of Texas's case could redefine how drug firms publicize potential danger. If the state succeeds, it could pave the way for other states—or even federal agencies—to advocate for new warning labels or payment for injured families. If Johnson & Johnson succeeds, it would affirm that existing scientific proof is not up to the legal mark to establish harm.Concurrently, the consolidated multi-district lawsuit against Tylenol producers continues. A federal judge recently rejected some expert witnesses testifying on behalf of the plaintiffs, stating there was not sufficiently robust scientific proof. That ruling was appealed to the 2nd U.S. Circuit Court of Appeals, so several years of additional court fighting would be expected.
No matter those results, the controversy is a turning point in public consciousness. For decades, acetaminophen has ranked as one of the safest pharmaceuticals around. Nowadays, the dialogue has changed—reminding everyone from the public to policymakers that even familiar medicines deserve ongoing examination.
The Takeaway
Whether or not taking Tylenol during pregnancy raises the risk of autism is still unknown. Some research shows there may be a connection, others find none. Health authorities disagree, scientists tread cautiously, and the courts are now in the picture.For the public, the trick is to be aware but not to fear unnecessarily. Pregnant women should always consult their physicians prior to any medication, even over-the-counter medications. While research goes on and litigation unfolds, society is reminded that scientific certainty is not immediate—and that public health policy must both exercise caution and consider context.
Until new information arrives, the best course might be moderation, not panic.