Dr. Casey Means, President Donald Trump's nominee for Surgeon General, appeared before a Senate committee on Wednesday for a confirmation hearing. The proceedings focused on her professional background, her perspectives on public health issues including vaccines and birth control, and potential financial conflicts of interest. The hearing concluded without a vote after more than two hours of testimony.
Nomination Background
Dr. Means was initially nominated for Surgeon General by President Trump in May, following the withdrawal of his prior nominee, Dr. Janette Nesheiwat.
This nomination came after a recommendation from Robert F. Kennedy Jr., for whom Means served as a campaign adviser, contributing to his "Make America Healthy Again" agenda. Her brother, Calley Means, also advises the Health and Human Services Department under Kennedy.
An initial confirmation hearing scheduled for October was postponed due to Means' labor. Her nomination subsequently expired, leading to a re-nomination by President Trump on January 13.
Professional Qualifications and Experience
Means graduated from Stanford University School of Medicine. She began a surgical residency program at Oregon Health and Science University but left in 2018 before completion.
Means does not hold an active medical license, which lapsed in January 2024. She stated during the hearing that she does not intend to reactivate her license if confirmed. Prior to her nomination, she operated a functional medicine practice in Oregon but stopped seeing patients several years ago.
Her nomination has drawn questions from some medical professionals regarding her qualifications for the role. This is particularly salient given that the Surgeon General oversees the Public Health Service Commissioned Corps, which requires its officers to maintain active licenses.
Dr. Georges Benjamin, CEO of the American Public Health Association, described Means as "less qualified professionally than any other surgeon general in history."
Means' professional focus includes nutrition, the national rate of chronic diseases, and addressing what she refers to as "root causes" of poor health.
Views on Public Health
During the hearing, Means addressed her perspectives on various health topics:
VaccinesMeans stated, "vaccines save lives." When pressed, she did not explicitly recommend childhood vaccinations for measles and flu, instead emphasizing the importance of conversation and informed consent between doctors and patients. She later agreed that, at the "population level," the flu vaccine lowers the risk of injury or hospitalization.
Regarding the debunked link between autism and vaccines, Means stated, "I do accept that evidence. I also think that science has never settled." She also supported Kennedy's initiative to examine "all environmental factors that could be contributing to autism," adding that "Vaccines are not part of my core message."
Prior to her nomination, Means had expressed concerns online about the previous vaccine schedule contributing to "health declines in vulnerable children."
Hormonal Birth ControlMeans told Senator Bill Cassidy that she believes oral contraception should be "widely accessible" but emphasized the need for patients to discuss risks and benefits with their doctor. She had previously stated online that hormonal birth control poses "horrifying health risks."
General Health PhilosophyMeans has voiced skepticism regarding traditional medicine and the influence of large corporations in the food and pharmaceutical sectors. She has also endorsed raw milk.
Scientific consensus affirms the safety of routine childhood immunizations and indicates that serious complications from hormonal birth control are rare.
Means expressed support for Health Secretary Robert F. Kennedy Jr.'s leadership and his "Make America Healthy Again" agenda during the hearing. The hearing occurred amid scrutiny of Kennedy's leadership, during which he has changed the childhood vaccine schedule, expressed skepticism about the role of vaccinations during a measles outbreak, and reduced funding for certain research areas.
Financial Disclosures and Conflicts of Interest
Means is a co-founder of Levels, a company that provides blood glucose tracking via wearable monitors and an app. She has also sold supplements and wellness products through her website.
Public Citizen, a consumer advocacy group, reported that Means had not consistently disclosed potential profits or benefits from these sales and questioned potential profits she could derive from Kennedy's support of wearable devices due to her role in Levels.
Means signed an ethics agreement in September, committing to resign from her advisory role at Levels, cease monetized social media posts, discontinue her newsletter, and stop promoting her 2024 co-authored book, "Good Energy." The book promotes principles for improving health, such as diet, sleep, physical activity, and understanding disease risk. Means stated she would divest from her companies if confirmed.
During the hearing, Senator Chris Murphy questioned Means regarding a pending complaint alleging FTC rule violations for not disclosing financial relationships to products she promoted. Means denied these assertions.
Role of the Surgeon General
The U.S. Surgeon General leads the more than 6,000 members of the U.S. Public Health Service, which includes physicians, nurses, and scientists. The role involves serving in the Department of Health and Human Services and issuing public advisories and reports on health information.
Statements and Outcome
Emily Hilliard, a spokesperson for the Department of Health and Human Services, stated that Means' "credentials, research background, and experience in public life provide her with the insights necessary to ensure America's health." Means did not comment prior to the hearing. The committee concluded the hearing without a vote.