Dr. Casey Means, President Donald Trump’s nominee for U.S. Surgeon General, told senators during her Feb. 25 confirmation hearing that hormonal birth control carries “horrifying health risks,” while also maintaining that the medication should be widely accessible to women.
During the more than two-hour hearing before the Senate Health, Education, Labor, and Pensions Committee, she also answered questions about her stance on vaccines and the abortion drug mifepristone.
Sen. Patty Murray, D-Wash., pressed Means about past comments in which she described birth control as a “disrespect of life” and warned of the medication’s “horrifying health risks for women.” Murray also quoted Means as saying Americans “use birth control like candy.”
Murray said the Food and Drug Administration (FDA) has approved 18 hormonal and nonhormonal contraceptive methods and argued that Means’ beliefs go against “decades of evidence showing that every one of these birth control methods is safe and effective.”
“I’m curious if you’re aware of what the side effects of hormonal contraceptives are?” Means replied during the exchange.
SEN. MURRAY: “There are decades of evidence showing that every one of these birth control methods is safe and effective.”
— Chief Nerd (@TheChiefNerd) February 25, 2026
CASEY MEANS: *deep breath* “I'm curious if you're aware of what the side effects of hormonal contraception are?”
SEN. MURRAY: 🦗🦗🦗 pic.twitter.com/uIrGbLzUMj
“I absolutely believe this medication should be accessible to all women,” Means said. “And also, all medications have risks and benefits, and in our current medical climate, with the burden on doctors, doctors do not have time for a thorough and informed consent conversation.”
She pointed to blood clots and stroke, particularly for women with clotting disorders, women who smoke, and women who are obese, as “some of the horrifying side effects of birth control.”
“I’m speaking about particular women that can be hurt if there is not informed consent,” Means added.
At another point in the hearing, lawmakers pressed Means on whether she believes the chemical abortion drug mifepristone should only be prescribed after an in-person visit with a doctor. The FDA had for years required in-person dispensing but removed the rule under the Biden administration.
“The question of whether it should be an in-person visit is out of the purview of the surgeon general's office, but I do believe that every patient needs to have a very thorough conversation with their doctor before taking any medication,” Means said in response to repeated questioning from committee chairman Bill Cassidy, R-La.
Means added that in today’s healthcare system, informed consent conversations often do not happen. Every medication “has risks and benefits,” and all patients deserve “to have a thorough conversation with their doctor and have true informed consent before taking any medication,” she said.
In 2025, Health and Human Services Secretary (HHS) Robert F. Kennedy Jr. announced that the FDA would conduct a review of mifepristone’s safety. Administration officials have since indicated that the review will likely take a year or more to complete.
Trump nominated Means in May 2025. If confirmed, she would report to Kennedy and issue national health advisories.
Senators from both parties also questioned Means about vaccines. She said she believes “vaccines save lives” and are “a key part of every public health strategy,” adding that patients and parents should have detailed conversations with doctors before receiving any medication.
Cassidy also asked Means if she accepts evidence that shows vaccines do not cause autism to which she responded, “I do accept that evidence. I also think that science is never settled.”
Throughout the hearing, Means emphasized that if confirmed, she plans to address chronic disease by targeting root causes such as poor nutrition, environmental toxins, and lifestyle factors. She criticized “reactive sick care” and called for policies that put “more whole, healthy foods on American plates,” while warning that ultraprocessed foods are a major driver of illness.
“Our nation is angry, exhausted, and hurting,” she said. “If we’re addressing shared root causes, we’re going to be able to stop the whack-a-mole medicine that’s not working for us.”
The committee will now consider whether to advance Means’ nomination. If advanced, it would go to a vote in the full Senate.