When President Trump claimed that Tylenol use in pregnancy causes autism, the immediate institutional pushback was swift. The FDA, the American College of Obstetricians and Gynecologists (ACOG), the UK’s Medicines and Healthcare products Regulatory Agency (MHRA), and autism scientists all rejected the claim.

Yet the episode revealed a much deeper problem that we encounter time and time again in a health crisis. The science was clear, but the communication was not. What people heard was not what institutions meant to say. The messages were lost amongst science-register terminology.

Instead, audiences heard the usual litany, the word salad, the tired and sterile way of communicating health information and the utter awkwardness when explaining anything in lay language. In the same way that Trump stumbled over the pronunciation of “acetaminophen”, it took TV doctor Hillary Jones from the UK three attempts to say the word “unsubstantiated”. Why even use this word? Or “causation” and “correlation”, for that matter, or any terms that are precise in a professional context but alienate lay audiences? These terms sound abstract, rather than concrete, signal caution without clarity and feel procedural, rather than empathetic.

The over-arching problem was not only about tackling misinformation, but also the knowledge gap. This is the mismatch between professional registers and lay registers of understanding, between the head and the heart.

This article examines how that gap manifested in the acetaminophen-autism controversy. It shows how President Trump’s emotionally charged rhetoric travelled far faster than scientific corrections because it closed the knowledge gap with feeling, albeit with false information, while institutional replies widened it with jargon, hedging, and inaccessible phrasing. It also situates this clash in the wider context of populist versus scientific communication in health debates.

The Emotional Register

Trump’s performance was built on three pillars of emotional resonance:

1.       Fear: Autism was invoked as a looming danger, a crisis that was entirely preventable.

2.       Drama: The announcement was hyped as “one of the biggest” in history, lending weight through spectacle.

3.       Stoicism: Pregnant women were told to “tough it out”, a phrase that drew on cultural scripts of endurance and sacrifice.

Of course, this was not science; it was more like storytelling. It offered a villain (Tylenol), a victim (the unborn child) and a moral test (maternal toughness). That clarity and moral framing made the claim compelling to some audiences, despite its lack of evidence.

The Scientific Register

The rebuttals from health institutions were, by contrast, careful and accurate, but couched in technical language. Examples included:

·       FDA: “An association between acetaminophen and autism has been described in many studies but a causal relationship has not been established.”

·       ACOG: “Acetaminophen remains a safe option when used as directed, though ongoing research continues.”

·       MHRA: “Paracetamol is recommended for use in pregnancy when used as directed.”

All these are factually correct. However, their phrasing assumed background knowledge of research methods, statistical language and the difference between correlation and causation. To many lay readers, “not established” suggests uncertainty; “association” suggested danger. The professional register widened the knowledge gap rather than closing it.

The Knowledge Gap as a Choice

As we stated in previous articles, the gap between professional and lay understanding is not simply inevitable; it is perpetuated when communicators choose jargon and hedging over clarity. In this case, institutions defaulted to their medical register, prioritising precision over accessibility. The result was predictable: anxious parents looking for certainty found it in Trump’s rhetoric and not in the regulators’ caveats.

The choice is stark. Communicators can narrow the gap by using plain language, the same language that they speak every day outside of work and they are native speakers of. They can narrow it by using metaphors that mean something to people and empathetic framing. Alternatively, they can widen it by clinging to professional idioms that would have their peers nodding sagely but would also alienate lay audiences. In this controversy, as, indeed, in any other health crisis, most institutions chose the latter.

Facts Alone Falter

This asymmetry reveals why misinformation often travels faster than corrections. Falsehoods offer certainty and narrative; facts offer caveats and process. In cognitive terms, people gravitate toward messages that fit their emotional state. In communication terms, false information “closes” the knowledge gap, albeit falsely, by giving people an answer they can grasp. Science often leaves the gap open by refusing to package truth in emotionally legible terms.

What Worked Better

Not all responses failed. Individual clinicians and science communicators on social media provided clearer, gap-narrowing messages:

·       Short declaratives: “Tylenol does not cause autism. Treat your fever. It’s safer for you and your baby.”

·       Empathy first: “We know these claims are frightening. Here’s what the evidence shows…”

These worked because they blended accuracy with emotional intelligence. They recognised the knowledge gap and sought to close it, not widen it.

Links to Broader Patterns

The Tylenol episode is not unique. Other health controversies reveal the same populist-scientific tension:

·       Vaccines and autism: Discredited but emotionally powerful claims thrived because they offered simple villains and certainties, while science spoke in probabilities.

·       COVID-19 cures: Hydroxychloroquine and ivermectin narratives gained ground because they promised hope and clarity, while institutions emphasised a lack of evidence and the need for testing.

·       Masks and mandates: Emotional appeals to freedom and identity resonated more strongly than charts of transmission curves.

In each case, populist rhetoric narrowed the gap with certainty and feeling, while science left it open with hedging and complexity.

The Gendered Dimension

The “tough it out” phrase also touched a raw nerve in the history of women’s health. For centuries, women’s pain has been dismissed, psychologised or minimised. To many listeners, the phrase echoed that legacy. Yet, institutional counters rarely addressed this emotional resonance. They listed the clinical risks of fever but did not challenge the cultural script. Again, the knowledge gap widens: people heard stoicism while institutions offered statistics.

Lessons for Institutions

1.       Lead with clarity: “One doesn’t cause the other. A fever that isn’t treated can be dangerous, so treat it.”

2.       Frame empathetically: Acknowledge fears, then provide evidence.

3.       Translate and do not hedge: Replace “association not established” with “studies do not prove that one causes the other.”

4.       Anticipate narratives: Counter not only the false facts but also the emotional frames, such as fear, drama and stoicism, that give them power.

Conclusion

The acetaminophen-autism controversy revealed not just a clash between truth and falsehood but between two communication registers: populist storytelling and institutional caution. Populist rhetoric closed the knowledge gap falsely by offering certainty and narrative. Scientific institutions widened it by speaking in inaccessible, emotionally flat terms. The lesson is that truth must be communicated not only with accuracy but also with resonance. The knowledge gap is not inevitable, it is a choice. If institutions continue to choose caution over clarity, then false information will keep winning the battle for public trust. When are health communicators finally going to start to learn this?

Thank you for reading,

Mark Gibson, Leeds, United Kingdom

Nur Ferrante Morales, Bonilla de la Sierra, Spain

September 2025