FDA Chief Counsel Hilary Perkins Steps Down After Two Days in Role

Political Pressure Sparks Swift Exit

Hilary Perkins’ abrupt resignation as the U.S. Food and Drug Administration’s chief counsel, just 48 hours after her appointment was announced, has sent shockwaves through the health policy community, spotlighting the intense political tensions surrounding the FDA’s leadership under the Trump administration. Appointed as part of a Department of Health and Human Services reorganization effort giving HHS’s new general counsel oversight of the FDA’s top legal position, Perkins stepped into the role with a robust background from her tenure at the Department of Justice since 2019. However, her swift exit, confirmed by an FDA social media post on X and her own LinkedIn statement, underscores how her past legal defenses of FDA policies on abortion pill access and vaccine mandates clashed with current administration priorities, drawing sharp criticism from Republican Senator Josh Hawley and ultimately derailing her brief stint.

Perkins’ appointment came amid a broader HHS restructuring unveiled earlier this week, aligning legal oversight across health agencies including the FDA and the Centers for Disease Control and Prevention. Her role as chief counsel was poised to be pivotal, leveraging her experience in the DOJ’s consumer protection division where she defended the FDA in high-profile cases, notably advocating to maintain unrestricted access to mifepristone, the abortion pill, in a Supreme Court case, and arguing against easing in-person dispensing restrictions during the pandemic. These positions, detailed in legal filings reviewed by Reuters, positioned her as a seasoned litigator but also a lightning rod for controversy in the politically charged landscape of 2025. In her LinkedIn post, Perkins acknowledged this friction, stating that her DOJ work, performed diligently under her oath to represent the United States, became an “unnecessary distraction” from the Trump administration’s goals, prompting her resignation.

The catalyst for her departure appears rooted in immediate backlash from Senator Josh Hawley, who publicly condemned her appointment hours before she stepped down. Hawley, a key voice in the Senate, criticized Martin Makary, President Donald Trump’s nominee for FDA Commissioner, for selecting Perkins, branding her as “pro-abortion” and highlighting her support for vaccine mandates during her DOJ tenure. This opposition was not merely rhetorical; Hawley threatened to shift his vote on Makary’s confirmation, a move that could jeopardize the nominee’s path forward given the tight Senate confirmation process. Makary, who has yet to be confirmed and passed a key committee vote on the same day Perkins resigned, had reportedly viewed Perkins as a reliable career attorney, according to sources cited by The Daily Wire. Yet, the political firestorm ignited by her past legal stances forced a rapid reconsideration, with Hawley later expressing approval of her exit as a sign Makary had “reconsidered” his choice.

This episode reveals deep fissures in the FDA’s leadership transition, particularly around hot-button issues like abortion pill regulations and vaccine policies, which remain divisive in the U.S. health policy arena. Perkins’ legal track record, while professionally commendable, included defending mifepristone’s availability without new restrictions, a stance that clashed with the Trump administration’s broader agenda and drew ire from conservative lawmakers. Makary, for his part, has signaled intentions to review mifepristone data and dispensing rules if confirmed, suggesting potential shifts in FDA policy that Perkins’ presence might have complicated. Her resignation thus not only clears a political hurdle for Makary’s confirmation but also raises pressing questions about the future direction of the FDA’s legal strategy, especially as it navigates ongoing litigation and regulatory challenges.

Beyond the immediate political fallout, Perkins’ exit highlights the precarious balance federal agencies must strike in appointing leaders amid polarized times. Her two-day tenure, one of the shortest in FDA history, contrasts sharply with typical leadership transitions, underscoring the unique pressures of 2025’s health policy landscape. The FDA’s chief counsel role is critical, tasked with defending agency decisions in court and shaping legal interpretations of regulations, yet Perkins’ swift departure leaves a vacuum at a pivotal moment. With no immediate replacement named and the HHS announcement of her appointment quietly removed from its website, as noted by Reuters, the agency faces uncertainty in its legal leadership just as it braces for potential policy overhauls under Makary’s prospective tenure.

The broader implications of this resignation ripple across health policy and political spheres. For stakeholders tracking FDA chief counsel resignation controversy, the event signals how deeply partisan divides can infiltrate even career-based appointments, traditionally seen as less ideological. Perkins’ case also amplifies interest in Martin Makary’s FDA Commissioner nomination process, with analysts suggesting her exit might expedite his confirmation by mollifying critics like Hawley. Meanwhile, the absence of official comments from HHS and FDA, despite requests from multiple outlets, adds a layer of opacity, leaving Perkins’ LinkedIn statement and the FDA’s X post as the primary windows into her decision. For those invested in abortion pill access legal battles or vaccine mandate policy shifts, her departure marks a turning point, potentially reshaping how the FDA approaches these contentious issues in the coming months.

This rapid turn of events, verified by sources like Bloomberg, Fierce Pharma, and Fox News, reflects a rare convergence of legal expertise, political pressure, and administrative upheaval. Perkins’ resignation, while a personal decision framed as avoiding distraction, speaks volumes about the challenges of aligning career civil service with the ideological currents of a new administration. As the FDA moves forward, the focus now shifts to who will fill this critical role and how they will navigate the same turbulent waters that capsized Perkins’ brief tenure, all while the agency remains under intense scrutiny for its handling of America’s most pressing health policy debates.