Rachel Hotez, 33, walks to work at Goodwill Industries in Montrose several days a week. She lives with her parents, has an active social life and is one of the few Americans who actually delights in paying taxes.
“So what?” some might ask. Rachel was diagnosed with autism in 1994 when she was 19 months old. Her father, Dr. Peter Hotez, is a global expert on vaccines and infectious diseases. Dr. Hotez doesn’t buy into what he says is misinformation peddled by the federal government, particularly by U.S. Health and Human Services Secretary Robert F. Kennedy Jr., and he is gravely concerned about the potential ramifications of inaccurate messaging that’s coming from the White House.
Kennedy’s rhetoric — that autism is “caused” by vaccines, environmental toxins and possibly prenatal Tylenol use — would be almost comical if it weren’t so dangerous, Hotez said. Since the president’s appointee is making claims that aren’t rooted in scientific fact, many families are left to discern the true from the false on their own, a challenge for those who don’t know who or what to trust, the doctor said.
A statement made by the HHS secretary in April is still reverberating among doctors, medical experts and people on the autism spectrum.
“These are kids who will never pay taxes,” Kennedy said at an April 16 press conference. “They’ll never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date. Many of them will never use a toilet unassisted.”
He later attempted to walk it back, saying he was referring to those with severe, nonverbal autism who require significant, lifelong support.
Dr. Audrey Nath, a pediatric neurologist at the University of Texas Medical Branch, called Kennedy’s comments “a gross mischaracterization” of autism.
“The autism spectrum encompasses a broad range of symptoms, from more mild sensory sensitivities and language issues to more profound disabilities,” she said. “Less than 40 percent of children with autism are classified as having an intellectual disability.”
Hotez said a big problem with the messaging from the federal government is that “Bobby Kennedy talks about autism the way a child would: the’ cause’ of autism, the ‘cure’ of autism.” Kennedy has even referred to autism as a “preventable disease.”
“Autism is a complex set of conditions with more than 100 autism genes and there’s more than 100 different types of autism,” Hotez said. “To talk about the cause of autism is like talking about the cause of cancer. Everyone knows that cancer is a complex interplay of oncogenes and different environmental factors. In the case of autism, the environmental factors are all operating during pregnancy. Autism is not a post-natal event.”
Hotez, who serves as co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine, said the federal government has failed to acknowledge the complexities of neurodiversity and intellectual and developmental disabilities of persons on the autism spectrum.
Some people with autism are brilliant physics professors and have certain repetitive social behaviors; others require far more help and intervention, Hotez said.
“It’s a complex topic to talk about,” he said. “It’s also complicated because there are neurodiverse people who, especially if you medicalize it too much, they appropriately get offended. ‘Wait a minute, I’m not something that needs to be cured. This is who I am.’ There’s a lot of nuance and ethics about talking about autism.”
“It’s a whole ecosystem that needs to be addressed in a meaningful way and it’s certainly not going to happen with this administration,” he added. “The problem is a combination of the fact that Bobby Kennedy is so simplistic and childlike in the way he talks about autism and portrays it in such a dark foreboding way and really has no intellectual interest or capacity in understanding the nature of autism and its causes and what we do about it.”
Vaccines Did Not Cause Rachel’s Autism
Hotez published a book in 2018 titled Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad.
At the time of the book’s publication, former pharmaceutical executive Alex Azar was the HHS secretary, Donald Trump was in the White House for his first term and the influential anti-vax community was mobilizing. The movement would grow stronger during the COVID-19 pandemic a couple of years later. Today, post-COVID, cases of measles and whooping cough have spiked to the highest numbers in over a decade, which experts attribute to lower childhood vaccination rates.
Nath said RFK’s “alarmist” rhetoric simply isn’t rooted in fact. The HHS secretary is an environmental lawyer, not a medical doctor.
“Initially I think that people started to associate the [measles mumps rubella] vaccine, which is given around the first birthday, with autism symptoms that can also manifest at around the same time,” Nath said. “But, just as increased ice cream sales in the summer are not the cause of increased drowning deaths, the vaccines themselves are not what causes autism. It’s mistaking correlation with causation.”
Absolutely, children should be vaccinated, Nath said.
“When vaccination rates drop and we lose herd immunity, we get the resurgence of awful diseases,” she said.
The Great Tylenol Debate
In late September, the White House and the Department of Health and Human Services gave a briefing on the “autism epidemic” and announced it would issue a notice to physicians about potential risks associated with the use of acetaminophen (the active ingredient in Tylenol) during pregnancy, suggesting a link to autism. President Trump explicitly advised against taking the medication during pregnancy.
The New York-based Autism Science Foundation released a lengthy statement saying it was deeply concerned about the suggestion that taking acetaminophen during pregnancy could cause autism.
“Any association between acetaminophen and autism is based on limited, conflicting, and inconsistent science and is premature,” said Autism Science Foundation Chief Science Officer Dr. Alycia Halladay. “This claim risks undermining public health while also misleading families who deserve clear, factual information. For many years, RFK and President Trump have shared their belief that vaccines cause autism, but this is also not supported by the science, which has shown no relationship between vaccines and autism.”
Alison Singer, president of the Autism Science Foundation, said no new data or scientific studies were presented or shared when the announcement about Tylenol was made.
“Instead, President Trump talked about what he thinks and feels without offering scientific evidence,” Singer said. “He said ‘tough it out,’ meaning don’t take Tylenol or give it to your child. It took me straight back to when moms were blamed for autism. If you can’t take the pain or deal with a fever, then it’s your fault if your child has autism. That was shocking. Simply shocking.”
The White House’s proposed Autism Action Plan announced this fall would fund $50 million in much-needed research but hinges heavily on the assertion that Tylenol creates a risk for autism, contradicting scientific evidence, Hotez said. It also dismisses the complexities of Autism Spectrum Disorder, neglects better-established prenatal drug exposures and does not adequately address the financial and mental health struggles endured by autism families, he said.
The bottom line, experts say, is there is no single “cause” or “cure” for autism. The current scientific understanding points to a neurodevelopmental difference, not an epidemic caused by a single toxin.
Nath said she recommends families navigating a new diagnosis of autism use the resources available at Autism Speaks rather than taking their cues from RFK.
“Children with autism can make great strides with therapies,” she said. “Specifically the Applied Behavior Analysis therapy, many children show improvement in communication skills and socialization.”
Hotez said it’s important to focus resources and promote actual scientific data when dealing with the complexities of autism. Families are often getting a diagnosis when a child is between 1 and 2 years old and should be referred to a developmental and behavioral pediatrician or psychologist to confirm the diagnosis and make an intervention plan with the child’s school.
Hotez said he’s not sure what leeway educators in either public or private institutions have to direct parents away from government resources and steer them toward scientific data, basically “calling BS” on what the Trump administration is saying.
“That’s a good question,” he said.
Administrators for Houston’s private educational academy for children with autism, The Westview School, could not be reached for comment Thursday.
As if Kennedy’s public statements weren’t questionable enough, Trump last week referred to Minnesota Gov. and former vice presidential nominee Tim Walz as “seriously retarded,” in the wake of a National Guard shooting, suggesting that Walz was providing access to refugees from Somalia and allowing them to prey on residents.
The “R-word” is regarded as hate speech used to demean, marginalize and dehumanize individuals with intellectual disabilities. Although likely intended to insult Walz rather than demean persons with intellectual disabilities, critics say Trump’s use of the word signals a tone-deafness that the President and his administration have on the topic.
Developmental disabilities don’t diminish a person’s value, Hotez said, stating what he says he believes ought to be obvious. Hotez’s daughter Rachel has a verbal IQ of about 90 and a functional IQ of about 40, her father said.
“She can’t count money and she can’t live independently,” he said. “She has a very interesting life. She has friends and she goes to the movies. In contrast to what Bobby Kennedy says, that they can’t use the toilet and they’ll never be useful to society, Rachel earns a paycheck at Goodwill and she’s proud to pay taxes.”
This article appears in Jan 1 – Dec 31, 2025.