Casey Means Faces an Uncertain Path to Confirmation as the Next U.S. Surgeon General
by
The confirmation of wellness influencer Casey Means, Donald Trump’s pick to become the next U.S. surgeon general, is uncertain after her appearance before the Senate health committee last week.
Some Republican members — including Senators Lisa Murkowski of Alaska, Susan Collins of Maine, and Bill Cassidy of Louisiana — said they still hadn’t made a decision after Dr. Means gave ambiguous answers about her stances on vaccines.
During her hearing, Means stressed her focus is on addressing the root causes of chronic 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 Senate’s health committee still must decide whether to advance her nomination. From there, it would go to a vote before the full Senate.
Unlike past Surgeon Generals, Means doesn’t have board certifications or an active medical license. While she completed her training as a medical doctor and holds an MD, she dropped out of residency and doesn’t have board qualifications or an active medical license. A strong proponent of the Make America Healthy Again (MAHA) movement, she has long criticized mainstream medicine and the power of the pharmaceutical industry. She’s criticized the use of pesticides and other environmental toxins, and also publicly voiced controversial views on vaccines and birth control, among other topics.
Here’s a closer look at Means and her background, as well as what a potential confirmation as America’s top doctor could mean for public health.
Who Is Casey Means?
Means is a medical doctor who received her degree from Stanford University in 2014. She did four years of head and neck surgical training in otolaryngology — a speciality commonly called an ear, nose, and throat doctor, or ENT.
Her official biography says that she resigned from her residency in 2018 to “focus on reforming the ‘sick care’ paradigm in American healthcare.”
Means has conducted biomedical research, and opened a private practice in Oregon in 2019 called Means Health that focused on holistic health and functional medicine. However, she eventually stopped practicing medicine, and her license expired. Also in 2019, Means cofounded the health company Levels, which markets continuous glucose monitors to people without diabetes for the purpose of “revers[ing] the metabolic disease epidemic” and optimizing health.
In 2024, she published the book Good Energy: The Surprising Connection Between Metabolism and Limitless Health, which suggests that improving metabolic health can lower the risk of depression, infertility, insomnia, heart disease, and other chronic illnesses.
What Does the Surgeon General Do?
The surgeon general’s purpose is to communicate “the best scientific information available” on health and illness to the public, usually through advisories, reports, and calls to action, says Jeff Niederdeppe, PhD, a professor of communication and an associate director of the Cornell Health Policy Center in Ithaca, New York.
The surgeon general also oversees the U.S. Public Service Commissioned Corps, which Dr. Niederdeppe describes as “a public health rapid response team of sorts.” While the surgeon general doesn’t set policy, the person holding the title “advises policymaking bodies,” Niederdeppe says.
But the power of the surgeon general is somewhat limited, says Georges Benjamin, MD, an internal medicine doctor and CEO of the nonprofit American Public Health Association. “The surgeon general has no regulatory policy or authority directly,” he says. “Most of the surgeon general’s powers have been moved to the secretary of the Department of Health and Human Services,” currently Robert F. Kennedy Jr.
However, Means has an existing relationship with Kennedy, along with her own public following. If approved, “She will have enormous clout,” Dr. Benjamin says.
Casey Means’s Public Stances on Big Health Issues, Explained
Here’s what Means has said about major health issues.
Vaccines
Means has been a vocal critic of vaccines and the American vaccination schedule. “There is growing evidence that the total burden of the current extreme and growing vaccine schedule is causing health declines in vulnerable children,” she wrote in a May 2024 newsletter. “This needs to be investigated.”
Means took a more moderate approach during her confirmation hearing when asked if she would recommend that parents vaccinate their children against measles.
“I’m not an individual’s doctor. And every individual needs to talk to their doctor before putting a medication in their body,” she said. “I absolutely am supportive of the measles vaccine, and I do believe vaccines save lives.”
When asked by Senator Tom Kaine of Virginia if the flu vaccine reduces serious illness and hospitalization, Means reiterated her stance that the decision to get any vaccine should be an individual decision made in consultation with one’s doctor. When Kaine pressed her for a more direct answer, she said the shot was effective “at the population level.”
Scientists generally agree that individual vaccination can help prevent flu transmission within a community; this effect is also known as herd immunity.
Autism
Means was measured in how she responded to questions about autism during her hearing.
“The reality is that we have an autism crisis that’s increasing and this is devastating to many families. We do not know as a medical community what causes autism,” she said.
Means said that she “accepts” evidence that shows vaccines do not cause autism. “I also think that science is never settled,” she said.
Food and Pesticides
In 2025 appearance on The Tucker Carlson Show with her brother and frequent collaborator Calley Means, she said that chronic illnesses are driven by a “toxic food system and our toxic environment,” adding, “these subtle insidious forces which are creating slow progressive illness … allow patients to be profitable and on the pharma treadmill for their entire lives.” As a result, Means said, people are “drugged for life.”
She has specifically spoken out about the health dangers of glyphosate, the active ingredient in the widely used pesticide Roundup.
When asked during the hearing about her stance on glyphosate, Means replied: “We must as a country move away from using toxic inputs in our food supply and we must study these chemicals more to understand their effects. I am very gravely concerned about the health impacts of these chemicals.”
Hormonal Birth Control
Means has been critical of oral birth control in the past, writing in her newsletter that “we use birth control pills like candy in women to try to control the cycles of women,” and suggests that these medications are “neutralizing our life force.” Means also encouraged people to “stop overusing birth control pills en masse for illogical reasons like acne.”
During the hearing, Means said that she thinks women should have access to oral contraceptives, but they should also be better-educated about potential risks.
Supplements
During the hearing, Means was asked about potential conflicts of interest from receiving at least $325,000 to promote supplements since 2024, along with the $1,500 annual membership fee required to use Levels.
“You’ve said that our healthcare system is broken, but it seems to me that you’ve spent your career making money off the flaws of the system,” said Senator Tammy Baldwin.
Means responded by saying those were “incorrect characterizations” and that she is “committed to giving Americans the best public health information possible.”
