The National Organization of Short Statured Adults is opposed to the use of human growth hormone for short but otherwise healthy children. "The growth hormone deficient child suffers from an underlying medical problem that affects the body's health in different ways. The non-growth-hormone-deficient child has no underlying medical problem. They simply present as a variation on the norm with regard to height. The decision to medically intervene on the healthy child's stature is socially based due to height discrimination and prejudice." - Ellen Frankel
An article by Ellen Frankel:
Stop Trying to Make Healthy Short Kids Taller
Many short children are perfectly healthy. Their height is a matter of genetic make-up rather than any medical problem resulting in short stature. Despite this, many parents are turning to human growth hormone injections in an attempt to add inches to their short child’s height. It’s understandable that parents worry about their children’s short stature because we live in a culture that favors certain body types above others. Heightism – the cultural bias favoring the tall over the short – is pervasive in our society, so parents often reason that trying to add inches will benefit their child. But beware: using human growth hormone treatment for healthy short children is potentially harmful on many levels.
• People naturally come in different shapes and sizes: If you think of a bell-shaped curve to plot children’s height, you’ll find that most people fall in the middle (average height), fewer fall into the left or right of that middle (the shorter than average and the taller than average), and still fewer fall into the tail ends of the growth chart (the very short and the very tall). Targeting healthy children who fall into the shortest percentiles of a normal distribution for medical treatment is dangerous. It takes a social prejudice against short people, and treats the victims of that prejudice as patients in need of treatment. What we need instead is to educate those who discriminate against short people, not the genetic engineering of its victims.
• Safety and efficacy of human growth hormone treatment: In 2003, the Federal Drug Administration approved the use of human growth hormone therapy for very short, healthy children, yet the safety and efficacy of this practice raises many red flags. Human growth hormone treatment involves subjecting the child to daily injections over an average of 5 years at cost of $20,000 per year. Research has revealed that on average, a child may add 1 to 1 ½ inches to final adult height, if any added inches occur at all. It appears that while some children may grow faster as a result of treatment, they don’t necessarily grow taller. In other words, they simply reach their adult height faster. Moreover, there are potentially serious side effects that include: a possible association with certain cancers, hypertension, spontaneous bone fractures, headaches, fevers, stomach problems, vomiting, impaired glucose tolerance, kidney damage, and a worsening of scoliosis. The synthetic version of human growth hormone has only been available since 1985, so the possible long-term adverse affects are unknown at this time.
• Height and self-esteem: Many doctors and parents believe that adding inches to a short child’s height will increase self-esteem. However, the treatment itself may potentially decrease self-esteem. What is the child to think about his or her own height if doctors and parents are prescribing human growth hormone treatment; that being short is unacceptable and therefore that they are unacceptable? Children often have the fantasy that growth hormone treatment will actually make them tall, when at most, it can offer an inch or two. What is the child to think after years of treatment and the bursting of the fantasy that the shots will make him/her tall? That he/she is forever unacceptable and doesn’t “measure-up?’ And if the child does gain an extra inch, he/she will still be short, but now the child has the added burden of years of treatment that is costly physically, emotionally and financially.
• Paying the price: Treatment is expensive, costing an average of $100,000 over five years. Who will have access to this costly treatment? Do we, as a society, want our limited health care dollars to go towards this type of intervention? If insurance doesn’t pay, only the wealthy will be able to afford treatment, making this into a class issue as well as size discrimination issue. How much greater will the prejudice against short people become if parents are now expected to “grow” their short children?
• Profiting from prejudice: By targeting the shortest height percentiles of a population, the pharmaceutical companies producing human growth hormone have insured that they have a built in population to treat that will boost profits significantly. Even if children were taller, on average, there will always be those who fall into the lowest tail ends of a bell shaped curve, providing endless potential recipients for treatment. This targeting of children supports and reinforces a social bias against short people, while business profits from that prejudice.
Being short can be a stressor in the lives of both short children and adults, from school playgrounds to corporate boardrooms. However, the great majority of problems that arise stem from the social prejudice directed against short people rather than any inherent problem in being short itself. The answer to this social issue must be in the form of combating the cultural bias against short people, not in trying to make the victims of that prejudice taller.
Ellen Frankel, LCSW is the author of Beyond Measure: A Memoir About Short Stature and Inner Growth, (Pearlsong Press 2006). You can visit her website at: www.beyondmeasureamemoir.com
"The solution to prejudice is education for those who are its purveyors, not the genetic engineering of their victims." -Andrew Kimbrell.
"The right response to the random prescription of growth hormone for children is to stop it, not to study it." - Arthur Caplan.
"Many of the 'problems' short children exhibit stem from the prejudice and discrimination directed toward them from others. Placing blame on the victim of societal prejudice and directing efforts at changing his/her height ignores the cultural bias against short stature and its various manifestations." - Ellen Frankel.
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