We're following the confirmation hearings for the Trump administration. See our full politics coverage, and follow NPR's Trump's Terms podcast or sign up for our Politics newsletter to stay up to date.
Who: Dr. Casey Means
Nominated for: Surgeon General
You might know her from: Casey Means is a wellness influencer, entrepreneur, and author. Last year, she published a bestselling book about diet and metabolic health Good Energy.
- She coauthored the book with her older brother, Calley Means, who works for the Trump administration as a special government employee and is a close advisor to Health Secretary Robert F. Kennedy Jr.
- She did not complete her surgical residency and does not have an active medical license, which would be a major departure from past surgeon generals.
- She runs a company that promotes the use of continuous glucose monitors.
- She has described America as in "spiritual crisis," questioned the childhood vaccine schedule and the use of birth control and has called out what she calls "corruption" at the FDA.
What does this role do? Known as the nation's top doctor, the surgeon general leads the more than 6,000 members of the U.S. Public Health Service, which include physicians, nurses, and scientists working at various federal agencies.
The surgeon general serves in the Department of Health and Human Services and issues public advisories and reports to convey health information to the public.
What's expected at the hearing
It's been more than five months since Trump announced Casey Means would replace his initial choice, Fox News contributor Dr. Janette Nesheiwat.
She will be joining the senate hearing remotely, which is unusual. The Health, Education, Labor and Pensions committee, which is holding the hearing, did not explain why she would be joining virtually. Her brother, Calley Means, shared in May that she was pregnant.
Senators will likely have tough questions for her about her qualifications and potential conflicts of interest. In financial filings released ahead of the hearing, Means committed to resigning from her continuous glucose monitor company if confirmed. She also disclosed financial ties to the supplement industry from which she promised to divest.
Means is 38 years old and a graduate of Stanford Medical School. She completed most of her residency training to be a head and neck surgeon, but quit before finishing.
In the years since, she pivoted to what's known as functional medicine, a field that focuses on root causes of illness and often encompasses lifestyle change and alternative medicine approaches that are not always evidence-based.
She briefly had a functional medical practice in Oregon. But she did not become board certified and her Oregon medical license is currently listed as inactive.
Means grew her public profile on social media and through her book Good Energy. She did the rounds on big podcasts in the wellness space with her brother and coauthor Calley Means. Her message tends to echo Kennedy's and that of his allies in the Make American Healthy Again movement, especially in flagging the high rates of chronic illnesses in the U.S.
"What we are dealing with here is so much more than a physical health crisis — this is a spiritual crisis," she said at a congressional roundtable led by Republicans last year.
She often talks about the U.S. food supply and environmental toxins and she criticizes the pharmaceutical industry. Kennedy has said she will be the greatest surgeon general ever.
Pushback on several fronts
There has been significant opposition against Means's confirmation from medical and public health experts. They point to her lack of leadership or clinical experience, something that surgeon generals traditionally have, and some of her views. For example, she has raised concerns about the safety of the childhood vaccine schedule and questioned hormonal birth control. She has also endorsed raw milk, as has Kennedy, who would be her boss.
"The Senate's likely confirmation of Casey Means as Surgeon General, an individual who never completed medical training, would mark a disastrous precedent for the nation's top public health role," Dr. Jerome Adams wrote in a statement to NPR. Adams served as surgeon general in the first Trump administration.
"Numerous qualified candidates — fully trained, licensed physicians who champion prevention and wellness —could lead the 6,000-person [U.S. Public Health Service] with distinction," he added. "Confirming Means reflects a capitulation to political pressures, not a desire to get the best person for the job."
Earlier this year, opposition to her nomination also emerged from some of Kennedy's MAHA supporters, partly out of concern that she wouldn't be critical enough of vaccines or carry forward other priorities of their movement.
Still, it seems unlikely that the Senate would have scheduled the hearing if the Trump White House weren't confident that Means could be confirmed. The withdrawal of previous health official nominations from this administration have all happened before a hearing took place.
Copyright 2025 NPR
