Is Being "Too Short" a Disability?

By Kyle Munkittrick | April 22, 2011 8:44 am

Human growth hormone (HGH) is one among the many hormones your body naturally produces. HGH influences growth in that it helps encourage cell reproduction and regeneration. Athletes really like to pretend that HGH makes them more powerful. It might, but it probably doesn’t. Whether it works or not, athletes should be allowed to utilize it. But banning performance enhancers is a topic already covered, so let’s look at something more interesting.

As part of a thread called “The Bias Against Short Men,” Andrew Sullivan’s The Dish published an email by a reader struggling with a difficult question:

The doctor noticed that my son was comfortably sitting at the bottom of the growth chart and that he would most likely end up a measly 5’5” (a little more than my wife and myself). He went on to say that this could qualify as “idiopathic short stature syndrom.” And that we could potentially get our son on HGH (actually, it’s called rGH I think – see here) if we felt that his projected short height could affect his self-confidence and ultimately, his mental health.

Unlike HGH in athletes, HGH used to treat medical conditions has clinically observable benefits. A child given HGH treatments will have an appreciable difference in height as an adult. The reader feels inclined to give his son the treatments, while the reader’s wife is appalled at the idea. When is it alright to use HGH to help your kid grow to a “normal” height? If you do “treat” a child’s shortness, does that mean it’s a disease?

Crack open any text on bioethics and I can almost guarantee that the “is shortness a disability” example will be somewhere among the pages. Shortness (and deafness, which The Dish is also exploring at the moment) sits right in the blurry space among disability, disease, and normal. How short is “too short?” Why is 5’2″ too short for a man, but not a woman? The answer is pretty much: because we think it is. Human height does fall along a bell curve, but it varies around the world and throughout history. Yet, at some point, being short goes from a relative and descriptive term (e.g. I am shorter than Yao Ming) to a normative one implying a disability.

We might think something is a disability for a few possible reasons. The first is that there is a clear physical issue that prevents events self-care. An example of this might be total-body paralysis. That person is literally unable to care for him or herself.

The second is that a person’s physical attributes allow them to care for themselves, but make it difficult to exist in a society set up for people abled in a different way. A good example of this is that those in wheelchairs are perfectly able to do everything a non-wheelchair bound person can do, it’s just that most things are designed with those who walk in mind. Arthur C. Clark’s Childhood’s End has a race of intelligent aliens that are winged. As a result their buildings have doors wherever they are convenient – as it so happens, ground level is rarely convenient. Stairs are unnecessary. Thus, a person who would be normal among human buildings is utterly disabled and helpless among the world of Clark’s winged aliens. Because most people are enabled in one way, those enabled in another become disabled due to the way things are built and designed.

Finally, and most confusing, are social disabilities. These are disabilities that are a result of the advance of civilization. Think of it this way. Today, we’d consider illiteracy a disability. It prevents a person from learning, pursuing most careers, and significantly lowers quality of life. Imagine trying to use the internet without being able to read or write. For our prehistoric ancestors on the savanna, no one could read, yet we’d hardly describe any of them as disabled. Social or civilizational disabilities are the result of cultural demands not necessarily health related.

Shortness (and deafness) move between those last two definitions if they are considered a disability at all. It’s critical to recognize that changes in social conventions and the way we design products and facilities can actually change what is a disability. Also, technologies that enable a person to do something which he or she was previously unable to do can dissolve the category of disability.

Which brings us back to the question of the Dish reader and his son. The son is short because the reader and his wife are short – genetics 101. Neither the father nor the mother consider themselves disabled, and the son is projected to be taller than his parents. Yet being tall can confer a huge social advantage. Heterosexual women tend to prefer taller men and taller people get bigger paychecks. On the other hand, the other side of the bell curve, too tall, is not much fun either. Taller folks are often crammed into cars and plane seats designed for a general population that needs less space. Additionally, excessive growth often has associated medical issues.

On issues such as this, I tend to defer to personal liberty and the discretion of the parents. The reader is clearly not taking the choice lightly. He sees both his wife’s concern and the doctor’s suggestion to use HGH as legitimate. He is considering letting his son get a bit older, so that his son can at least make something of a choice regarding the HGH injections. The relevant question isn’t “is shortness a disability we should treat with HGH” but, “would making a child who will likely be short a bit taller improve that child’s overall quality of life?” The question is complex and unique to each child, but if investigated earnestly and carefully, I see no reason why increasing a healthy child’s height would be wrong.

Follow Kyle on his personal blog and on facebook and twitter.

Image of frightening vegetable holding ruler to measure height by hoyasmeg via Flickr Creative Commons

CATEGORIZED UNDER: Biology, Medicine, Philosophy

Comments (30)

  1. Dan

    I am taller than the average male adult, but not excessively so (6’3″). In reference to the penultimate paragraph (I like that alliteration) I can verify that long flights and compact cars are definitely pains in the patoot.

  2. Pixiedragon

    Being a tall girl (6’1) I can say there are definitely problems with being tall. Not cultural for me (being Dutch, we’re taller than most people on average apparently) but things like back problems etcetera.

  3. Mark Houston

    I don’t think Tom Samaras would agree with the assumption that short stature means a medical condition: http://www.humanbodysize.com/

  4. Mike

    I actually went through this very treatment. My mother is just over 5′, my father just over 6′. As a freshman entering high school (having began the treatment just a short while before), I was 4’11”. By the time senior year ended, I’ve comfortably cemented in at 6′.

    “Yet, at some point, being short goes from a relative and descriptive term (e.g. I am shorter than Yao Ming) to a normative one implying a disability.”

    Well, yes, but if at some point you are describing yourself as shorter than everyone else, does that imply disability? Because at under 5′ in high school, I was shorter than the vast majority of boys (sometimes by a lot) and a big portion of the girls. Didn’t exactly do wonders for self-confidence.

  5. I am just over 5 feet tall and I sometimes to find shortness to be annoying, like when I can’t reach things easily. Other than that it’s mostly the social stigma that gets to me.

  6. Phyllis

    I don’t know. It’s not a disability, but it is a social handicap. And those height prediction things are a complete joke. My adopted sister grew early and they said she’d be six feet tall, but she’s 5’2″.

    I’m 5’9″ and my husband is 6’4″ (and can barely fit his legs into our Toyota Corolla, much less an airplane seat) (and look, I’ve chosen a tall person as a mate!) and our kids are among the tallest in their classes. So would I give them some sort of hormone to make sure they’re *only* 6’0″ or so? Or should I give them growth hormone to make them tall enough to play center in the NBA? Or should we just leave them alone?

    I think the decision will come down to the parents, the child himself…. and have there been any long-term studies on high doses of HGH and cancer or life span or whatever?

  7. Ian Tindale

    I’m left-handed.

  8. Sara

    I’m 4’11” and surprised to learn that I’m disabled. I’ve certainly never felt disabled, but apparently my parents should have pumped me full of hormones and toxic chemicals to make me more average.

    I’m honestly surprised to see such an ignorant article. I pity the author. Perhaps his parents should have medically altered him to make him more intelligent?

  9. Cecile

    I stand about 5’2″ and, honestly, would have loved the opportunity to have HGH treatments when I was younger. I can’t say from a day to day basis, I’m disabled. Quite the contrary, I fit. . . actually very comfortably in airplane seats, have a larger population of guys I can date and sometimes can still even buy children’s clothes which save a lot especially with snow boarding gear. That said. Being 30 AND asian, none the less, and being a manager and trying to train and manage (especially) much older and taller men, I can understand why they would look down on this seemingly 23 year old person and think, why should I listen to what they’re saying? Especially in the business world, it would have a great advantage. Plus, I wouldn’t have to hem all my pants since petite is still actually 5’4″

  10. Jim Johnson

    I’m 5′ 7″ – shorter than average, but not massively. I’m not sure disability is the word I would use to describe short stature, since “disability” implies some lack of ability – that persons without this “shortcoming” have an extra ability we shorter people don’t. Other than the “changing light bulbs without a ladder” ability, that’s not so.

    A better word would be “disadvantage”. American men average nearly $1000 larger yearly salary for each additional inch in height, an “advantage” short men must do without. Think about that: every single year, every single inch in shortness costs a thousand dollars (on average).

    With that in mind, the question of whether HGH treatments should be administered would be better looked at by observing the advantage that being “at least average” confers. If you had a young child with a disfiguring blemish on the face, you probably wouldn’t call that a disability, but would that prevent you from seeking a solution? Probably not. You’d know that although this blemish “won’t really hurt them”, it would still cost them both in the job hunt and in the mate hunt, so you would probably choose to have that blemish corrected if you could.

  11. Tony

    Being 5’3″ is a huge disadvantage in dating. The vast majority of women prefer, and are more attracted to tall men. I have only a fraction of the romantic chances that a tall man has.

  12. miker

    This general issue was addressed in depth in the movie Gattaca. HGH is just the tip of the iceberg. When direct genetic modification becomes a readily available technology, as it inevitably will, the implications for human society as we know it will be staggering.

  13. Kyle Munkittrick

    @Sara: Where, precisely, do I say that being short is a disability? Is it somewhere among the paragraphs where I painstakingly outline how nebulous and contextual the word “disability” is? My whole point is that shortness is relative and what some may consider normal is a huge disadvantage to others. Nowhere do I say anyone below height X is disabled and should therefore be compulsively healed via forced HGH injections. Good lord, take a breath and actually read what I wrote.

    @Jim J: Great analogy with the blemish. I agree, being short isn’t a disability in the sense we normally think of. Again, it is a disadvantage as a result of a taller average height and social perceptions (like Mike and Tony’s dating frustrations). A big part of the point I was trying to make is that we lack a category for these types of treatment.

    @Phyllis: From what I’ve seen, no concrete studies showing significant evidence one way or another re: cancer and HGH. More research and trials are definitely necessary. And, like I said at the end of the article, I agree with you: it’s up to the parents to make the call they feel will be best for their child.

    @Cecile: You mentioned snowboarding. It’s interesting that Shawn White, who is “short” by most standards, is among the greatest snowboarders of all time. Why? Less mass to rotate, flip, and twist through the air (and he is outrageously talented). You also highlight a good point when you note that height and perceived age (and perhaps gender) play into your difficulties as a manager. Isn’t it bizarre how much authority we place in what are biological facts unrelated to ability?

  14. Calculate the average height of US Presidents starting with Washington. A tall male always has an advantage when competing socially. Fighter pilots above 5’6″ have less high gee-resistance.

  15. TF

    I think HGH should be reserved for those with some sort of proven medical condition causing their short stature. For example: Turner’s syndrome, which I have. I am a 4’7″ female in my mid 30’s. As a young child I was diagnosed with Turner’s syndrome, and I was put on HGH injections. To this day I do not think there is any doctor who can say for sure that I reached a taller height that I would have without the HGH – but HGH was worth a try. Being short does not define me though, and I am very happy the person that I am. You can be short and still succeed in business and in love. I am happily married, and I have a very rewarding career as a nurse (and I am in a supervisory position). I do not make less money than other nurses becuase of my lack of height. My co-workers respect me because of my knowledge. It’s all a matter of being confident in yourself – no matter what you look like. If you are confident and smart, you can succeed just as well as any “normal” sized person.

  16. The Twilight Zone episode “Number 12 Looks Just Like You” is still relevant all these years later.

    What are the repercussions for a body whose DNA blueprint is for one height when you muck about with a person’s growth and make it another? I’m not talking about cancer or the like, but what is the long term physical toll?

    With regard to the disadvantages of the height in the business world, one would probably be well served to have one’s ethics and empathy removed as well as taking some HGH.

  17. Matt B.

    Think of successful people like Linda Hunt and Robert Reich.

    The label of disorder or disability is probably worse than the condition when it comes to shortness. I had a friend up until 6th grade who was on growth hormone. No one had a problem with him; his height was a non-issue for anyone that knew him for 10 minutes. But I think he ended up with some emotional problems, because it didn’t end well.

  18. Blake

    This leads to the question, “Why are women attracted to taller men?” I have a theory: taller men stand out.

    How well does a shorter man do who stands out without relying on his height?

  19. Aaron

    Women are attracted to tall men for the same reason most men are attracted to buxom women… tall men appear to be better suited as protectors of children while buxom women appear to be better able to birth and care for children. This is an evolutionary throwback paradigm from our distant hunter-gatherer ancestors. The primitive part of our brains are hardwired to procreate and search for specific characteristics. I’m not saying some people are more or less developed than others… just that we all have a common ancestry and hence, common attitudes by and large.

  20. dave chamberlin

    If I had given my athletic 6 foot 4 inch son HGH I would not have had to pay for his college education, he would have received a basketball scholarship. I wouldn’t have done it even if HGH was cheap and readily available, bad ethics all around. But not everyone is going to feel that way. Ask top tier basketball players if they would choose to be taller if they could be and many would say hell yes. And if their 8th grade sons appear to be following in their footsteps they may chose to give them HGH. It is interesting that major league baseball with all it’s problems in the past with steroid abuse still won’t test for HGH.

  21. Doct Orb

    I’m another one at the other end of the spectrum, I’m 6’6″. I’d say I have a number of disadvantages. Travel is uncomfortable, furniture is rarely scaled for me (I bought a counter-height dining room table), and purchasing clothing often involves collecting everything in my size and deciding which is least offensive (big and tall stores mostly cater to big or big and tall, not just tall). I also have back problems. I had a major episode brought on by working in a lab with a hood and benches that were all just slightly too low, so I spent hours stooped over.
    Growing up, I loved it. I was proud in high school to be the tallest person in the school (I hated basketball, however!). Now… not so much. I think I feel more awkward in some situations than I did before. It might be that I’m more self-aware of others, but when I’m around people that are shorter than me (which is pretty much all the time) I sometimes feel self conscious. I’m now a teacher and I hate feeling like I’m looming over my students. I’ll usually try to sit down if a student approaches me after class and a chair is handy.
    Plus, I’ve had to listen to the “wow, you’re tall!” comment innumerable times. Gets old.
    So I can certainly say I’ve pondered the idea of being shorter than I am and if I would change it or not. I have said before “I wish I wasn’t so tall.” But honestly, my height is part of who I am and I like who I am so I wouldn’t want to change that. I would hope that “short” individuals who might have the opposite experiences also arrive at the same emotional place.
    I don’t think homogeneity of height is going to solve discrimination problems anyway. We should address things like salary discrepancies but I don’t think hormones are a good answer to that (women make less money than men, should we give baby girls injections to make them physically appear as men?!).

  22. ToddJansensMonkey

    I’m not tall. About 5’5″. I don’t mind being short.

    I find it funny when I talk to other short guys who fight for every inch. Younger guys who are a couple of inches shorter than me insist that I must be taller than 5’5″. “You’ve got to be like 5’7″ or 5’8″ because I’m 5’6″ and you’re taller than I am.” Let it go brother, we’re not tall people.

    Again, I don’t mind being short. I’ve even dated a couple of women who are 6′ tall. I do not fret over the stigma of it all.

    I embrace my short stature but I am also aware of its social limitations. I also look young for my age; even more so when I was in my early twenties. I have gone on many jobs interviews where I felt immediately judged due to my younger appearance and shorter height. I got a lot of comments like, “He seems like a good kid.”

    I volunteered briefly promoting a speaker seminar a few years back and I recall someone making the comment, “When you’re old enough to get married.” I was 27-years-old at the time.

    Being short has it’s downfalls but can ultimately be overcome socially.

    Now, considering the use of HGH to enhance height. Hmm… I supposed I do not really see a problem with it if the patient consents. But I do not see it as an absolute necessity to make everyone taller. Being short just means that you’re fun size.

    Giving HGH injections may be somewhat extreme when just trying to quell the anxieties about the height of children. Yet, as a proponent of enhancement technologies, I do not see a problem with voluntary HGH use.

  23. RLM

    I am 4’8” and a woman. I actually, legally, am allowed to apply for a handicapped parking pass. I never have. I have never registered as handicapped. I never would. I find it inherently insulting that someone would think I was handicapped.

    I am far smarter than the average bear (top 10 school undergrad, currently getting an MBA). I am creative, beautiful, outgoing, and in no way less than someone of average height. I do not have dwarfism or any other genetic disorder. I simply received short genes from both my parents. Am I short? Very. Am I handicapped? Hell no. There are people who have physical need for a parking spot closer to the door. I am not one of them. The American (and global) obsession with height has become unhealthy and counterproductive.

  24. Dave

    Being of (slightly) above average height, I never considered shorter people to be disabled, nor taller people to be burdened. Now that I consider the fact that some women select based on a height standard, I would want to help a child that is likely to have a small pool of potential mates.

  25. Brian Too

    Certainly being short is not a disability. Being too short is, but the trouble there is to define “too short”. One can come up with something I feel certain, yet it is likely to be subjective at it’s core.

    My guess is that ultimately this relates to the usual human desire to “fit in” and “be normal”. Height might be a partial exception to this, in that I can imagine a small preference towards being slightly taller than average.

    Personally it took me years to become very comfortable with my distinctness. I consider it to be a valuable marker on the journey to adulthood.

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  27. Michael

    I qualified for growth hormone as a child and my parents would not let me have it. I asked them every year and they said no. Height becomes more important the older you get. Being picked on in middle school is nothing compared to being a short adult. If there was anything I could have done to get growth hormone I would have done it, however as a short person no one respects you so my requests went unheeded and were laughed off. Now my parents know exactly what I think of them. Under the age of 18 I had no choice to get the treatment myself and after 18 as an adult I have the option as an adult but my bones were healed so the Doctor casually laughed it off saying too late. Now I have to live the rest of my life like this unless I pay tens of thousands for leg lengthening surgery.

    As a child who qualified for human growth hormone who had that opportunity taken away from him I want to let every single parent know, your child will not forgive you if he qualifies for growth hormone, desires it, and has that opportunity taken from him. I was a joke to my parents and as a short male I continue to be a joke to society. There is zero benefit to being a short male at all and do not let anyone trick you into thinking there is.

  28. alias

    am 5’3″….partner 5’7″….first son 5’10″…..second son 5’8″….well I used to stretch behind my door….almost killed me.as I later found out I have fused cervical segments hence I’m shorter than my mum….my partner wore platform shoes, my first son never really minded….and our younger son would’ve traded with the ‘devil’ to be as tall or taller than his brother…well…We’ve been conditioned programmed etc to vie for the greatest advantage in life….and as all parents can relate to “we want the best for our children”…but at what price?

    My young son has mellowed in his expectations when he realised that his height is ideal for his dreams…to one day go out in space and explore….

    So soon our tempest subsides and we become the best we can aim for …. for what we have before us is our universe that isn’t measuring us with a tape measurer….

  29. Paul

    As a 5’8″ male I do not feel totally out of sorts, but any less would definitely have been worse. As it is, I know plenty of women who express a preference for taller men. This said, I do not consider it a disability to be a little less than average ( I think it’s 5’10”) but I would prefer to be 6′. If someone had offered me the opportunity to be taller, I know I probably would have taken it. I have a son on the way, and if I am faced with this situation, I will likely let him decide once he is of age 14, but I will give him my point of view.

  30. Europe

    It’s hard when you are small, but you will overcome.

    I’m 5’5″, and the average is 6′ 0.8″ for Dutch male, far more than the so that sucks when I’m living here.

    Quite bigger than the average American white male: 5′ 9.3″

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