Michelle

From The Times:

May 30, 2009
Is small stature a problem to be 'cured'
There are drugs; you can even be stretched. But is small stature a problem to be ‘cured’?
by Anna Moore


Twig. Squirt. These were only a couple of my childhood nicknames. I can’t recall feeling hurt by them, though. For some reason the jokes about me being the smallest child of my year usually went over my head — in every sense.

It must have been a very different story for Hajnal Ban, an Australian local politician recently outed as the author of a book entitled God Made me Small, Surgery Made me Tall. Ban had her legs broken and stretched by screws, wires and surgery because she was concerned that her height would hold her back at work. The procedure cost Ban $40,000 in Siberia and ensured that she went from 5ft 1in (155cm — my height) to 5ft 4in. Was she right to be concerned? A study in Australia has found that taller people do, indeed, earn slightly more. But many buck the trend.

My experience has also been positive. I had friends and boyfriends. I passed my A levels. I’m where I’d like to be in my career. Others feel differently: Steven Goldsmith, who is 5 ft 2in and runs a short persons’ support website, [Only Registered Users Can See Links. Click Here To Register], receives at least two e-mails a week inquiring about “leg lengthening”.

Statistics are elusive because these operations happen privately around the world. You can be stretched in 18 countries, including Egypt, Iran, China and Macedonia, though the procedure is not available in the UK. “In the US it can cost up to $200,000, so people are opting to travel to cheaper places,” Goldsmith says. “I always warn them against doing it because I’ve heard so many horror stories — being immobile for months in unbearable pain. Sometimes a union between the broken and stretched bones doesn’t form and the person is left permanently disfigured. It’s horrendous.”

There are also drugs. Six years ago in the US drug companies were licensed to sell growth hormones to treat children who are at or below the 1.2 percentile, yet have no discernible health problem. The “cure” involves almost daily injections for up to five years — and adds about 1¼in to 2in (3-5cm) of growth.

Eli Lilly, the maker of Humatrope (a sort of Miracle-Gro for children), supplied US doctors with standard child growth charts, with an added red line at the 1.2 percentile cut-off point. By the following year Humatrope sales had jumped 16 per cent, to $430 million. Sales of Pfizer’s Genotropin had also soared.

In Britain the NHS does not treat short children who are not growth-hormone deficient, since the cost and risks outweigh the small height “benefit”. Growth-hormone treatment in children who are growth-hormone deficient is linked to higher rates of lymphatic and colonic cancers. The US has yet to discover the long-term effects of injecting it into children who already have normal amounts in their bodies.

On top of this are the psychological implications. David Sandberg, a psychologist at the University of Michigan, has spent 20 years working with short children and worried parents wanting treatment. He says: “If bullying is the reason behind it, getting hormones is a terrible response. It’s like telling them, ‘Yes, there’s a problem, the bullies have a point. A syringe will fix it’.”

Evidence suggests that, left to their own devices, small children cope pretty well. Sandberg’s studies, as well as European research tracking small children, have reached similar conclusions — height makes no difference. Short children are just as good at making friends.

In adult life, other studies suggest some small evidence of disadvantage. For instance, a UK study found short men to be 7 per cent less likely to marry than the average. Nevertheless Sandberg thinks the new focus on the “problem” of size is profit-based. “There are people who can make money out of it now. Once you’ve created a drug, your job is to get it to the maximum number of people.”