Wellness influencer picked by Trump for surgeon general faces Senate grilling

Casey Means, Donald Trump’s nominee for surgeon general of the United States, will answer questions before lawmakers on the Senate committee for health, labor and pensions on Wednesday, after her initial confirmation hearing was postponed in October when she went into labor hours before she was set to testify.

Means is the president’s controversial pick for the role of the nation’s top doctor, responsible for disseminating the latest public health guidance. Although she graduated from Stanford School of Medicine, she did not complete her head and neck surgical residency at Oregon Health and Science University, is not board-certified, and does not have an active medical license. Her scientific experience is mainly focused around her work as a wellness influencer, and a leader within the Make America Healthy Again (Maha) space – which has become the key pillar of the Trump administration’s health policy under Robert F Kennedy Jr.

Means has spurned the medical establishment, noting that she dropped out of her residency because she grew “disillusioned with traditional healthcare”, which, she claims, focuses on diagnoses and prescriptions instead of diet and lifestyle.

In 2024, Means co-authored a book, Good Energy, with her older brother Calley, an entrepreneur who currently serves as one of Kennedy’s close advisers and has also railed against the US medical establishment. The siblings argue in their book that metabolic health as the key to reversing chronic illness, a framing that critics say verges into pseudoscience. “Many doctors are doing the wrong things, pushing pills and interventions when an ultra-aggressive stance on diet and behavior would do far more for the patient in front of them,” Means writes in the book.

The prospective surgeon general also co‑founded Levels, a health tracking company built around continuous glucose monitoring, as part of her belief that people need real‑time data to understand what’s driving their symptoms.

While Means has trodden lightly when it comes to the efficacy of vaccines, she is aligned with Kennedy’s routine skepticism of the number of vaccines children are recommended.

“I also find it perplexing that people are often shamed for asking any questions about the 70+ injected medications going into their children’s bodies before the age of 18,” she wrote on her website. “I am not making a statement about the utility of vaccines; I am making a statement about an $80bn industry getting to have legal immunity from wrongdoing and having the American population in a chokehold that forces them to comply with the complete schedule or face consequences.”

Earlier this year, the Trump administration announced it would slash routine vaccine recommendations during childhood from 17 to 11 jabs, a move that public health experts said would erode trust in inoculations and allow infectious diseased to spread.

Means’s nomination has received significant backlash from the US scientific community. Former surgeon general Richard Carmona, who served under George W Bush, told the Guardian that Means’s nomination is a “disgrace” to the future of America’s public health system. “She has no significant public health background experience. She has no scalable leadership experience,” he said.

At Wednesday’s hearing, all eyes will be on the committee’s chair, Republican senator Bill Cassidy. The Louisiana lawmaker cast the deciding vote to confirm Kennedy as Trump’s health secretary last year, despite skepticism about Kennedy’s anti-vaccine agenda. Although Kennedy made assurances to Cassidy – namely that he would not touch the Advisory Committee on Immunization Practices (ACIP) – he has reneged on his promises and overhauled the Department of Health and Human Services (HHS). Cassidy’s office did not respond to the Guardian’s request for comment.

Under Kennedy’s leadership, the health department has been beset with chaos. Grants have been terminated, there has been a mass exodus of officials from key agencies, and anti-vaccine loyalists have been installed to the ACIP.

Last year, the Senate-confirmed director of the Centers for Disease Control and Prevention (CDC), Susan Monarez, was ousted from her role less than a month after starting. In September, she told health committee senators that she was forced out of the CDC for her unwillingness to comply with Kennedy’s vaccine agenda. This month there was even more turnover at the CDC when Jim O’Neill, Monarez’s replacement, left the agency. His number two, principal deputy director Ralph Abraham, stepped down from his position this week.

Means is Trump’s second nominee for the surgeon general position. Last year he put forward Dr Janette Nesheiwat, but withdrew her name before her Senate confirmation hearing amid criticism from the right and reports of misleading medical credentials. Means will have to convince lawmakers on Wednesday that her own limited experience will suffice in the role.

Carmona said that his optimism that lawmakers will push back against Means’ credentials is “muted”.

“We see too much ideology and not enough science,” he said. “You’re putting an untrained person in the position … at a time when we probably need a real leader more than ever because of the mis and disinformation that’s out there.”