President Trump’s second choice for U.S. surgeon general has set off a wave of infighting within the Make America Healthy Again (MAHA) movement.
Casey Means is a prominent health influencer and ally of Health and Human Services Secretary Robert F. Kennedy Jr., but she is seen as insufficiently skeptical of vaccines by some of his prominent supporters — and a “total crack pot” by others in Trump World.
Trump chose the Stanford-educated doctor-turned-chronic disease entrepreneur to be surgeon general after withdrawing his first pick Janette Nesheiwat, a former physician and Fox News host. Means, like Kennedy, has focused much of her health advocacy on diet and nutrition.
“Bobby really thought she was great. I don’t know her. I listened to the recommendation of Bobby,” Trump said of Means. “I met her yesterday and once before. She’s a very outstanding person. A great academic, actually. So I think she’ll be great.”
Nesheiwat’s nomination was withdrawn the day before her Senate confirmation hearing, after media reports called her credentials into question and conservative figures attacked her for praising the COVID-19 vaccines.
Like Kennedy, Means has expressed skepticism about vaccines, promotes food as medicine and is critical of the current health care system. But the pick was unpopular with other health influencers aligned with Kennedy.
“I can’t help but think this is a very carefully groomed and selected person. Just about no clinical experience. Talks a great game about everything but vaccines. Feels all wrong,” said Suzanne Humphries, a medical researcher who, like Means, has appeared on Joe Rogan’s podcast.
“She’s not a health freedom advocate,” Mike Adam, who goes by Health Ranger, wrote on social platform X. “She’s not a vaccine truther. She’ll never recommend natural cancer cures or remedies. She’s basically cosplaying as a MAHA champion.”
Means became a key influence in the MAHA movement last year along with her brother Calley Means, who works as an adviser to Kennedy in Department of Health and Human Services.
They co-wrote the book “Good Energy: The Surprising Connection Between Metabolism and Limitless Health” about the connection between metabolism and personal health, and they promoted their ideas across conservative media, including a hit episode of Tucker Carlson’s podcast.
The blowback to her nomination reflects the broader tensions within the MAHA movement, as different factions vie for influence in the Trump administration. The surgeon general serves as the public health face of the administration and wields a powerful bully pulpit, but has little actual authority.
Richard Carpiano, a professor of public policy at the University of California, Riverside, researches social factors affecting vaccine uptake and the anti-vaccine movement. He said Casey Means seems to have failed the purity test among some Kennedy supporters, but that public infighting also reflects the realities and limits MAHA.
“This is really kind of showing or pointing to questions of, you know, to what degree is it really like a movement or is it really just this kind of like brand that that Kennedy is really just trying to push,” Carpiano said.
MAGA influencer Laura Loomer in a series of posts on X accused the president’s advisers of poorly vetting the new nominee for surgeon general.
She called Means a “total crack pot” and “Marxist tree hugger,” in the post, pointing to various alternative practices Means has written about, including communicating with spirit mediums and using hallucinogenic mushrooms as medicine.
Kennedy’s former running mate, Nicole Shanahan, has also criticized Means’s nomination, writing in a post on X that she was told neither of the Means siblings would work at department if she supported Kennedy.
“With regard to these siblings, there is something very artificial and aggressive about them, almost like they were bred and raised by Manchurian assets,” she wrote, adding that she suspected Kennedy was being controlled.
Kennedy has vehemently defended Means’s nomination.
“The absurd attacks on Casey Means reveal just how far off course our healthcare conversations have veered, and how badly entrenched interests–including Big Food and its industry-funded social media gurus–are terrified of change,” he wrote Thursday on X.
Calley Means on Friday shot back at Loomer, writing on X, “Just received information that Laura Loomer is taking money from industry to scuttle President Trump’s agenda. @LauraLoomer if that’s incorrect, sue me and let’s do discovery.”
Loomer responded by calling him a “PR spin master” and accused him of being “threatened” by her “access to President Trump.”
Casey Means left a five-year residency program at the Oregon Health & Science University after 4 1/2 years due to anxiety and feeling she wanted to do something different, the Los Angeles Times reported.
She has since cultivated a large following online and is the co-founder of Levels, a health technology company that focuses on tracking health information through devices like continuous glucose monitors.
Those who’ve worked with Means describe her as someone with a genuine concern for public health, particularly when it comes to young people.
Soh Kim, executive director of the Stanford Center for Innovation and Design Research, worked alongside Means at Stanford University, teaching a food, design and technology course.
“She is very rare in terms of, like, her rigorous medical knowledge but also, she is somebody who can, you know, talk to anyone in the class with their level,” Kim said.
But others questioned her qualifications for such a high-profile public health role. Former U.S. Surgeon General Jerome Adams noted, shortly after Means was nominated, that the surgeon general position has historically been required to be held be a licensed physician.
“As the Senate is considering confirmation, it is important that historical precedent, the ability to effectively lead the USPHS, and the law, are all taken into consideration,” he wrote, referring to the U.S. Public Health Service, which the surgeon general oversees.
