Over the holidays some of my family and friends were discussing a topic I found interesting: Should short kids be given growth hormone to boost their height? Now, I am not a medical doctor, but I do think this question provides us with an opportunity to explore some powerful social issues that face fitness professionals today.
The reasons presented to rationalize the use of growth hormone (GH) in short but otherwise healthy kids typically are that taller people earn more money than their shorter counterparts. In addition there is often worry or fear from parents that shorter kids may be teased and may have lower self-esteem as a result of their height. Leadership positions seem to be preferentially given to taller people (1).
On the surface I can see the logic behind the recommendation, but I believe when you explore the issue at a deeper level it is clear that we should not prescribe short kids growth hormone (assuming they otherwise healthy). Let me tell you why.
All of the reasons above are correlational studies – on average taller people earn more than shorter people (2). What this really represents is there is some discrimination present against short people. When discrimination is encountered, should we try to change the person being discriminated against? Or should we work to eliminate said discrimination in the first place?
I had always heard that taller people make more than short people, although when I looked at the numbers I personally was surprised at how small the difference is. Studies seem to show a difference of $789 in annual income per inch of height (3). To me that is statistically significant but it is not earth shattering. Giving growth hormone generally accounts for an increase in a child’s height of 1-3 inches (1) – you can’t take a kid that is going to be 5’2” and make him 6’2” with GH. The bottom line is if he was going to be short without GH, he’ll still be pretty short even after taking GH. And it is worth noting that GH is extremely expensive, usually costing around $35,000 – 50,000 per inch (1). I am also not a financial advisor, but I am pretty sure if you took that money you would spend to increase a child’s height (which is done when they are at a young age), invested it for 20 years, and gave it back to the child when they were an adult that would much more than compensate for the measly $800 bucks a year they are being underpaid. And I am going to bet that money in the bank might improve their self-esteem and confidence a little bit as well.
If we decide that being taller is better (it is worth noting those studies show increased earning all through the height spectrum, so a 6’ tall male would make more, on average, than a 5’10” tall male) (2) shouldn’t we then give growth hormone to everyone? What if we have a child is that already extremely tall, would it not be ideal for them to be even taller? And if taller is better does that mean that those cultures that produce taller people are better than those cultures that produce shorter people?
If you apply this logic - that a child might be discriminated against because of something they can’t control and this might affect their social or economic status in the future, then shouldn’t we look for other areas we can ‘improve’ on as well? The research is very strong (much stronger than when examining height) that skin color affects earning potential and social status (4). Dark skin is associated with lower earning levels than lighter skin (5). Should we not take those children with dark skin and then ‘help them’ by attempting to lighten their skin tone? Hopefully the slippery slope that this attitude creates starts to become clear.
And let’s be very explicit, being short or having darker skin has absolutely zero negative impact on a person’s health. What do we do about much more pressing situation – for example children that are overweight? The research is also clear that heavy people are paid less than their thin counterparts (6). The research is also clear that an overweight child is much more likely to be heavy as an adult (7). And of course being heavy, both as a child and as an adult, does have significant negative health implications. Does this mean we should start encouraging overweight kids to take appetite suppressants, fat burners, and stimulants to help them lose weight? What are the unintended consequences of giving powerful drugs to kids? We simply don’t know (1).
How about instead of judging people and telling them how to be, how to look, and what they should do we start preaching love and acceptance of each other? This is the anti-bullying age. To me that means that we stop judging and discriminating against people that are different. It is worth noting that this ‘different’ is from some sort of arbitrary standard of normal (when it comes to height for example, average height for a male in Denmark is 6’, for a male in Taiwan it is 5’4” – should all the Taiwanese kids be given GH to compensate for their short stature?) (8).
To me there is a big difference between self-improvement and self-alteration. Self-improvement is when a person makes a conscious and intentional effort to better themselves. Examples of this including reading, going to school, exercise, and eating well. You are taking the current system and attempting to make it better without introducing any fundamentally ‘new’ things. Self-alteration is when a person changes themselves (or their bodies are changed by others) to fit a predetermined mold. This is usually done by introducing something ‘new’ that the current system doesn’t have or has very little of. Cosmetic surgery, tattoos, drugs, etc would be examples of self-alteration. I am not saying those things are fundamentally bad, what I am saying is that self-alteration should be done by adult making a conscious decision about what they want to do to their body. I also want to be very clear, I am not anti-medicine or anything like that. When my gall bladder stopped working or when my quad ripped off the bone, I was extremely grateful to have advanced medicine available to me. But again there is – in my mind – a significant difference between fixing something that is clearly broken and attempting to ‘fix’ something that is clearly not broken, just different.
If we focused more on loving and accepting ourselves, and less on hating ourselves or parts of ourselves or wishing we were like someone else, I believe people would be much happier and healthier. Being fit, being strong, being healthy are fine ideas to work towards, but let’s not make the mistake – as fitness professionals or as a society – of judging or looking down on those who are different from us. The world is more connected now that it ever has been, and it is likely our differences that make us stronger as a whole.
Your body is the most complex, amazing, and expensive machine you will ever own (9). It may not be perfect, but it is yours and it is unique. Learn to love and appreciate it, and respect and accept those that might be different from you.