The Social World

Tag: autism

  • By order of the non-doctor

    By order of the non-doctor

    Health and Human Services Secretary Robert F. Kennedy Jr. did not say, in yesterday’s cabinet meeting, that circumcision causes autism. But the fact that we’d even consider that a real statement shows just how far down the rabbit hole into the MAHA Wonderland of his mind RFK has dragged us. In fact, RFK said that after doctors circumcise boys, they give them too much Tylenol, and that causes autism. President “Don’t Take Tylenol” responded, “there’s a tremendous amount of proof or evidence. I would say as a non-doctor, but I’ve studied this a long time.” 

    A non-doctor is right, and I say this as someone who’s not a fan of male circumcision, a practice based on dated religious superstition. If we abhor female circumcision as a barbaric practice (and we should), then why is male circumcision any different? This is a personal issue for me. My wife didn’t want to circumcise our son more than 20 years ago, but my Jewish parents, now deceased, threatened to disown him, and me, if we didn’t do it. There was no bris. We didn’t enjoy wine and bagels afterwards. A urologist strapped our baby to a board and caused him untold pain, for no reason. I’ll never be able to unhear those screams.  

    Thank you for allowing me to process that trauma. But the point here is that the doctor probably gave our son Tylenol, and our son doesn’t have autism. I’m also circumcised, as are most men I know, or at least I assume they are. We don’t talk about such things. No one ever interviewed me for the studies that RFK cited at the cabinet meeting. “Circumcision leads to autism” is just embarrassing crankery that plays on people’s emotions.  

    Then, on the same day we saw “RFK claims circumcision causes autism” headlines, the Wall Street Journal decided to run a light feature story on RFK’s strange habit of working out wearing jeans. They show photos of him bench-pressing in denim and climbing Phoenix’s Camelback Mountain in denim. I grew up in Phoenix and did that Camelback hike many times. It’s no fun in workout shorts; hiking in jeans is suicide.  

    We live in interesting health times, where the Health Secretary issues a joint “fitness challenge” with the Secretary of War, does a gym circuit wearing Levis, and claims that vaccines and Tylenol cause autism. At least there’s no more Red Dye #12 in our beef tallow Steak and Shake fries. And I have to wonder if this is actually making us healthier, or if we’re just fetishizing the lifestyle eccentricities of a wealthy bulked-up falconer from America’s most famous political family.  

    This movement is starting to feel like a mirror image of the “more doctors smoke Camels” ads that the tobacco industry used to produce. In 1930, Lucky Strike said that “20,679 Physicians say ‘LUCKIES are less irritating” because of a “toasting” process. Millions of people died because of those campaigns. 

    It’s a long way down the path from that to MAHA claiming that sugar is poison (true) and that brief morning exposure to sunlight helps regulate our circadian rhythms (also true). So let’s bring it all together and list my true prescription for a healthy life: eat moderately, exercise often but not excessively, don’t smoke, don’t get circumcised, DON’T TAKE TYLENOL, and, for god’s sake, don’t climb a mountain in jeans.  

  • The reality of raising an autistic child

    The reality of raising an autistic child

    Although I disagree with Donald Trump’s and Robert F. Kennedy Jr.’s suggestion that mothers who took Tylenol during pregnancy may have caused the huge rise of children born with autism in the US, I also can’t agree with the spate of articles and interviews that have followed – several by high-functioning autistic adults, others by parents of autistic children – basically saying it is great to be autistic. I understand that they are fearful that Trump’s idea of a “cure” could result in anyone with special needs being regarded as subnormal and a second-class citizen, but it’s not helpful, either, to pretend that autism is without its many frightful drawbacks.

    My son, 42, was diagnosed with Asperger syndrome on his 13th birthday in 1996. Then, not so much was known about the condition, and my ex-husband, my daughter and I went through hell wondering why my son was so difficult – and then dealing with his strange, often explosive behavior. I would invite children over to play with him and his older sister, but he seemed to regard them as an alien species and she would end up playing with both visiting children.

    When he went to kindergarten, in the room with all his peers, he would often put his hands over his ears and scream. He preferred to be alone in the corridor. When I asked why he didn’t like his companions he said: “They have squeaky voices” and imitated them. Instead of toys, he had his obsessions – balloons, then houseplants, the cartoon film Robin Hood, tarantulas. The obsessions seemed to give him as much pain as pleasure. The balloons burst or flew away or weren’t the right type. (One category he called “All March Down the Room Balloons.”) He would think a houseplant was dying when it wasn’t and scream with frustration, even grief, and throw the plant and its pot down.

    Aged 11, he announced: “My obsessions have ruined my life!” Years later, I recall his only real friend Peter, then 31, who also had Asperger’s, waiting with me in a car park for my son to turn up. Peter turned to me and said seriously: “We don’t want to have our obsessions. We’d rather not have them.”

    Their obsessions, their high anxiety, their misunderstanding of others’ talk and gestures and their inability to hold conversations, make even high-functioning autistic people isolated and unable to lead a calm, fulfilling life.

    My son’s condition causes him to reiterate the same obsessive stories going round and round in his head

    My son has tried several simple jobs such as cleaning in a supermarket, being a night porter in a hotel, working in a care home for the elderly, but has failed through misunderstanding the social behavior of his coworkers. (In the care home he was intimidated by the advances of what he called “yee-ha girls” – forward young female workers.)

    Much is made now of special interests and the genius of certain people with autism being able to concentrate on their great skills, but I wonder which of them wouldn’t sacrifice these just to have one proper friend. Peter no longer lives near my son, so he is mostly reliant on part-time carers, tolerant women of my age and his father’s elderly relatives. The overtures of a sweet local artist of his age were rejected.

    To be blunt, he is no further on with his contemporaries than he was as a child. His autism causes him to reiterate the same obsessive stories going round and round in his head, often about the past, even about dead relatives – such as my father – whom he has never met. How can most people relate to this? My son wants to marry and have a family but does not know how to go about it and says if the children don’t fit his criteria he won’t like them.

    And would anyone wish to live, as he does, with a terror of dragonflies, convinced they bite? Or with an exaggerated fear of certain local areas, making travel difficult because of a past misunderstanding with a bus driver or passenger? (Actually it is my son, over 6ft, sometimes shouting on a bus, who probably frightens other passengers.)

    And what about us mothers and fathers? In my experience, there are constant discussions and often blame between the parents of these children on how best to treat them. Studies show that 80 percent of parents of autistic children split up. The financial strain – difficulties getting funding for them – stress and emotional toll associated with raising any child with a disability are all contributing factors. There’s also the frequent problem of physical aggression, surely a manifestation of extreme frustration and surging hormones, when the autistic child reaches adolescence. At 14, my son would would often lash out at me, his father – we split up when he was eight – and his sister.

    And it can continue into adulthood. A friend’s nonverbal autistic adult son caused a knee injury to a carer which will never properly heal. Another friend’s adult autistic son, intelligent and articulate as my son also can be, smashed up his parents’ house during lockdown. My son once destroyed the staircase of a rented apartment and the police have been called because of his behavior. At 17 he was involuntarily hospitalized for 28 days and in his twenties was in a psychiatric unit. And what about nonverbal autistic adults who need the physical care normally given to babies? How much I admire parents and carers who have to deal with that.

    On the plus side, my son is a good artist who has sold paintings to strangers, he is an excellent cook and can perform hilarious imitations of people and situations. He likes to make meals for his three young nephews and has given them many well-thought-out gifts. He is in some ways more compassionate than I am to people who are bereaved.

    I will let him have the last word: “Some people with Asperger’s can do extremely well and have successful jobs. But autism, OCD and ADHD get in the way of learning and living life.”

    This article was originally published in The Spectator’s October 13, 2025 World edition.

  • Is Trump right to link autism with Tylenol?

    Is Trump right to link autism with Tylenol?

    Donald Trump’s apparent suggestion that people could protect themselves against Covid by injecting themselves with bleach marked a low point in his first administration. It provided his critics with evidence that he was an erratic president trying to ride roughshod over scientific evidence as well as common sense. It is easy, therefore, to dismiss the American president’s announcement that government health warnings will henceforth be printed on packets of Tylenol – the brand name for acetaminophen – telling pregnant women to avoid the painkiller for fear it will cause autism in their unborn children as yet another anti-scientific diatribe.

    The involvement of health secretary Robert F. Kennedy Jr. – a long-term vaccine skeptic – adds to the impression that the association between autism and acetaminophen might be a little cooked-up. The American College of Obstetricians and Gynecologists lost no time in branding the presidential announcement as “irresponsible.”

    But is there any genuine link between autism and the consumption of Tylenol? There is quite a lot of evidence on this and interestingly, it doesn’t entirely dismiss a link, although if there is one, it does not appear to be very strong.

    A review of the evidence was published in the journal Environmental Health in August – carried out by a team of scientists from several universities, including Harvard and the University of California. It looked at 46 studies, 27 of which found a link between acetaminophen use and neurodevelopmental disorders in children (not just autism but also attention deficit and hyperactivity disorder, ADHD). Of the others, nine found a null link and four found a negative association – i.e., suggesting that acetaminophen could actually lower the risk of neurodevelopment disorders. It didn’t classify the remainder of the studies into either of those groups. Pointedly, however, the review suggested that the higher-quality studies were more likely to show a positive association between acetaminophen use and neurodevelopmental disorders.

    But how big is the link? One of the most comprehensive studies on this subject uses data on 2.5 million Swedish children born between 1995 and 2019. It found that 1.42 percent of children whose mothers had taken acetaminophen during pregnancy went on to develop autism, compared with 1.33 percent of children whose mothers didn’t take the painkiller. There are other things to consider behind this rather weak association – mothers who took acetaminophen were quite likely to have been in worse general health than those who did not, so their acetaminophen use is surely not the only thing going on here.    

    Yesterday’s announcement is not purely some off-the-cuff move by Trump – it is backed by Jay Bhattacharya, Director of the National Institutes of Health (whose background is nevertheless in economics rather than medicine). He was one of the signatories of the Great Barrington Declaration in 2020, which called for young people less at risk of Covid to be allowed to get on with their lives during the pandemic.

    While evidence for any link between Tylenol and autism is certainly not strong, it is not unreasonable to ask whether pregnant women – and many other people, for that matter – should try to avoid taking Tylenol if they can. Taking medical drugs is often a trade-off between risk and reward, and while the risks in this case might not be great, nor, in many cases, will be the rewards.

    A lot of people are taking painkillers far too routinely without considering that pain is there for a reason: it is telling you not to put too much weight on that injured ankle or warning you that there might be some serious problem in your stomach. Kill the pain and you kill the warning with it.       

    The presentation of the Trump administration’s policy, however, is dreadful. Trump’s assertion that the Amish community don’t have autism because they don’t take painkillers does seem a little dubious, as does RFK Jr.’s claim that there aren’t many 70-year-olds with full-blown autism. The diagnosis of autism has certainly increased dramatically in recent decades but it seems to me to be strongly related to it being a fashionable diagnosis. There are plenty of 70-year-olds living in institutions who were never diagnosed with autism when they were young but who would be now.    

  • A hedge-fund protagonist – Gary Shteyngart takes aim

    A hedge-fund protagonist – Gary Shteyngart takes aim

    ‘We lived in a country that rewarded its worst people. We lived in a society where the villains were favoured to win.’ So says Seema, the 29-year-old wife of hedge-fund manager Barry Cohen in Gary Shteyngart’s fourth novel, Lake Success. The relationship between fiction and the world of high finance has a complicated history. Having largely ignored Wall Street — Tom Wolfe, Bret Easton Ellis and F. Scott Fitzgerald aside — novelists found in the crash of 2008 a galvanic moment. Suddenly bankers were everywhere, from Sebastian Faulks to John Lanchester to Anne Enright, while younger writers such as Adam Haslett and Zia Haider Rahman wrote memorable novels that made (flawed) heroes of the money-men.

    Perhaps the most interesting thing about this belated encounter between fiction and finance is the relatively easy ride that bankers have been given in recent novels. Faulks’s villainous John Veals in A Week in December aside, authors have sought to present their financiers as imperfect but essentially decent human beings whose mistakes were comprehensible, even forgivable. Partly this is a matter of form: the novel is a sympathy machine. The bond that is forged between reader and protagonist allows us to overlook any number of sins and omissions. It is this tension — between the natural sympathy that builds between the reader and Barry Cohen, ‘a man with 2.4 billion dollars of assets under management’, and the reader’s mounting horror at the crimes that he commits — that animates Shteyngart’s novel.

    The narrative is shared chapter by chapter between Cohen and his wife, and opens with the 43-year-old hedge-fund manager in the full throes of a mid-life crisis. After a dinner party in which his wife has accused him of lacking imagination and soul, and reeling from a series of bad investments, Cohen sets off to ride a Greyhound bus southwards armed only with his black Amex and a suitcase full of absurdly expensive watches. Part of the reason for his flight from Wall Street is the dream of reconnecting with his university girlfriend, Layla, but there also seems to be a deeper motivation: the wish to see real Americans in the age of Trump, a nostalgie de la boue that Benjamin Markovits wrote about so brilliantly in another novel about hedge-funders, You Don’t Have to Live Like This. Cohen has a further reason to escape — his son, Shiva, has been diagnosed with autism and he can’t cope with either the practicalities of dealing with ‘the vacant boy-king’ or the social stigma attached to having a non-neurotypical child.

    As Cohen’s journey unspools, taking in a postmodern Baltimore in thrall to the version of itself presented in The Wire; a visit to a previous employee, now a creepy incel in Atlanta; a meeting with Layla’s parents and then, finally, Layla herself; we are led deeper into Cohen’s warped, self-pitying vision of himself. We read of his obsessive and ludicrous collecting of watches, his sense of himself as a novelist manqué — his hedge fund is called This Side of Capital, a nod to Fitzgerald’s first book — and his political position as a ‘moderate fiscal Republican’ who nonetheless quite likes Trump’s tax plan.

    Having started out portraying Cohen as a nebbish, a likeable klutz who gets lucky and enormously rich, Shteyngart subtly darkens our picture of him until, at the end of the novel, we loathe our hero. This repugnance is intensified by the parallel narrative of Seema, who not only copes after her husband’s desertion, but flourishes. It all makes for a book of compelling moral complexity whose bleakly powerful ending feels like just deserts for an industry that so far appears largely to have escaped literary censure for the crimes of the financial crisis.

    This article was originally published in The Spectator magazine.