NORMAL AT ANY COST

Sobering story of what parents, and doctors, will do to help short and tall children become “normal.”

In the 1930s and ’40s, popular magazines and newspaper columnists warned that tallness could be a handicap for a girl and shortness could turn boys into sissies or young Napoleons who faced bias in the job market. Such societal views prompted parents of children outside the height norms to turn to the controversial therapies detailed in this information-packed book. Medical journalists Cohen and Cosgrove begin with the FDA’s approval in 1941 of diethylstilbestrol (DES), a synthetic form of estrogen administered at Massachusetts General and other medical centers to inhibit growth in tall girls. The drug encouraged early puberty and had many side effects; its use to “treat” an inherited trait (height) was immediately controversial. Nonetheless, DES in large doses slowed growth and quelled parental anxieties, which later dissipated as tallness in females became more socially acceptable, and fewer girls received estrogen treatment. In the ’50s, Yale chemist Alfred Wilhelmi and others began using anabolic steroids, which include synthetic testosterone, to spur growth in short boys. Through the stories of patients and scientists in the United States and abroad, the authors examine the rise of the vast growth-hormone industry, which skyrocketed in the ’80s when Genentech developed a biosynthetic hormone. By the ’90s, many children whose bodies produced growth hormones were receiving still more by prescription, despite the fact that the long-term safety and effectiveness of the drugs remained uncertain. Meanwhile, complications continued to surface in women who took DES years ago. The authors question the motives of all the key players—parents, doctors, drug companies—and note that there have been many more incentives to encourage treatment with hormones than to study the drugs’ long-term effects. “Once a treatment exists, its existence becomes a reason to use it,” they lament.

Solid reporting on the reckless use of medical technology for socially dubious ends.