The Senate Committee on Health, Education, Labor, and Pensions (HELP) on Wednesday questioned President Trump’s pick for Surgeon General, wellness influencer Casey Means, M.D., on a wide range of public health issues, including vaccines, chronic disease, reproductive health, environmental exposures, nutrition, ethical disclosures, and the role of technology in youth mental health.
Chairman Sen. Bill Cassidy, M.D., (R-La.) opened the nearly three-hour hearing by emphasizing the importance of a surgeon general who can communicate clearly, rebuild trust, and provide non‑politicized medical guidance. He highlighted a national landscape of vaccine skepticism and confusion following the COVID‑19 pandemic.
Ranking Member Sen. Bernie Sanders (I-Vt.), condemned what he called a “broken” health care system and warned that recent administration policies could worsen disparities and reduce access to care. He openly questioned Means’ ability to stand up to political pressure.
Means’ vision: Tackle the chronic disease crisis
In her opening statement, Means described her central mission as reversing the country’s chronic disease crisis, calling the United States, “the most chronically ill high‑income nation in the world.” She cited rising rates of metabolic dysfunction, autoimmune disease, cancer, depression, youth suicide, dementia, and type 2 diabetes—conditions she argued share “modifiable root causes” including diet, chemical exposures, chronic stress, and over‑medicalization.
She praised the administration’s “Make America Healthy Again” strategy and highlighted efforts to pivot federal policy toward prevention, improved nutrition, new research on environmental exposures, and transparency around incentives and conflicts of interest in federal agencies.
Means’ background as a Stanford‑trained physician, health‑tech entrepreneur, and metabolic health advocate influenced her testimony. She described her vision as unifying and “grounded in science, dignity, shared humanity, and a respect for freedom—not politicization and division.”
Senators press Means on vaccine consistency, clarity
Vaccines became the hearing’s most contentious focus. Senators repeatedly asked whether Means unequivocally supports existing scientific consensus, especially regarding MMR vaccination amid ongoing measles outbreaks, flu vaccine effectiveness, autism, and hepatitis B birth‑dose recommendation.
Means repeatedly stated that vaccines save lives, vaccines are essential to public health, and she supports guidance from the Centers for Disease Control and Prevention (CDC). But she returned frequently to themes of “shared decision-making” and “informed consent,” which senators said sounded evasive in contexts requiring clear public health messaging.
On autism: When Sanders confronted her with the American Medical Association’s position that there is “an abundance of evidence” showing no link between vaccines and autism, Means acknowledged the evidence but maintained that “science is never settled” and that ongoing research into environmental factors was justified.
On hepatitis B: Means affirmed it is an effective, lifesaving vaccine but also said parents should have autonomy in decision‑making, prompting frustration from senators representing states with high Hep‑B prevalence.
Reproductive health: Thoughts on birth control and medication abortion
Sen. Patty Murray (D-Wash.) asked Means about past comments describing hormonal birth control as a “disrespect of life” and warnings about “horrifying” side effects. Means defended her concerns as being about specific high‑risk subgroups who need more individualized counseling, not opposition to birth control availability.
When asked whether she considers antidepressants unsafe in pregnancy, Means again emphasized risks, benefits, and individualized care. Senators pushed for clearer statements endorsing well‑established safety evidence.
Ethical questions on undisclosed paid relationships
Senators Tammy Baldwin (D-Wis.) and Chris Murphy (D-Conn.), questioned Means’ paid promotions of supplements, lab tests, wellness brands, teas, elixirs, and glucose‑monitoring services.
Murphy cited evidence that Means failed to disclose paid relationships in many online posts, contrary to Federal Trade Commission rules. He confronted her directly with examples of posts labeled “not sponsored” during periods when she had active financial relationships.
Means called the claims “false representations,” insisted any omissions were inadvertent, and said she had worked extensively with the Office of Government Ethics to eliminate conflicts.
Baldwin pressed Means on receiving money from companies that later faced investigations, settlements, or safety concerns—including firms accused of selling unsafe supplements or contaminated food products. She questioned Means’ judgment and the appropriateness of her past endorsements.
Psychedelics and mental health: Senators probe statements in Means’ book
Sen. Susan Collins (R-Maine) asked Means about comments from her book, “Good Energy," which described psilocybin‑assisted therapy and an “internal voice” that urged her that it was “time to prepare.” Means clarified that as surgeon general she would not recommend illicit drug use and that the comments related to personal spiritual reflection tied to her mother’s later cancer diagnosis.
She maintained that while research on psychedelics for PTSD and mental health is promising, it is too early for public endorsement.
Skepticism over medical licensure
Sen. Andy Kim (D-N.J.) challenged whether Means, who currently has her medical license on inactive status, can credibly lead the U.S. Public Health Service Commissioned Corps. Means emphasized that she still holds a valid, unexpired license and is eligible to serve. She said she does not plan to resume clinical practice and argued her background in research, entrepreneurship, and prevention uniquely suited her to the role.
Health impact of diet, chemicals
Senators from both parties asked Means about one of her signature issues: the health impact of diet and chemicals. She discussed ultra‑processed foods as major drivers of chronic disease, new federal dietary guidelines discouraging proceeded foods, the need for improved medical nutrition education, and concerns about pesticides, herbicides, and industrial chemicals.
However, Means balanced her criticism of agricultural chemicals with acknowledgment of farmers’ constraints and the complexity of reforming the food system.
Sen. Ed Markey (D-Mass.) pressed her on glyphosate, citing her past statements about its cancer risks. Means reiterated her concerns about chemical exposures but avoided directly contradicting the administration’s newly issued executive order promoting glyphosate production.
The link between technology and youth mental health
In bipartisan agreement, lawmakers and Means acknowledged the harms of social media on children’s mental health. Means expressed strong concern and openness to supporting new restrictions or warnings.
Sen. Josh Hawley (R-Mo.) brought up a case in which a teenager died by suicide after interacting with an AI chatbot, asking whether the health impacts of large‑scale AI should be studied. Means agreed the issue warrants urgent attention.