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End Human Growth Hormone Treatment for Healthy Short Children:
Activist Launches a Campaign Against Heightism
Ellen Frankel is a Massachusetts-based clinical social worker who has specialized in the field of eating disorders since 1987. She’s also struggled with her own eating disorder and body image, but her issues arose from her height rather than her weight.
Frankel explains, “The image I had of myself losing weight included a tall, leggy thin woman walking along the seashore, my long blonde hair swaying gently in the breeze, my blue eyes as crystal clear as the turquoise sea. I would be, in essence, Sea Time Barbie. Never mind that I am 4 feet 8 ½ inches tall with red hair and brown eyes. These were mere details. As it turns out, I was not alone. The role model for most girls is a Barbie doll who flaunts a figure unattainable in real life.”
In her new book, Beyond Measure: A Memoir About Short Stature and Inner Growth, Frankel speaks to the soul breaking attempts to fit an arbitrary and elusive cultural ideal of physical perfection. “Being short isn’t the problem,” Frankel insists. “Instead, the real difficulties lie in the social bias against short people.”
Frankel emphasizes the importance of looking at how short people are treated in this culture, because their struggle is either invisible or ridiculed. Yet heightism, the cultural bias favoring tallness and stigmatizing shortness, is rampant from school playgrounds to corporate boardrooms.
Frankel highlights the extreme of height prejudice in the recent practice of targeting healthy, short children with human growth hormone treatment in an attempt to make them taller. “We live in a culture that is obsessed with being tall and thin,” Frankel explains, “and now the pharmaceutical companies have jumped on the bias against short people. They calculated that they have a built-in population to treat that could boost profits significantly, because there will always be those who fall into the lower height percentiles on a bell-shaped curve.” The FDA is letting them get away with this thinking by approving the use of human growth hormone injections to treat these healthy, short children.
Frankel asks, “Are we willing to treat the victim of a social prejudice with medical technology that supports and reinforces that prejudice?” She points out that treatment involves subjecting the child to growth hormone injections an average of six times per week over an average period of five to ten years. The cost is approximately $20,000 annually, and may be physically and emotionally harmful. The possible benefit? “At best, the child may gain between 1 and 1 ½ inches, if any extra height is gained at all,” Frankel offers. The cost of that extra height? According to the March 2006 Archives of Pediatrics & Adolescent Medicine, $52,000 per inch gained.
Why is Frankel against this FDA approved treatment? “It’s a mistake,” she states emphatically. “What we need is education for those who discriminate against the short statured, not the genetic engineering of the victims of that prejudice.” She is on a mission to educate adults and children about the deleterious effects of heightism and to stop healthy, short people from subjecting themselves to needless medical interventions.
It’s obvious why short men and boys would have a difficult time emotionally with height issues, because in our society, males are expected to take up space and to be dominant. On the other hand, females occupy a second-class citizenship and are expected to take up less room, both literally and figuratively. “I propose that for many short females, there is a struggle that goes on in a deep way but is much less visible,” she says.
She concludes, “So many of us are taught that how we appear is more important than who we are. We are taught to seek external validation, be it from the numbers on the bathroom scale, the inches on a tape measure, the degrees we have achieved, or the people with whom we associate. But none of these external markings gives the person a true sense of power, a true sense of self. Our self-worth shouldn’t be based on the size or shape of our bodies. Who we are, in our fullness, is truly beyond measure.”
Frankel adds,” I know my Achilles heel, and for a long time that heel craved a stiletto. No more. Now I am proud to stand on my own two feet, short legs and all, and take a stand. Heightism is real, and it must be addressed.”
By Ellen Frankel
About the Author
Ellen Frankel, LCSW has worked in the field of eating disorders since 1987 in both outpatient and residential settings. She currently serves as adviser to the board of directors of The National Organization for Short-Statured Adults, an organization that is dedicated to combating heightism.
Ellen has appeared on local television shows speaking on topics related to eating disorders and has been a featured guest on numerous radio stations across the country discussing eating, weight and body image issues. She has also published in professional journals and has been quoted in traditional print and online magazines. Ellen has been featured in local newspapers including The Boston Globe and The Jewish Journal North of Boston.
Ellen is a dynamic speaker and a frequent presenter at numerous national eating disorder conferences including the annual Renfrew Conference with an average attendance of over 700 people. In addition, Ellen spent nearly a decade working on eating disorder prevention in schools across Massachusetts, from the elementary through the university level. She worked with students, parents, and faculty.
Ellen lives in Marblehead, Massachusetts with her husband, Steve, children, Allison and Matt, and dog, Karma. In addition to enjoying time spent with her family, her passions include hiking – especially in the Himalayas -- and sipping her morning cup of coffee at Dunkin Donuts or Starbucks while reading the newspaper. After realizing that “Life is Short and So Am I,” Ellen has tried to live each day fully and freely in the world. Besides Beyond Measure, Ellen has co-authored two other books: Beyond a Shadow of a Diet: The Therapist’s Guide to Treating Compulsive Eating and The Diet Survivor’s Handbook: 60 Lessons in Eating, Acceptance and Self-Care.
Suggested Interview Questions
What is heightism?
Can you give us examples of height prejudice?
Why do you oppose using human growth hormone treatment as an attempt to make healthy short kids taller?
You say that the pharmaceutical companies benefit from the recent FDA approval of the use of human growth hormone treatment for healthy, short children. Can you explain?
How are the struggles different for short males versus short females?
How has your gender and your height influenced your life?
You claim that our culture focuses too much on the external at the expense of the internal. Can you explain what you mean by this?
How did your short stature affect you as a girl? As a woman?
Can you explain how your past struggle with eating/weight issues is related to your feelings about being short?
What does it mean to search for inches in external ways?
You reveal aspects of your personal life that are quite private. Why did you feel this was important for your story, and was this difficult for you to do?
In the book, you write about finding your true self, and living an authentic life. How have you done this, and how is it manifested?
You say, “We are all dwarfed by Everest and beyond measure.” What do you mean by this statement? How have your experiences in Nepal influenced you?
Do you have any advice/suggestions for parents of short children?
How do you feel about your height now, and how has this changed overtime?
Can you talk about legislation that would make it illegal to discriminate against people based on height and weight?
Ethical controversy about human growth hormone treatment for healthy short children.
What are the ethical dilemmas of using human growth hormone treatment with healthy short children in an attempt to make them taller? Are we willing to treat the victim of a social prejudice with medical technology that supports and reinforces that prejudice? Why has the FDA approved this treatment for the healthy short population, and who stands to benefit? Ellen Frankel emphatically states, “What we need is education for those who discriminate against the short statured; not the genetic engineering of the victims of that prejudice.”
The cultural preoccupation with being tall, thin, and forever young.
Eating disorders have reached epidemic proportions. Plastic surgery is at an all time high. In July 2003, the FDA approved human growth hormone for perfectly healthy children who just happen to be short.
Those getting on in their years are turning to human growth hormone in an effort to stay young. What is the price of the cultural obsession with “perfection?’ Why can’t we celebrate bodies of all shapes and sizes, and honor the different stages of life? What are we sacrificing in this process?
What is the cost of focusing on the externals rather than the internals?
So many of us are taught that how we appear is more important than who we are. We are taught to seek external validation, be it from the numbers on a bathroom scale, the inches on a tape measure, the degrees we have achieved, or the people with whom we associate. None of these external markings gives the person a true sense of power, a true sense of self. It is only by nurturing the true self that lies within, and revealing that self to the world, that we can truly lead an authentic and fulfilling life.
The stereotypes associated with tall and short, male and female affect us all in different ways.
Because the attributes associated with males in this culture are the opposite of the characteristics of being short, boys/men have an overtly difficult challenge in being a short boy/man. The attributes associated with being female in this culture are similar to the characteristics of being short, and therefore it appears, at least on the surface, that it is easier to be a short female than a short male. For many short females, the struggle may be less visible than it is for short males, yet still difficult and challenging in various ways. The politics of body size and gender must be acknowledged if we are to combat the heightism that is rampant in this culture.