Extremely short stature can be caused by a wide variety of factors, including both medical and natural. There are some serious medical and genetic conditions that accompany extremely short stature, but they are extremely rare: only 5% of children who are in the bottom 5% of the height curve have an actual medical condition that is the underlying cause of the short stature. Although most people suspect that a child’s short stature must be due to an underlying disorder or pathology, in fact, 95% of children in the fifth percentile are short either due to a growth delay or due to their family genetics; or a combination of the two. They are perfectly healthy and normal, just short.
In the process of determining whether extremely short children might fall into the unhealthy 5% of the bottom 5%, they endure numerous detailed measurements of the body, complete medical examinations including genitalia, exposure to X-Rays and a series of blood tests. Once all these procedures are completed, some of which are quite invasive, 95% of these children should be given a clean bill of health. Unfortunately, either parental pressure or the need to justify all the medical resources already expended leads doctors to want to make the process seem worthwhile. So, doctors have created a medical diagnosis for these healthy 95% of short children – idiopathic short stature.
The word idiopathic literally means “of unknown cause, as a disease.” The medical dictionary defines the word disease as “an impairment of the normal state of the body or one of its parts that interrupts or modifies the performance of the vital functions.” However, idiopathic short stature actually means the absence of any medical disorder. Children with idiopathic short stature are healthy and normal, but unfortunately, the diagnosis promotes the perception that they are abnormal. The fact that there is no comparable “idiopathic tall stature” diagnosis for unusually tall children points to the fact that this diagnosis is grounded not in medical science but in height discrimination.
Diagnosing children with “idiopathic short stature” has a serious and long-lasting impact. The experience of being taken to the doctor is itself often a bad memory, leaving feelings of having been humiliated, poked and prodded. It sends the message to the children that the people they trust most in their lives – their parents and their doctor – believe that they are abnormal, that there is something seriously wrong with them. The experience also causes parents to worry about the child’s prospects in our prejudiced society and to try to do something to “fix” the problem through medical intervention. Many parents will even request unnecessary growth hormone treatment for children who have no medical need for such hormone.
In the United States thousands of children are currently receiving hGH treatment to “correct” their idiopathic short stature, at an enormous personal, social and financial cost and without clear evidence that such treatment provides a clear benefit which outweighs the risks. In essence, we are attempting to use medical intervention to physically alter an inherent trait that our society deems undesirable. The only appropriate word for that is “eugenics.”