Want a naturally tall guy? Don't try U.S., Asia

Boys in the United States and Asia face more pressure to achieve "normal" height than boys elsewhere in the world, researchers from the Children's Hospital of Philadelphia found in a new study.

The study, released in April, found that male children are twice as likely as girls to be treated with recombinant human growth hormones in the U.S. and Asian countries, especially Japan.

Yet boys are only slightly favored to receive treatment in Europe, New Zealand and Australia. And in the rest of the world, boys and girls receive the hormone equally.

Adda Grimberg, a pediatric endocrinologist at CHOP and the lead author of the April study, is trying to figure out "how much of it is pediatrician-based and how much of it is family-based."

"In real life," she noted, "the two often feed off each other."

Terri Lipman, a pediatric nurse practitioner at CHOP unaffiliated with the study, noted that "a crucial distinction must be made between when growth hormone is necessary versus when it is aesthetic."

In her experience, she said, it is "not infrequent" that parents of a boy with normal short stature will request such treatment for their child.

"Parents view short men as being at a distinct disadvantage in our society, and that happens to be true," she said.

Lipman added that she "wasn't surprised at all" with the study's results.

"I've known as a nurse practitioner for many years that there's a gender disparity in children who are referred for evaluation for growth disorders" by their physician, she said.

Even back in 1985, when rhGH became available, studies of U.S. children revealed that boys received the hormone twice as often as girls.

As this trend persisted, an obvious explanation was presented: perhaps growth disorders that require hormone treatment simply occur twice as often in boys as in girls.

But if that's the case, said Grimberg, "it should be true everywhere."

Most children who receive rhGH are just naturally deficient in the hormone, Lipman said, while a minority have "idiopathic short stature" - unexplained abnormal growth in children with a healthy amount of growth hormone.

Growth hormone is notoriously difficult to measure in humans, according to Grimberg, because it is emitted in pulses at certain stages of sleep.

To measure levels of the hormone, then, clinicians must rely on a set of tests - including stimulating the pituitary gland to secrete growth hormone - which can yield false and borderline results.

The Federal Drug Administration approved the use of growth hormone to treat idiopathic short stature in kids whom an "endocrinologist feels may benefit from growth hormone therapy but whose defect the tests can't capture," Grimberg said.

That subjective space, the clinical judgment call, might be another place where a social bias for male height sneaks in.

Comments (3)

I am a shorter than average adultmy height being only 4'9 and half.Now i am 42 yrs old and never quite managed to get as tall has my brother and sister.I alway put it down to my brother being 6'2 and 48 yrs old and my sister 5'11 and 45 yrs old.I used to say they must have used up all the height gene when it came to me.Now both my mum and dad are 5'9 and 6'0 so they wasnt really any reason for me to be so short.I do recall my great grandmother who was barely 5'0 and she used to appreciate me being around her has she used to say she get fed up having to look upwards when speaking to people.My other 2 grandmothers are 5'2 and 5'4.So i suppose i must have got my height from my great grandmother.When i was younger i used to get taken to my doctor alot has mum was worried about my height.I was always one of the shortest in the whole school.I would have jumped at the chance of h.g.h but i now know that alot of people who did have treatment years agon have ended up dieing so i am greatful.

Now i want to point out a few facts about myself.It is usually that you will find guys taller than woman.Now i have never been able to accept my stature. DAD---------------------------6'0 MUM---------------------------5'9 OLDER BROTHER-----------------6'2 OLDER SISTER------------------5'6 ME----------------------------4'10 YOUNGER SISTER----------------5'8. I have a grandmother who was barely 5'0 and a grandfather who was 5'1.Now i am in good company has they fully accepted their short height and it was easier for them growing up.Now that i am 25 yrs old and suffered predjudice all my life so far.I was riddiculed at school for being shorter than 95% of my class.I had 5/6 pupils in my class who were just near to my height.The class mainly laughed due to the girls being taller than me.I had 6 very good friends 4 were way taller than me and the other 2 were around my height.When we had a end of school party i had to take a girl who was 6 ins taller than me.When we picked her up i realized she was wearing heels and has we walked into the hall and had our pic taken the true extent was realized at the end when the pics came back.Now i didnt mean to take a tall girl but i did try to ask 3/4 slightly taller girls who all knocked me back due to my height.At the end of the night we had a big group pix taken and the shorter people were told to go in the front.I had 5 girls 1 side of me they were between 4'11 and 5'3 then i had 5 boys the other side of me who were between 5'1 and 5'5.bang behind me was my partner and she was way taller about 8 ins everyone laughed like crazy.So my school days were not very nice,i used to dread sports day has i was always last and when it came to trying to score a basket at the end of the run i had nothing but trouble.It took me about 10/12 attempts with people laughing at me struggling to score. I remember going to a club for my 21st birthday and being turned away it wasnt nice.We ended up in another one which was okay.I had to endure being best man for my older brothers wedding some 5 yrs ago.He was 1' and 4 ins taller,the pics looked riddiculous but it made my brothers day so i couldnt do much about it.Now i see my grandparents at least once a month and they keep pointing out that i am nearly their height to make me feel better but i jusy shrug and say yeah but they are shrinking so they may be nearly 4'10 now both of them.Now when i start to shrink i could end up somewhere between 4'7 to 4'9. I am still looking for woman but dont seem to get much joy even my sisters try to help but their friends are pretty tall anyway. I am better checking it out for myself.

Being a short older male living in Spain i dont feel that much out of place.Living in Spain i feel quite like a man rather than in England where i was born.I live in Southern Spain and the area i live the people arent massively tall.My adult height i am 5'2 tall and now 45 yrs old.Both my parents are relatively average height.My dad is 5'10 and mum is 5'6.I ended up being the oldest and shortest in the family.I had to endure my younger sister who is 43 reach 5'7 and my brother who is 41 reach 5'9.It took me years to work it out who i took after then it dawned on me when i was 15 at the time and i was about my height i am now.I was at a wedding of my cousins he was 21 at the time and he was a good foot taller than me then.The wedding pics were a laugh i tried standing near the back on the top stairs my head must have looked like a floating head.The photographer shouted out will the young boy at the back come near to the front.At first i didnt know he meant me till someone nudged me.So i was then put quite near the front.My sister was catching up fast i even had family telling me it wont be long till she outgrows me.I didnt know how true it was gonna be till a couple of years later she was way past me.I then thought well least my younger brother could keep me company with being short but he was also growing and growing.Going back to the wedding the reception was good i was slightly taller than some of my cousins but only because they were younger.It was at this time that my grandmother came up to me and said MAYBE WE SHORTIES SHOULD STICK TOGETHER.I said what do you mean gran.She explainned that i think you are gonna end up like me being short.I laughed and explainned that i was still taller than some cousins and slightly taller than my brother and sister.She mentioned that they are already getting tall and to just accept how we turn out.I didnt realize straight away till a couple of years when everyone did grow taller.At christmas 3 years after the wedding she came up to me and said TOLD YOU SO.I laughed and said well i managed to reach your height to which she said yes but only when i wear flat shoes.It dawned on me that even my gran was a little taller than me. Last time i saw her she was 92 yrs old and still mobile she ame up to me and joked I SEE YOU DID OUTGROW ME IN THE END. I have been married 10 years now and my wife is slightly taller than me she is 5'4.We have a son 5 and he is on the short side whereas our daughter who is 9 she is a tall bugger.

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