Short Changed

An Indianapolis based company wants FDA approval for use of growth hormone on extremely short but healthy kids. There doesn?t seem to be much danger involved; rather, the FDA is asking whether there is a ?need? for the treatment and fretting about ?the medicalization of shortness.? Right now, only short kids with sanctioned medical conditions can get their hands on the stuff. Curiously, no one is complaining about the push for treatment of Alzheimer?s, aka, the medicalization of aging.

Comments

[Jon H]

Wow, are you ignorant about Alzheimers.

Did you know that it can hit in your 40's?

[Jon H]

Oh, another comment.

Growth hormone would be a big improvement over another treatment for being short, which basically involves *breaking your legs several times a day*, which causes bone to grow in the gaps created each time.

Frames are screwed into the leg bones, and a screw in the frame is turned to move the upper and lower portions of the frame (and the attached bone) apart.

Turning the screw breaks the newly-grown bone, and creates a small, new gap. New bone grows to fill the new gap. Eventually, the leg bones grows an inch or so.

[Todd Fletcher]

Sounds like it's better to just stay short.

[Rick Barton]

Damn the FDA! We have got to abolish it or, at least, reduce their power. This example, and how many other desires of betterment through science are stifled at by beaurocratic whim? The problem is not the "medicalization" of shortness or any other human condition, it's the politicization of medicine that is the real problem.

[RS]

A few of the right pills can make you very happy. Just be carefull children.

[Jim]

To rephrase RS and make a bad pun, if the pills don't make you happy, you don't know where to shop 😉

If extreme shortness causes problems with self esteem or even the ability to reach the accelerator pedals on a car, then medicalizing it out of existence is probably a good thing. What happens however when everybody gets just a little bit taller? Does the bell curve of height tighten up or will it just shift, thus leaving the 5'7" and under crowd with the same social ills that the 5'5" and under crowd feels now? Hard to tell - some people might want to get taller but people over 6'6" have problems of their own (hitting your head alot is one of them I'm sure) so that may not really be desirable except for pro basketball players. Only time will tell....

[Anonymous]

Pluto says, "And thus comes the problem of intervention in private choice, where the government decides that there are certain things that people are not permitted to change about themselves..."

Certain individuals at the FDA who are reading your post right now, are laughing their ass off.

"The government" doesn't decide anything. Only specific individuals do. And those individuals are laughing at what you say, because they're safely ensconced behind that elusive non-entity called the "FDA."

Until we have actual names of SPECIFIC INDIVIDUALS whom we can hold responsible for such decisions, there ain't much you can do about the result.

[Sir Real]

Hmm...

Aside from the stunningly ignorant comparison of being short to neurofibralary tangles, there's one issue I can see here-

The slippery slope.

This is just a guess, but I'm willing to bet that a lot of people in favor of normalizing height are also against the massive prescribing of anti-depressants to children.

I happen to see these two issues as essentially the same. Nature makes kids one way. Parents/Society want them to be something else- sometimes for their own good, sometimes for the parents. A method is found to change kids in the requisite way. People who aren't the children's caretakers complain.

It would seem the difference is that shortness only inconveniences the child expressing it, whereas obnoxious inconveniences others. Or maybe altering childrens minds is somehow less meddlesome than altering their bodies? I don't claim to understand...

Nothing to see here people- move along...

(Mr. Barton? Your salmonella snake oil is waiting...)

[Madog]

Silly comments about Alzheimers being a normal part of growing old aside, who says that growing old isn't a major medical condition than must be stopped? I mean come on, every system in your body starts working like crap.

[Plutarck]

Rick:

There are two similar problems you missed, which I think even more important than "medicalization" (which is, upon consideration, a rather stupid/ignorant sort of concept): the gradual removal of the right to choose to refuse medical treatment (as with "mental illnesses" of various sorts), and a far more general problem with how people form their indentities. In general, one's identity (one's personal indentity, and the identity other people assign to that person) is created using persistant traits, and things which cannot be changed obviously tend to be quite persistant.

This isn't usually problematic, except when it turns out that things that once could not be changed suddenly do, or become able to be changed (especially through the excercise of choice).

This problem perhaps first became especially apparent with the advent of plastic surgery. Looking a certain way used to simply be a part of who you are, at least to a large extent...but now technology changes all this. Suddenly how you look can be changed to an enormous degree, and with a decreasing cost (in money, risk, and discomfort). Thus parts of an identity like "plain", "homely", "frumpy", and "geeky" can be illiminated suddenly and in rather short order. Suddenly formerly very prominent labels and attributes of identity like "beautiful" and "ugly" prove themselves not to be "shallow" be ephemeral in the extreme - a few thousand dollars and a month or so, and suddenly an entrenched label can be rendered invalid.

However the stir here is still rather minor, because there was forever the saying "Beauty is vain" and "never judge a book by it's cover" and the ever looming judgement of being "shallow".

Ah, but now here is where things get really hairy. All this time people dealt with emotions as really being deep. Yes, a deep person is one who cares about feelings and emotions, and attitudes, and things like that. Happyness, sadness, anger, fear, depression, pain, joy - the extents to which one displayed, and experienced, these often tended to be persistant and somewhat obvious, and thus they came to be used in the formation of identity. But then came pharmaceuticals and drugs, and the veil is ripped off to reveal that emotions are perhaps just as ephemeral and shallow as one's physical appearance. First it was "just a few cuts and pokes and you can be beautiful", and now we have the equivalent of "just a few pills and you can be happy".

Well if it really is true that things like happyness are as ephemeral and shallow as beauty, then what's the big deal? If one's physical appearance is shallow, what's wrong with changing it? If emotions are so ephemeral and can be altered with nothing more than a little plastic-covered pill, what's wrong with changing them as well?

If it's ok to be short or tall, then why the hell isn't it ok to not be short or tall anymore, if you don't want to be?

This all ends up manifesting itself at a time when there is a strange combination of a crushing push for conformity - look this way, think this way, act this way, like this, hate that, approve of this, disapprove of that, make fun of this, don't make fun of that - and yet there is another push that seems to demand people simply not change (either just plain not change, or "don't give in").

My solution to these problems is really quite simple, and is perhaps natural to many of us: Individualism and freedom of choice. How about this: "You're an individual. If you want to change, change. If you don't, don't. Either way you should be Left The Hell Alone." A "I do/don't like that, but it's not my choice anyway", or something to that extent, will suffice.

And thus comes the problem of intervention in private choice, where the government decides that there are certain things that people are not permitted to change about themselves, trade offs they are not permitted to make - inexplicably - unless someone declares that there is something wrong with them, in which case it may or may not then be ok.

[Plutarck]

Of course, in addition to the above, there is the natural problem that occurs when it's children who have to have the choices made for them.

Best solution I've heard is that anything that seems obvious and incredibly undesirable to have is forbidden...and all else is left to the parents to choose. In this instance, is not being short really some tragedy? Do we need the government to protect shortness? WHY? If it really doesn't matter, as it _supposedly_ doesn't, then one shouldn't care about it being changed.

I fail to see how the world would be ever so worse a place if people were taller. Big damn deal.

[fyodor]

I must admit that it disturbs me at a certain level that shortness might be medicalized out of existence. But at the same time, I believe in freedom of choice first. I have the right to say that I think it's wrong and lame for parents to be scared to allow their children to deal with such a minor "handicap," but I don't have the right to use the law to stop them.

[Kerry Howley]

The comparison was made to highlight the ambiguities of the term "medicalization," which can be applied to any number of conditions and isn't a sufficient reason to withhold treatment.

[joe]

Plutark,

Pills don't make you happy. They may remove one obstacle to being happy - unhealthy brain chemistry - but the external world and the influence it has on you go on regardless.

[Plutarck]

joe:

"Pills don't make you happy."

Well no, not yet in the experiential sense (I don't mean in the philosophical/intellectual "feeling happy is different than being happy" sense)...but then, some drugs do produce the feeling of happyness, even if not in-and-of-themselves.

On re-reading, I meant "and now we have the equivalent of "just a few pills and you can be happy"" to be "and we will eventually have the equivalent of "just a few pills and you can be happy"". Note that this isn't a claim that the pill itself is _solely_ responsible for the creation of happyness - which I believe addresses your objection about external influence.

[Iggy]

I wish life could be Swedish magazines.

[joe]

"If extreme shortness causes problems with self esteem ..., then medicalizing it out of existence is probably a good thing."

Being black caused problems with self esteem in old dixie. Being gay causes problems with self esteem in many places today. Should we cure those infirmities next?