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PaperclipPerfector  1mo ago (text post)   30571 thread views

Culture War Roundup for the week of September 22, 2025

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Trump and RFK blame acetaminophen for childhood autism. I couldn’t find a transcript yet, but the meandering press conference is recorded here. Was this on anyone’s bingo cards?

I’m confused. I vaguely knew that the Trump campaign had decided to fight autism at some point, but I always figured it was appeasement for the antivaxxers. Is there an untapped pool of Tylenol haters out there? Is this a stalking horse for a broader wave of FDA guidelines targeting the usual suspects?

Maybe there’s some sort of political smokescreen going on. We don’t appear to have started any new wars, and domestic hate for Trump looks more or less like it did since last week. If it’s a distraction, it’s not a very efficient one; I had a hard time finding reporting on it, and all the sites that bothered were also eagerly blasting his abuses of the Justice Department and the Supreme Court. That leaves the old-fashioned political motive of throwing meat to the base. Maybe Trump is just checking off campaign promises. But again, it’s so niche.

I suppose there could be some sort of personal beef. If Trump is trying to tank someone’s stock, uh, this is still a pretty weird way to do it.

That’s not even touching the medical case. The administration doesn’t appear to have provided much substance behind their claim. This will dissuade approximately no one. Enjoy your fresh CW battleground.

Hard to even pass the smell test as a primary driver when tylenol was invented in the mid 1950s and its use was more prevalent and at higher doses and during pregnancy for decades before some of its dangers were better known. Did the Autism increase markedly in 1960? 1965? 1975? 1985? No, it didn't. Did Autism see a marked decline (even with a delay) when tylenol use collapsed in the early 1980s over the tylenol murders? No, it didn't.

RFK promised to deliver something and maybe even has something. If I had to guess, he was told to slow his roll or even go back and get more and better evidence about vaccines specifically by the Trump admin, or more specifically people like Pam Bondi, Susie Wiles, and others closer to Trump's ear in the admin with deep ties to pharmaceutical companies. And so RFK is going to attempt to dent the barricade or perhaps even craft a trojan horse and test out the message using tylenol because it likely is an aggravating factor to the primary cause which is likely the vaccine schedule. Perhaps this trojan horse will at the very least unlock funding for better studies to target the vaccine schedule. Along with this announcement comes recommendations which alter the schedule or at least how it's typically administered, so I suppose it's a distraction from the other stuff which came along with the announcement and which makes a dent in fortress vaccine.

If weak positive evidence from studies with big flaws isn't good enough to do anything, I cannot help but roll my eyes into the back of my head at so many people here and in the old place during the covid hysteria.

You’re telling me that the right response to a nothingburger is to take it as evidence in favor of the next big reveal?

If RFK had better evidence, he’d have jumped on it. He’s already got the FDA, he’s got Trump in his corner. Building a “Trojan horse,” however that works, doesn’t buy him anything.

File this one with the UAP disclosures, the Epstein files, and the Second Coming. I predict you’re going to be disappointed.

It's not a nothing burger. It's weak positive evidence with flaws.

If RFK had better evidence, he’d have jumped on it. He’s already got the FDA, he’s got Trump in his corner. Building a “Trojan horse,” however that works, doesn’t buy him anything.

No. He wants to maintain a good relationship and his position in the Trump admin to do this in a way which can actually get it accomplished. Your assessment of the inner factional politics inside the Trump admin is just wrong.

How "building a trojan" horse would work is to show weak positive evidence which points to tylenol being one possible cause. This results in a motivation to study the connection which could include other correlative causes, e.g., why the person is having pain and/or inflammation in the first place. Getting an excuse, support, and money to do better studies on the subject would be a win compared to the status quo.

I predict you’re going to be disappointed.

given the alternative, it's pretty hard to be disappointed

Why is the American right so obsessed with autism and discovering some unknown or suppressed cause for it?

Politicising medicine in general is baffling to me, like how Ivermectin is right-wing while vaccines are left-wing (and I remember 20 years ago most antivax people were leftwing). At some point it feels like American politics is about picking any conceivable topic and flipping a coin to declare one side Republican and the other Democrat.

It's a sop to a subgrouping that has been co-opted by the MAGA movement.

Think of it as the RFK equivalent of the Cuba embargo: most don't care, and a subgroup cares A LOT, so you go with what the subgroup wants.

There’s definitely some cynical politicking involved here but the autism thing seems to be one of Trump’s personal hobbyhorses given he was tweeting about it back in like 2012.

This is not innately a bad way of doing politics. If you have a minority that cares A LOT about something that most people are indifferent towards, it’s actually good for the minority to win, because it helps them more than it hurts the majority. Of course this can be exploited.

Conservatives are the ones having kids and so are the more concerned now about what they're putting into their kids bodies.

They are also more aware of the breakdown in classroom behavior, increase of violent outbreaks, and having a medical reason to pin it on is useful.

I agree. As a conservative and a parent I had a lot of genuine fear about things like severe autism, chromosomal abnormalities, and birth defects. You roll the dice each time you have a kid, and if it’s possible to fix those dice and prevent the worst outcomes…well, parents are a very motivated audience.

This is compounded by the fact that conservatives are more likely to be pro-life. This doesn’t matter for autism, since there’s no way to detect it in utero, but if a pro-lifer finds out he’s having a Down Syndrome kid he knows that is going to change the rest of his life. There’s no “abort” option.

Conservatives are the ones having kids and so are the more concerned now about what they're putting into their kids bodies.

I could just as well turn this around. "If conservative women have three kids, that is is enough redundancy that they do not need to bother with measles vaccines."

In the real world, almost all parents want what is best for their kids, they just disagree about the facts.

the breakdown in classroom behavior, increase of violent outbreaks,

Is this actually a thing or is it yet another moral panic, like the superpredator scare, the D&D satanism scare, the rock music scare, the violent video game scare and so on?

and having a medical reason to pin it on is useful.

Sure, but why not go for some timeless classic like "autism is caused by demonic possession", instead of badmouthing paracetamol?

the violent video game scare and so on?

Interesting you should mention this, because it's not like that one has gone away; we have people like this guy blaming the assassination of Charlie Kirk on Robinson having played "violent murder simulators":

3 of these games are extremely violent shooting and firearms simulators with graphic imagery where Tyler no doubt honed his skills and learnt how to shoot and murder.

Leaving aside all the other issues with that tweet (which I'm not accusing you of endorsing) -- which is the third "extremely violent shooting and firearms simulator with graphic imagery"? Garry's Mod? VR Chat? Is Dick suggesting he learned to use a rifle from Hearts of Iron?

Is Dick suggesting he learned to use a rifle from Hearts of Iron?

I believe that's so, because they apparently thought it was also an FPS or something. Because, when people in replies tried bringing up that he also plays video games, Dick responded with, IIRC, something like "I play games, like Mario, not violent murder simulators." Very much like the anti-gun folks who, when they end up revealing their utter ignorance of basic firearms facts, are downright smug about said ignorance. Because they hate the thing they want banned so much that even just learning something about it would be getting unacceptably close to it, and that anyone who doesn't share their ignorance is tainted by their knowledge (like how anyone familiar enough with guns to distinguish fully automatic from semi-automatic is thus "a gun nut" — yes, I've had people say this — or, as we see here, anyone familiar enough with "military" video games to know that HOI IV is a strategy game is probably just another ticking time bomb taught to murder by violent video games).

Yes, none of these scares truly go away, there are still people worried that Harry Potter might be satanic, but they are just a fringe group now.

Per the community note, that twitter poster is full of shit wrt the Steam screenshot.

He is certainly also full of shit when he claims that video games translate to real world skills. At most, playing shooters can help you overcome the inhibition of shooting at a person, perhaps. But it will not turn you into an competent rifleman any more than playing street fighter will turn you into a MMA champion or watching a lot of porn will turn you into some sex god.

By contrast, what does actually turn people into competent shooters is exposure to guns, either culturally (like Robinson was) or through military service. I would rather have some guy who spend 10k hours playing call of duty taking shots at me than someone who spend 100 hours at a gun range.

I could just as well turn this around. "If conservative women have three kids, that is is enough redundancy that they do not need to bother with measles vaccines."

The difference isn’t birth rate per mother, it’s likelihood of being parents.

Is this actually a thing or is it yet another moral panic

Difficult to get data on afaict. Short version you've probably heard before is admin doesn't want too many suspensions (disparate impact; doesn't matter that the school is 90% black either), teachers eventually stop reporting unless the behavior is a severe threat, so maybe you can muddle it out from surveys of teacher unhappiness/early retirements, but I wouldn't be confident at all if someone said "suspensions are down so behavior can't be that bad."

From local teacher anecdotes, yes, it's a thing, but I don't know for sure how widespread.

In the real world, almost all parents want what is best for their kids, they just disagree about the facts.

Yes, and a conservative is more likely to have a kid than a liberal.

Is this actually a thing

There are surveys that say it's gotten worse, but whether that's a screen-time effect or an inherent neuropsych effect I don't know. https://www.edweek.org/leadership/is-student-behavior-getting-any-better-what-a-new-survey-says/2025/01

It's simple, over the last decades, the left has succesfully taken over multiple fields through academia, including medicine, and there is a fear from conservatives that this political capture is tainting the quality of the science that comes out of it. In some fields of medicine, particularly those at the intersection of hard sciences and social sciences, for instance study of the transgender phenomena, it's hard to argue that the conservatives don't have a massive point. In more hard science aligned ones, such as which drugs are effective/dangerous, it's less legible, but the conservatives do have (IMO) a smaller point that the left relishes the power to force public policy and is not wielding it objectively. The gleefulness with which they they resorted to coercive methods to force people to vaccinate during COVID is a great example.

The problem is that MAGA offers no credible alternative. If they had a trans-skeptic secretary of health who would cut down woke excesses back to the level of empiricism, that would be one thing.

Instead they have someone whose whole point was to bring in the votes of the anti-vaxxers and a president who joins him in announcing their big medical discoveries.

I mean, sure, if one believes that the medical priesthood is made up out of charlatans who talk about make-believe concepts like proteins, p-values, PCR or the like, then there is no problem in replacing them with different charlatans who can make just as convincing a show of knowing the secret language of the priesthood.

The gleefulness with which they they resorted to coercive methods to force people to vaccinate during COVID is a great example.

I will grant you this. For a lot of vaccines, the social benefit is that the immunized can no longer transmit the infection. Not so for COVID. So the main public health effect is not present.

A fair solution, in my opinion, would have been to announce that vaccination would be entirely voluntary, but that in triage situations, the willfully unvaccinated would simply get a penalty in their QALY-based score. Say divide their expected QALY gain from interventions by a factor of two, so that you might be indifferent between putting a 40yo unvaccinated patient or a 60yo vaccinated patient on oxygen.

This has good precedent: we already allow people to engage in a lot of dangerous activities such as smoking, drinking, or base jumping, which frequently kills them. The idea is that everyone has their own risk appetite, and as long as they just kill themselves we should generally let adults do what they want. Only when they endanger others is when we should restrict their behavior.

So if someone decides to gain immunity to COVID the natural way instead of getting microchipped by Bill Gates, let them. Just don't let them take a spot in the ICU from someone who followed the recommended vaccination schedule if spots are limited, send them home with a bucket of Ivermectin or something.

Sadly, our society is utterly incapable of discussing care prioritization in triage situations at all. The closest we get to it is probably taking current alcohol abuse into account when deciding who gets a new liver first.

The problem with suddenly slapping a QALY triage system on covid vaccination is that covid just doesn't have that big an effect on QALY. About 1-2 weeks loss per infection on average. This pales in comparison to other risks, like smoking (loss measured in years) and even to politically polarised risks like being a sexually active gay man. If you were assembling a checklist or survey you use for the calculation you wouldn't bother putting covid vaccination on it over hundreds of other risk factors.

This policy would rightly be seen by its victims as a blatant and obvious political attack on them specifically rather than part of a calculated dispassionate healthcare strategy. So no different than the mandates themselves.

My argument was that in most of situations, if people want to get the covid vaccine or not is a private choice between them and their risk appetite, same as smoking or driving a motorcycle.

The difference between covid patients and lung cancer patients is that covid patients are not poisson distributed and a wave of infections can easily overwhelm the medical system.

In situations where the medical system is overwhelmed, we need some triage procedure to prioritize patients. Using the QALY gains from the intervention seems like the obvious choice here. Obviously this makes a big difference. If a 50yo with severe covid has a 50% higher survival chance with O2 than without, that is decades of QALYs.

However, in health care emergencies, I find it fair to prioritize people who were not complicit in causing the health care emergency. If ten patients come into the ER after a highway accident, and you know for a fact that five of them were involved in an illegal street race which caused the accident, then I would think it fair to operate on the other traffic victims first, all other things being equal. (Typically, you do not know such information reliably, which is why we do not have policies for that.)

Outside of healthcare emergencies, everyone should receive care, of course, no matter how stupid and complicit they were in causing their health care problem. Smokers get lung cancer treatments, anti-vaxxers get ICU beds and so on.

My policy proposal is a lot less paternalistic and impactful than vaccination mandates. Most of the triage situations I heard about were from before vaccines became widespread. It would be also compatible with free market solutions like some anti-vaxxers voluntarily paying a private ICU facility a premium to keep a fraction of a bed to compensate for their higher risk of overwhelming the medical system.

This is very different to my approach to other vaccines where the immunized do not spread the disease, and being unvaccinated means, in the more extreme cases, that you are actively playing for team Nurgle.

I find it fair to prioritize people who were not complicit in causing the health care emergency.

Sure, but there is no existing policy for this, no past policy, and to bring it in for 2021 would obviously be perceived as an ad-hoc move to punish political enemies.

Further, if done in a dispassionate way, the main people who are complicit in causing a COVID emergency will be the elderly for the crime of being old.

It would be also compatible with free market solutions like some anti-vaxxers voluntarily paying a private ICU facility a premium to keep a fraction of a bed to compensate for their higher risk of overwhelming the medical system.

What is the risk of "overwhelming" a free market private medical system? This is like saying gluttonous people should have to pay restaurants a premium in case they show up when the restaurant is already full - a misunderstanding of what a free market would actually mean in terms of having the choice to turn away customers.

This is very different to my approach to other vaccines where the immunized do not spread the disease, and being unvaccinated means, in the more extreme cases, that you are actively playing for team Nurgle.

Again this would end up being ad-hoc because we don't actually treat behaviours that spread disease like this in proportion to their risk of spreading disease. Outside of obvious culture war examples like anal sex, consider that alive while immunosuppressed will do a lot of damage all by itself.

Proposal: triage based on available annual renewable term life insurance premium for each patient conditional only on those attributes predictably downstream of a patient's choices. This plan would ensure that foregoing the covid vaccine resulted in a difference in triage ordering that was correct. This plan has no downsides. Thank you for coming to my TED talk.

Covid vaccination has such a minor effect compared to other patient choices that you would never bother surveying for it unless you are doing so for political partisan reasons. Covid just isn't dangerous enough for that to matter.

To provide an example, heavy smoking (which is a lower threshold than you'd expect) costs the average heavy smoker about 10 QALY, so any amount you charge for being unvaccinated, you'd have to charge heavy smokers ~500 times more. Already this stretches the bounds of feasibility. Any cost high enough to cover the cost of repeatedly vaccinating yourself for covid (Yep, that's a thing still, are you up to date according to local recommendations?) will be greater than the additional insurance cost, unless the premium increases by so much that you bankrupt all smokers. Not to mention the "gay tax" you'll have to charge for HIV risk, which for sexually active gay men is also a much higher risk than covid.

Edit: For the sake of providing real-world numbers, with the caveat that the UK doesn't operate on an insurance model, official recommendations are 1 booster shot every 6 months for £100 each when offered privately. Therefore if you increase insurance premiums on the unvaccinated, they will need to be at least £200/y more to be more expensive than simply being unvaccinated. Therefore you'd want to look at charging heavy smokers an extra £100,000 a year, which is multiple times the average annual income in the UK.

I'm afraid no matter what you try to do to construct a rational basis for punishing covid vaccine dissidents, it will succumb to the simple fact that covid isn't dangerous enough to justify it, unless you are also willing to simultaneously hit other groups with orders of magnitude more severe punishments.

Unrelated note - it might be fun at some point for us to do an adversarial collaboration on covid vaccines, because I hold the position that the mRNA vaccines (the speed of development and production scaling) were actually a bright spot in the covid pandemic and gave us some tools which we should be investing a bunch more into. Pretty much everything the public health policy makers did during covid in the US was stupid but the vaccines themselves are a medical miracle.

This wouldn't be particularly adversarial. The vaccines are kind of mediocre but fine. A bright spot in the covid pandemic is like the least stinky shit in a sewer. My disagreements are all with how states used vaccines to engage in yet more flagrant violations of human rights and violate medical ethics. I think we shouldn't invest into these tools, not as an isolated principle against mrna or viral vector treatments, but because of the risk the current institutions would use that investment just as they did in 2020-2022 for ill.

If the vaccines were released outside the context of lockdowns and other restrictions I would have nothing to say on them and there would have been no substantial opposition to them.

The joke was "covid vaccination status fades into noise by the annual renewable term life insurance premium metric". It's similar in spirit to proposing that we keep plastic straws, but charge consumers a carbon tax for the carbon that goes into its production (i.e. proposing to keep plastic straws but tax them at $0.0002 each), except my proposal is also "let's spend lots of time getting price quotes on term life insurance for people in medical triage, trying to address equity concerns in a triage situation is definitely a good use of resources so we should make sure to do it right".

How many academic journals would even consider a well-researched trans-skeptical study? Not even publish, but get to the point of doing a serious peer review? And going down the list of other things MAGA/MAHA takes seriously, tge same question— if a journal received a paper that was well-researched but says ivermectin is an effective treatment for Covid, do they send it out for peer review, or is it simply circular filed and ignored? In order to start doing the serious alternative research you want MAGA/MAHA to do, they need access to the journals and conferences that give legitimacy to the science. Furthermore, could a secretary go back to empirical evidence if the studies are strongly biased and the journals are captured? If the medical and science establishment were radically traditional Catholic, you aren’t going to be able to roll back to “evidence backed monotheism” because anything that isn’t in line with traditional Catholic teachings hasn’t gotten through.

How many academic journals would even consider a well-researched trans-skeptical study? Not even publish, but get to the point of doing a serious peer review?

In theory, a fair amount.There was the Cass Review, which included many published and peer reviewed papers, and the recent Gordon Guyatt drama resulted from trans-skeptical studies being published, though as the authors would have it, the issue was not the studies themselves, but the fact that they were used in a trans-skeptical way, which is why the customary activist pressure was applied.

I’m pretty sure that’s post hoc reasoning. It’s popular, probably because it dovetails nicely with the Trump’s general platform, but the timeline is wrong. Where was this argument during the fights over Obamacare? During the early-2000s measles resurgence? Even within Trump I, when people were suddenly deeply concerned with institutional capture, medical research was almost a non-issue.

It’s a referendum on COVID policy, plain and simple. Which really means it’s a referendum on Biden. The outcome was predetermined.

I think at that point a big enough portion of the normie-right still believed that the hostages could be saved, that these hostile institutions had to be preserved even if sometimes you had to account for their biases. COVID certainly had an effect as to demonstrate how captured institutions could be weaponised against them. I think another aspect that pushed the normie-right towards preferring burning it all down rather than living with the captured institutions is the insistance from institutions, in and around the same years, on allowing kids to transition without their parents' approval; to a conservative parent, nothing could feel more like an existential threat.

I’m not American so I’m not too familiar with what you’re describing. Where I live the vaccination enforcement and lockdown measures were significantly harsher than anywhere in the US, and there was broad social support from all political parties. Shouldn’t conservatives, i.e. the party of law and order, be a fan of measures which promote public safety?

And the right in the US, especially in its current MAGA incarnation, is just as gleeful in its authoritarian tendencies. It doesn’t even feel economically right wing anymore; tariffs, protectionism, anti-immigration, the government having ownership of major companies… that was all leftist policy 50-60 years ago.

Shouldn’t conservatives, i.e. the party of law and order, be a fan of measures which promote public safety?

Should Conservatives be a fan of law and order in Stalin's USSR?

This is just bad understanding of what conservatives believe. There are authorities worth following, and authorities that are not, differing slightly depending on form of conservatism.

conservatives, i.e. the party of law and order, be a fan of measures which promote public safety?

Define public safey. Because the moment authorities in the US cracked down on anti-lockdown protestors, but then allowed BLM protestors free reign (because "racism is a bigger threat than COVID) it became transparently obvious that either lockdowns had nothing to do with safety, or that those in charge of determining what constituted safety had no idea what they were doing. Or plausibly both. For mild evidence in support of this, I refer you to Sweden which had more mild lockdowns thsk most of the US, and achieved better outcomes.

right in the US, especially in its current MAGA incarnation, is just as gleeful in its authoritarian tendencies

It's fairly obvious that you get your US news from lefty sources, but a few moments of consideration would show that mostly what the MAGA agenda is about is deregulation, sprinkled with some mercantilism. I understand there is a great temptation to slap the evil "authoritarian" label on things you don't like, but getting rid of laws is not authoritarian by any possible stretch of the word. The few genuinely authoritarian actions, like banning red dye 40, have mostly gone unnoticed.

Shouldn’t conservatives, i.e. the party of law and order, be a fan of measures which promote public safety?

This assumes they perceived the COVID restrictions to have promoted public safety, and significantly biased (and capricious) enforcement blew that all to hell.

Biased vaccine distribution schedules also likely harmed public tolerance and public trust for any measures.

I don't know how it went in your country, but in the USA, Lockdown measures continued in some places for a LONG time, even after the vaccines were widely available. I personally felt like the goalposts had been moved; all the pro-lockdown people around me had said they wouldn't stop demanding lockdowns until there was a vaccine; a vaccine became available, and the pro-lockdown people continued to be pro-lockdown and said they wouldn't stop until the vaccines were mandatory with 100% compliance, also we need vaccine boosters every X months for the new variant. They also didn't think that anyone gained any natural immunity from having gotten covid, even though that's exactly how the vaccines they were waiting for work, by giving you the benefits of natural immunity without you having to get sick first, because it turns out that the people who Believe The Science don't actually know the fucking science; they were expecting a 100% effective vaccine when even our yearly flu shots are only 70% effective. Masking and Taking Covid Seriously became a leftist cause because they saw a conservative not wearing a mask and hand to triple down on doing the opposite, until of course there was street protesting to be done.

They kept on looking for excuses to keep being afraid. I will neither forgive nor forget that those people trapped me inside, stopped me from dating, stopped me from engaging in my hobbies, stole three(+) years of my life, and when one of them who had been my friend threatened me with vague promises that one day soon I'd be a minority and get my comeuppance, called me a White Supremacist, then betrayed me and his other roommates, emotionally abused his girlfriend and tried holder her hostage, and attacked me with an axe, and suffered NO loss of reputation among his Leftist friends, because he was a Queer Marxist of Color and therefore could do no wrong.

I still see young-ish mask-wearing leftists every. single. day.

The MAGA conservatives in the US chase votes and approval by dunking on the left. The bases of both parties have been radicalized by a decade plus of propaganda that makes them think of the other side as an existential threat to the future; MAGA doesn't have to be consistent or effective on policy, it just needs to give the impression that it's fighting Wokeness, and Woke made a lot of enemies.

I still see young-ish mask-wearing leftists every. single. day.

Are you on the left coast? Not disputing your claim, merely curious. I'm in flyover country and the only people I see consistently still masking are lib-left Boomers.

Chicago, west side.

Oh yeah that's a bad spot for those types lately. You've got to get good at giving off the "I'm nice but don't fuck with me" vibe, and that doesn't really work if you were enmeshed in those social circles before they went all the way off the deep end.

I don't quite know what you mean.

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I live near an East Coast city, and I too see masked-up young-looking people (seemingly) every time I take the bus or subway or go to the mall. They're not common, they're definitely a small minority, but they're common enough that I continue to notice them during my day-to-day times in public spaces.

I still saw them a month ago when I went up to Lexington, so they definitely exist east of the Mississippi.

I very rarely see mask wearers who arent plausibly sick, but when I do they are invariably leftish looking women.

Mid-Atlantic here and it's an interesting split, mask-wearers I see are either older black people or (seemingly) younger, especially women, of funny hair color. Not major numbers of either though.

In Northern VA, most of the masked people I see are Asian. I understand that going out in public masked has been very common in East Asia since the SARS epidemic more than twenty years ago.

I’m not American so I’m not too familiar with what you’re describing.

And the right in the US, especially in its current MAGA incarnation, is just as gleeful in its authoritarian tendencies

As an aside: Do you see the contradiction in these two statements? You are not American, and you admit that you have holes in your cultural knowledge, but you are also able to speak in broad certainties about the behavior of a certain class of citizen?

To go back to the COVID restrictions, there were clear instances of policy positions that were class based and/or tribal in their implementation.

The most egregious was obviously the medical establishment's stance on the fiery but mostly peaceful protests of 2020 vs anti-lockdown protests, but it scaled down as well. One of the great lakes states banning the sales of "red tribe" items (like vegetable seeds) while leaving "blue tribe" store shelves (holding things like personal lubricant) wide open is one that really stuck with me, personally.

Shouldn’t conservatives, i.e. the party of law and order, be a fan of measures which promote public safety?

I'll try to explain this cultural gap as someone with a bit of familiarity with both American and European (I assume that's where you're from) conservative culture. To massively generalize, for American conservatives, the purpose of law and order is to enable the liberty of law-abiding people. Strong law enforcement, yes, but of laws written to be relatively minimal and with a common-sense focus on "real crime", with the goal to enable people to freely live a "normal" (i.e. productively employed, not using drugs, etc.) life. Red Tribers are often happy to break laws they see as unnecessary government overreach if they can get away with it. They're concerned about the breakdown of law and order, but just as concerned that abuses of state power will crush that freedom to live one's American life. Covid measures were a question of the latter issue to American conservatives. They don't see what MAGA is doing in terms of law and order, like ICE raids, as authoritarian because it's going after people who have broken what they consider just and reasonable laws, but lockdowns were unjust.

As for MAGA's populist economics, yeah, in many ways it's no longer a movement of 80s free-market economics. The more hardline economic populists will tell you that the left-wingers advocating those policies a hundred years ago were the real populists back then, and they were wrong to give up economic populism in the 20th Century in order to fight over culture and long march through institutions - they'll even be gleeful when leftists point that out.

There remains a fairly large contingent of traditional law-and-order conservatives, the kind who believe every regulation is a good thing and to be followed, that if you were arrested you are guilty and in any conflict between an individual and authority, authority is right. Rather overrepresented among police officers (who of course see themselves as authority), but rather underrepresented among online conservatives, "second amendment people", and MAGA.

I'm sure that's true, also among older conservatives in red states. I've only known big-city cops, who generally take a somewhat cynical attitude to their department and a relaxed attitude to common-sense violations of regulation because both are necessary for their job.

be a fan of measures which promote public safety?

If they knew for sure that they did, they might. But when they see the medical establishment visibly torturing the science to fit the progressive agenda in subfields that are legible to laypeople (see again, transgenderism, or the immediate endorsement of BLM protests from the american medical establishment despite the pandemic), the result is distrust of the pronouncements in the subfields that are not as legible. If you're lying to my face about something that I can independantly observe, why would I just shut up and believe you when it comes to something I'm not able to observe?

I’m actually in agreement that there is political distortion from the left in the social sciences (less so in medicine), but the American right has not presented any credible alternative and instead doubled down on even worse distortions of their own, and burning down the whole thing. The American medical establishment supporting protests (perhaps due to internal political pressures?) does not mean you should distrust the whole institution when it comes to non politically influenced matters.

I’m transgender myself, and I would love for the left to stay out of my medical condition, and for there to be actual studying of the phenomenon and treatment options without political bias influencing it. Unfortunately the right does not offer any solutions and seems interested in stopping research and putting laws that restrict treatment.

I was a fan of the anti-woke movement early on - the intellectual dark web so to speak - but it really feels like Americans just traded one flavour of woke for another.

Unfortunately the right does not offer any solutions

The right totally offers solutions -- see that clip that was circulating of Charlie Kirk talking to somebody considering hormones; you just don't like the solution. (ie. talk therapy, find a way to be comfortable in your own body that doesn't involve intense, largely unstudied, lifelong pharmaceutical intake + extremely invasive surgeries, carry on with life)

The politicization is the reason that this hasn't been studied -- while there's no intrinsic reason such a study couldn't be done in an ethical way, you would struggle to get it by and IRB (due to politics), and even taking such a thing on would be a death sentence both career-wise and socially in the current campus/PMC political milieu.

Why are you blaming the right when the left has blocked all the paths (ed. other than the one that they chose, apparently for political reasons) to a scientific solution? "Burn it down and start over" seems like the only thing to be done in the current situation, and it's not the right that has brought us here.

The right totally offers solutions -- see that clip that was circulating of Charlie Kirk talking to somebody considering hormones; you just don't like the solution. (ie. talk therapy, find a way to be comfortable in your own body that doesn't involve intense, largely unstudied, lifelong pharmaceutical intake + extremely invasive surgeries, carry on with life)

And what if those other solutions just don't work? I did try talk therapy for years, I did everything I could to convince myself I didn't need to transition. I went to the gym and became very physically fit, I dated men and women both, I talked to TERFs and tried to read what they said with an open mind. And yet, the pharmaceutical route - just a estradiol gel you apply daily to your skin - is so far what has made me the most comfortable in my body and reduced my body dysmorphia by a huuge amount.

The history of trans medicine goes back over a hundred years and is not just a fringe modern leftist medical movement. If you read say, Harry Benjamin's famous book from the 1960s, he describes how psychotherapy has been completely unable to cure transsexuals and transvestites from their mental affliction and provides numerous psychiatrist reports to that effect. This is from a time when gender non-confirming behavior risked severe social disapproval, and was often outright illegal, and all pressure would have been on patients to not be a transsexual as opposed to today where there is acceptance and even encouragement. Psychotherapy has advanced since the 1960s sure, but why do you think talk therapy would be more effective at reducing gender dysphoria now than it did back when transitioning meant losing your job, your family, your friends?

There's plenty wrong with the modern trans movement, I won't deny that. But the right wing proposal - "find a way to be comfortable with your own body", "carry on with life", I'm sorry, that's not an actionable solution I can put in practice, that just sounds like "cope harder". Why would I subject myself to lifelong psychological pain, have it be this constant weight on my shoulder, have difficulty being intimate with a partner when I can just... accept that I'm trans, follow an established treatment plan, and have all that inner suffering massively reduced? I didn't pick that option out of some ideological belief, it's just the best option I tried so far, and I'm lucky enough that it hasn't had any negative social or professional consequences.

I do think talk therapy, etc, have a place as a first-line intervention and everyone is too quick to jump to puberty blockers/HRT, but ultimately I agree with you: estradiol worked, the other things didn't.

I even had reason recently to stop it for a while which seemed like a good chance to test if it was still necessary or whether the other changes were enough. Sure enough, things were terrible again (long after the period where the hormone changes had largely settled down).

My position is that it's kind of like chemo: it may not solve things and dear God don't do it if you don't have the relevant issue, but if it works it's invaluable.

the American right has not presented any credible alternative and instead doubled down on even worse distortions of their own, and burning down the whole thing

Give it a couple decades and the cycle will start again.

Of course the right doesn't have any replacement, outside of "rogue" doctors and scientists who by being outside of the medical establishment will cluster around non-central views.

But you can hardly blame them; just telling the right to shut up and inject whatever people that have already clearly revealed themselves to be their ideological enemies tell them to is not going to go smoothly. Even if they cannot really tell whether what they're asked is harmful or not, the people telling them to do it are not trustworthy anymore.

It's the same with libraries; having a place funded by the community where kids can discover reading material for free is great, perhaps even important, and I think everyone in that community would agree with in general. But if the librarians insist they must host drag queen story hour, and that this is not a negociable part of its functions, despite it being considered unacceptable by a very large part of the community, then they shouldn't be surprised if the answer is to cut funding to the library, even if it affects the non-objectionable part of its functions.

Basically, the left is learning, a bit late, that they cannot hold important impartial societal functions hostage to get their way in politics. The right is willing (and increasingly able) to shoot the hostages to remove the threat.

Rather in the same way that a cop killing an innocent person is more outrageous than rando killing someone; the cop is supposed to protect people, and is empowered by the state to do so. I have high standards for the medical and scientific establishment and find it particularly perverse and outrageous when they cave to/follow political pressure. I have very low standards for a populist movement of anti-vaxxers and fox news youtube clip viewers led by Orange Man.

When the president is saying shit like this all you can do is weep: I hear Cuba doesn't have it because it's very expensive… they don't have tylenol and I hear they have essentially no autism. You'll have to check it out.

https://x.com/Acyn/status/1970244475328016848

This was telegraphed in advance. More than likely RFK went looking for something that he can point the finger at for autism and didn’t want to come up empty handed.

Of course, it might also be cover for the recommendation to delay hep b vaccines until 12.

Of course, it might also be cover for the recommendation to delay hep b vaccines until 12.

Why would this recommendation need cover at all, let alone in the form of such a red herring?

The case against universal infant Hep B vaccination can be made straightforwardly to the American people: Hep B is quite rare in this country and is generally transmitted vertically or through contact with body fluids, so the vaccine should generally be restricted to infants born to a Hep B-positive mother, or living in close contact with Hep B-positive people. I’m not saying this argument is a slam dunk: although it’s easy to test the mother for Hep B at the time of childbirth, it’s hard to test everyone whose body fluids the neonate might come into contact with, and understandably the mom-to-be may not answer survey questions like “Does anyone in your household shoot up hard drugs, or have lots of promiscuous sex?” honestly. I’m merely saying that this argument is cogent and plausibly defensible on cost-benefit grounds in a way that the “Tylenol causes autism” distraction just … isn’t.

Because arguing that any vaccine is unnecessary, ever, is a major controversy in America.

I'm reasonably convinced that this is nonsense, and even if it weren't, paracetamol is the safest analgesic in pregnancy.

For one, usage was widespread since the 50s/60s, and there was no massive spike in autism diagnoses till the diagnostic criteria was later updated/made laxxer.

You can look at this post from Cremieux, but the single most damming evidence against is the fact that sibling comparisons didn't find increased risk of autism.

It means they didn't find shit.

Of course, they can't say that. You saw how the base treated Kash Patel and Pam Bondi when they came up empty-handed after the Epstein investigation. Much easier to put-out some face-saving press release. "Uh, it was the uh, the pills. You know, the red ones. That's where autism comes from. Tylenol. Yeah..." No one ever got fired for telling pregnant women not to take drugs.

Should I wait to see the evidence he used to reach that conclusion, or is that just my insane moon epistemology talking?

I agree that sometimes, scientific findings announced at a press conference can be true. When I watched the announcement of gravity waves being discovered, I did not go into "well, they did not publish in a peer reviewed journal yet, so they are obviously full of shit".

Of course, my priors for LIGO discovering gravity waves were decent, and quite a few respected scientists were staking their reputation on that announcement.

By contrast, my priors for RFK telling his underlings "perhaps look into evil chemicals as a possible cause for autism" and them just finding The Cause (TM) after all these years because previously nobody had thought to look into exposure to drugs as a risk factor seem slim indeed. Nor does he have a scientific reputation to put on stake, I think the median medical scientist is likely of the opinion that he is a quack who has no clue about medicine and it is hard to go further down from there.

I mean, I can obviously not rule out that they found a minor risk factor which explains 5% of the autism cases, after all, the dumbest person in the world saying the sky is blue does not make the sky green, but I am very bearish on the findings living up to their sensationalist claims.

I really hope that there will not be another pandemic while RFK is in office, so that the damage he does is limited to moving NIH funding from projects mentioning trans-isomers in the application to his wild goose chases.

If they have secret actually-good evidence, then I invite them to show it. From what I’ve seen, the evidence presented has all the classic red flags:

  • No proposed causal mechanism

  • a plausible non-causal mechanism (pain and inflammation would be correlated both with Tylenol use and poor fetal health).

  • tiny effect sizes.

  • effects collapse when confounders are controlled (via sibling studies in this case).

I mean, I'd like to see the evidence, too, but I think the elephant in the room here is that the autism crisis is primarily memetically driven - both in that more functional autism behaviors can be turned into more dysfunctional autism behaviors by a more memetically hostile modern environment (the nonsexual equivalent of the "guy who wants to fuck toasters" thing), and in that the category of autism (and particularly a spectrum of autism) is itself a hostile meme propagated by psychopaths to pathologize their natural enemies.

Compare and contrast transgender.

With all due respect, that’s fucking ridiculous.

Have you met someone with serious, not-the-photogenic-kind autism?

Has there been a large increase in that kind of autism? Do studies even disambiguate anymore?

I expected so, but I didn’t have data.

The current step on the euphemism treadmill is “profound autism.” Here’s a study on its prevalence. Figure 2 shows what looks like a doubling between 2002 and 2010; that’s slightly lower than the non-profound category. More importantly, the total sample of autistic kids was something like 25% profoundly autistic. That’s not a trivial fraction, and it doesn’t appear to have held steady as the weaker forms grew.

Considering risk of bias, I tried other studies. It was hard to find one that was both longitudinal and bothered to distinguish between severity. But according to the latter study, 38% of children with a ASD diagnosis had an intellectual disability. Again, not trivial.

Did you just call Scott a psychopath who pathologizes his natural enemies?

I’m not following. Can you elaborate? Meme how? Functional to dysfunctional autism how? Who are the natural enemies? Who are the psychopaths?

Yeah it feels like a compromise climb-down. Vaccines are cool, but it's the Tylenol.

This was telegraphed a few weeks ago, the impression I got from Meddit at the time is that their is some inconsistent evidence for RFK's claims but that more likely than not he's wrong - however complicating matters is the fact that the medical community will instantly go blindly anti-Trump obscuring the issue.

Discussion today has seemingly forgotten the (mild) controversy in evidence and mainstream media coverage is repeating "trust the science" lies.

Sigh.

Some relevant facts: -Other analgesics have been slowly contraindicated in pregnancy over time, leaving Tylenol as the primary option. Does this mean a resulting increase in Tylenol is the cause of increased autism? Maybe not, but it is a thought and has been investigated previously.

-We don't actually really know how Tylenol works.* That makes it something of a boogie man.

*Please don't tell me this is one of the times that some important medical fact has changed since the last time I've researched it.

Isn’t Tylenol the easiest painkiller to accidentally take entirely too much of? Could pregnant women getting to dosage wrong be the cause?

Of course more likely this is a weak correlation but still.

Tylenol is weird. It absurdly safe for a drug (with the exception of someone with gross liver failure). Lots of continuous risk no matter how small for say ibuprofen, risks ramps up swiftly with pertinent comorbidity, chronic use, and high doses. Very much a "no dose is "safe"......but the benefits outweigh the risks" situation. In contrast Tylenol is usually just...safe.

Unless you have too much. Then rapidly you switch to one of the worst deaths imaginable. It goes from Safe to Dead faster than most drugs and with more sharp of a delineation. Stay on the right side of that line and you are good. Advil is more like alcohol - increasing risk that varies with the person the whole way.

This is an oversimplification but still.

For this reason dosage isn't usually a problem. But we don't know how Tylenol works, and maybe it works more like a regular drug for pregnancy and less is safer.

Could pregnant women getting to dosage wrong be the cause?

We'd have to establish that there is actually a problem before looking for a cause, right? Which as I understand it we have not done. Autism is not becoming more prevalent afaict. Diagnostic criteria have repeatedly been broadened and public attention has been drawn to the issue, but that's not the same as things getting worse.

Acetaminophen overdoses cause something like 50,000 ER visits and 500 deaths a year in the US. It's got a therapeutic index (the ratio of LD50 to ED50, i.e. how much a dose that delivers desired effects for for half of users has to be increased to be lethal for half of users) of only 10x, roughly as unsafe by that metric as ethanol and somewhat less safe than cocaine. Oh, and speaking of ethanol, you do not want to consume anything else that will tax your liver at the same time as you're taking the acetaminophen, because if you do the LD50 tanks.

It's supposedly even a bad way to kill yourself on purpose - suicidal people imagine popping a jar of pills and passing out to die right away, but instead just their livers die right away and they spend the next few days in agony while they inexorably drown in their bodies' own chemical wastes. No hyperlink for that one; I might be completely misremembering, but I don't want to read up on the details again.

So it's not impossible that scaring people away from Tylenol will do some net good.

But, as far as I know the negative effects of acetaminophen are purely via liver damage, and associations with autism exist but aren't causal - if you take a ton of Tylenol while pregnant then your kid might be up to 100% more likely to develop autism, but so will any kids who you were pregnant with without taking a ton of Tylenol; there's just some hidden cultural/genetic [edit: and/or medical - thanks to @MadMonzer for not missing the obvious] factors that correlate.

It's supposedly even a bad way to kill yourself on purpose - suicidal people imagine popping a jar of pills and passing out to die right away, but instead just their livers die right away and they spend the next few days in agony while they inexorably drown in their bodies' own chemical wastes.

It's how Bruce Ivins, the man accused of being involved in the anthrax attacks around 9/11, killed himself.

This.

I don't understand why it had to be hard-coupled with Autism. Tylenol is kind of ... bad? ... for people. As far as I'm aware, other general pain relievers like naproxem sodium and ibuprofen are roughly as therapeutically effective without the massive risk to your liver / accidental OD.

So, I agree with some other posters that this is "your brain on memetic reasoning ... and probably ChatGPT."

other general pain relievers like naproxem sodium and ibuprofen are roughly as therapeutically effective without the massive risk to your liver / accidental OD

For non-pregnant people, yes. But sources not linked to the US culture war suggest NSAIDs are potentially much worse during pregnancy than Tylenol, and can cause fetal defects and maternal hemorrhage risks. US sources suggest NSAIDs increase miscarriage risk early in pregnancy too.

Learning has occurred. Thanks!

It had to be hard-coupled with autism because RFK Jr. positioned himself as the "I'm going to solve the autism epidemic" guy, was getting raked for basically falling for Wakefield's frauds, and had to either double down and/or find something else he could point to instead.

There are still a couple pain-relief use cases for acetaminophen, though, even if it should be obsolete in general.

First: it doesn't interact with other pain relievers, so you can "double up" in cases of extremely strong pain, alternating doses of acetaminophen with a NSAID, taking both at full strength. My son had to do that recently for a broken arm; for the first few days of healing his only other sufficiently-effective option was a prescription for codeine (pre-combined with acetaminophen; not sure how much of that is "synergy" and how much is "we can deter opioid addicts by holding their livers hostage"), which he saved for when he needed to sleep.

Second, and more significantly in this context: it has been basically the only pain relief option that (assuming you're not allergic and don't overdose) is still thought to be safe during pregnancy! Even if you banned it for any other use case, there'd still be a strong argument to make it available for pregnant mothers, where the liver risks are the same but the next best alternative is "no pain relief" rather than "ibuprofen". NSAIDs increase risks of miscarriage when taken early in pregnancy, and risks of premature birth and birth defects when taken late. I've never dug into the research to see how much they increase risks, and of course typical lists of side effects never include probabilities, but these are the sort of qualitative risks that steer mothers and ob-gyns away from a drug regardless of the numbers.

So, I agree with some other posters that this is "your brain on memetic reasoning ... and probably ChatGPT."

Yeah, and it's not like we've all got formidable cognitive defenses to begin with.

Consider how "typical lists of side effects never include probabilities" gets treated as a normal, reasonable state of affairs - how can humanity be so innumerate that even teams of MDs can default to functional innumeracy without noticing? I like Mark Liberman's use of the Pirahã language (which has no words for numbers more specific than "some" or "many") as a metaphor, seeing their hand-wavy attitude toward numbers as a reflection of ours towards probability distributions ... but, damn it, the median first-world citizen educated enough to read his medication's fine print still isn't expected to be past the point of being hand-wavy about numbers! When it comes to questions like "how likely is it that the medicine you're about to swallow will make you sicker", we're not just simplifying "the Bayesian posterior looks like a lognormal with mean 1e-4 and standard deviation 1e-5" to "1 in ten thousand", we're effectively simplifying "1 in ten thousand" to "some"! We could translate it to Pirahã and back just fine!

medical community will instantly go blindly anti-Trump obscuring the issue.

I wonder if we'll see an overall increase in mortality due to consumption of Protest Tylenol over a six month period.

Has that happened for literally any other protest fad?

If “trigger confidence” wasn’t enough to show up in mortality rates, this isn’t going to be any worse.

I vaguely remember a similar trend around ivermectin, which made me think of it.

That said, there was so much propaganda flying in every direction at the time that I would not stake my life on it being true.

I hate having Tylenol in the house. It was one of the scarier parts of pregnancy and neonates. My 2 year old slurped up half a bottle while I was trying to dose the 3 month old and I called poison control crying. Couldn't sleep all night from shaking, though they told me it was below their threshold for going into the ER. An overdose is a miserable death.

That said, pregnancy sucks and you have to be able to give women something. If they can't take willow bark tea, can't have a shot of brandy, can't take anything more modern, they're going to come up with something. And that something is likely going to be dangerous.

I hate having Tylenol in the house. It was one of the scarier parts of pregnancy and neonates. My 2 year old slurped up half a bottle while I was trying to dose the 3 month old and I called poison control crying. Couldn't sleep all night from shaking, though they told me it was below their threshold for going into the ER. An overdose is a miserable death.

This attitude feels odd to me - I wonder if it is a difference in national cultures around paracetamol/acetaminophen (bizzare that the pharmaceutical name and not just the trade name has a BrE/AmE difference - I think it is the only drug where this is the case). I can't imagine not having suitable paracetamol preparations for all family members (Calpol is the brand of children's paracetamol syrup in the UK, the pills for adults are all generic) on hand if needed - and adult paracetamol in Europe is the strength of "extra strong" Tylenol in the US. I keep them safe with the prescription medicines - mostly for the dog's sake. (Paracetamol and antifreeze are the dog poisons our vet is most worried about, although according to the RSPCA slug pellets are the cause of most fatal dog poisonings in the UK). One time I forgot and the 4 yo tried to chug a half-finished bottle of Calpol, although he spilt enough that there was no risk of an OD.

I know the UK licensed safe paracetamol (with an antidote incorporated into the tablets so you can't dangerously overdose) for dementia patients. It was taken off the market because the antidote caused nausea often enough to be a problem, but we now have a better antidote. It seems odd that nobody has tried again.

It might be cultural, my parents always preferred ibuprofen. But also migraines run in the family, and ibuprofen is more useful for that sort of pain.

In the US there was an infamous Chicago Tylenol Murder spree when my parents were in the 20s, which probably gave the brand a bad name.

Actually the response by the company behind Tylenol handled the murder spree so well it's taught in public relations textbooks to this day as a great example of what to do in cases like that. The aftermath was what resulted in the no-tamper foil covers becoming common, for example, and fewer powder-filled capsules. They pulled it from the market for a while, cooperated with a detailed investigation, and then returned it with the new packaging and lots of marketing and they were back up top in market share pretty quickly. I'm sure some people kept grudges, though, because they always do.

Anecdotally some people I know respond more to Tylenol than others. For several members of my family it's kinda so-so in effectiveness compared to ibuprofen.

When pregnant I got headaches at the normal-to-me frequency. With Ibuprofen I can just take one pill, small dose, and it's gone. With Tylenol I would take the recommended dose, wait four hours of suffering, and then on the second dose I could finally feel some effects. The pain was gone but I could still feel the headache waiting. Numb but still pounding? It was weird and not pleasant.

But still better than absolutely nothing, which is what is left to pregnant women now.

Checking the history, ibuprofen was pharmacy-only in the UK until 1996 (whereas aspirin and paracetamol were on general sale). So when aspirin became contra-indicated for children because of the risk of Reye's Syndrome, a generation of kids grew up with paracetamol as the most available pain relief. The messaging from people who send public health messages (I was too young at the time to be more specific) was "ibuprofen is a stronger version of aspirin", so I assumed that it was also unsuitable for young children until I had kids of my own and bothered to check.

If we had organ markets we would be able to track the damage in real time.

Rationalists need to fund prescription markets.

A study was published last month.

https://ehjournal.biomedcentral.com/articles/10.1186/s12940-025-01208-0

We recommend judicious acetaminophen use—lowest effective dose, shortest duration—under medical guidance, tailored to individual risk-benefit assessments, rather than a broad limitation,

We recommend judicious acetaminophen use—lowest effective dose, shortest duration—under medical guidance, tailored to individual risk-benefit assessments, rather than a broad limitation,

Given that paracetamol is so hepatotoxic it would be hard to approve under today's standards, this is good advice for anyone, pregnant or not.

Numerous well-designed studies have indicated that pregnant mothers exposed to acetaminophen have children diagnosed with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), at higher rates than children of pregnant mothers who were not exposed to acetaminophen

Correlation? Likely. Causation? I don't think so.

I suspect Paracetamol use during pregnancy can be correlated to social economic class, which will correlate to better chance of diagnosis.

Even apart from diagnosis, it always seemed self-evident to me that many instances of what is grouped under "autism" are a case of too much of something that makes people successful in the modern environment (focus, monomania, non-response to standard (hyper)stimuli).

Is there even a good definition of "autism" at play? I have met enough cases that I kinda grasp it intuitively, but the lack of a concrete measurement for really any characteristic sometimes makes me wonder if in a slightly different world we'd be having the same arguments over "misanthropy" (including prefers things to people), or something like that. Imagine if we let people self-diagnose with something that caused irritability.

You could go with the pre-2013 definition for classic autism. That’s the year in which it was merged with Asperger’s and some other developmental disorders. I don’t know that the establishment was wrong to combine them into a “spectrum disorder,” but it certainly changed the calculus for self-diagnosis.

It’s worth mentioning that the uptick in diagnoses was not, AFAICT, limited to photogenic “nerd++” autism. It also includes the 25-30% of cases which were classed as intellectually disabled. I find it much less likely that growth in this category is driven by self-diagnosis.

Imagine if we let people self-diagnose

I mean, we kind of do? At least to the same degree as ASD. No one can actually stop you from citing “anger issues” any more than they can gatekeep “depression” or “anxiety.” They have to rely on social cues to warn you if you’re about to be cringe.

Consider whether one particular cluster of personality traits might be less likely to take those hints.

I was curious about this the other day since discussing increasing autism rates seems entirely pointless without distinguishing between non-functional autism and “nerd++” autism so I asked ChatGPT whether there’s research showing an increase in non-functional autism. It led me to this paper https://autismsciencefoundation.org/wp-content/uploads/2023/04/CDC-Profound-Autism-Statistics_ASF-Copy.pdf which shows that rates of non-functional “profound” autism have been increasing, albeit at a slower rate than ASD generally. This is somewhat convincing that there is something real about increasing rates of autism but could also still be an artifact of more people seeking diagnosis. The one thing that stuck out that makes me think the whole “increased autism” thing is probably fake though is that prevalence of “profound” autism in black children is almost double what it is for white children. My thought is it’s all just Goodhart-ing by school districts to get more special education funding and create more excuses for problematic/low-performing students.

The increase in autism doesn't include self-diagnoses, but does include diagnoses based on criteria that have greatly loosened over the years, in tests that are administered far more often to a more autism-aware populace. Yesterday's kid who likes model trains a lot is today's autism diagnosis with Individual Education Plan.

I'd assume there's also some actual increase that isn't just a measurement artifact, because autism has a bunch of plausibly-causative correlations with things that have increased over generations, like higher parental age and assortative mating of highly-educated parents. But IIRC, when people control for measurement artifacts, "has autism increased" is still an open question; "why has autism increased" investigators are getting ahead of themselves.

Paracetamol use during pregnancy is strongly correlated with having pain and fever during pregnancy (no citation needed), which are in turn correlated with a number of underlying conditions that are known or suspected to be causative of childhood autism. Without a proposed causal theory for paracetamol causing autism, Occam's razor says that this is a classic "umbrellas cause rain" result.

<snark>You can now make stereo-specific thalidomide without the teratogenic isomer, so perhaps pain relief in pregnant women needs to turn full circle</snark>

<snark>You can now make stereo-specific thalidomide without the teratogenic isomer, so perhaps pain relief in pregnant women needs to turn full circle</snark>

No, it turns out it racemizes in vivo, so that doesn't work.

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Why are you called The Motte?

A motte is a stone keep on a raised earthwork common in early medieval fortifications. More pertinently, it's an element in a rhetorical move called a "Motte-and-Bailey", originally identified by philosopher Nicholas Shackel. It describes the tendency in discourse for people to move from a controversial but high value claim to a defensible but less exciting one upon any resistance to the former. He likens this to the medieval fortification, where a desirable land (the bailey) is abandoned when in danger for the more easily defended motte. In Shackel's words, "The Motte represents the defensible but undesired propositions to which one retreats when hard pressed."

On The Motte, always attempt to remain inside your defensible territory, even if you are not being pressed.


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