She was diagnosed with a GH deficiency, not ISS. The problem was getting insurance companies to pay for the HGH. Many years we were forced into charity programs run by the drug companies themselves to afford treatment. The influx of people with ISS reinforces the insurance companies' tendency to not pay for the drug, even among the population who needs it for valid reasons.

The bottom line is that the drug companies who charge so much for this drug (which is now made via a process involving GE microbes and thus relatively cheap to produce), the insurance companies who deny coverage for any HG treatment, and the parents who submit their kids to needless therapy for ISS can all rot in hell.

The last sentence neatly sums up the whole issue.

We have a medical market, not a health service. Hence what is actually defined as a medical condition depends a lot on what drug company lobbyists can get away with--and drug companies have a lot of money to buy influence.

Hence, for example, as John McCain was famously asked about, many insurance companies will pay for quasi-recreational drugs like sildenafil and tadalafil which are available for a medical condition called male erectile dysfunction (né impotence), whereas drug treatment for contraception which is not really a medical condition often is not coverered.

Actually, you can make an argument like this about a whole slew of newly discovered diseases, or lifestyle diseases, such as nicotine addiction, eating disorders, Attention Deficit Disorder (formerly known as minimal brain damage), Conduct Disorder (né misbehavior, and so on ad infinitum.

One wonders if, in the future, tall hormonally enhanced sons of short parents will be obliged to reveal to their prospective spouses that they carry the dreaded short genes.

Doc, I was following you until you said erectile disfunction is "normal." Most men have no problem getting erections right up until the day they die. To say not being able to become erect is "normal" is like saying not being able to walk or talk is "normal."

Really shoots down your credibility.

Newly suspicious that you've got some axe to grind, I re-read the preceding paragraphs where you mention in passing that kids getting GH are medically diagnosed as short. Not just the shortest guy in class, not just shorter than the normal range, but more than two standard deviations below average. Medically diagnosed as short is to height as retarded is to IQ. If there was an injection which retarded kids could get to bring them up enough to mainstream, would you want to deny them that?

case I ever had, by far, was the 19 year old son of a doctor who had been able to have his son given some kind of growth hormone ( this was early 90's , not sure of source at that time, a primate I think) because he was too short as a child. More than a decade later the boy had a form of Creutchfeld Jacobs disease ( mad cow) and was not expected to live after a slow deterioration. This boy was going to school in my town - his parents lived in L.A.

.Sometimes we are just too smart for our own good.

There are only small souls.

I'm with you about the erectile dysfunction, but you're misreading the paragraph about standard deviations of shortness. Dr. Parikh states that it *used* to be that a child had to be 2.25 standard deviations shorter than average, AND have a genetic or hormonal deficiency to be prescribed growth hormone. Now, there are no such restrictions.

And height isn't like IQ--shortness by no means automatically translates into diminished functioning in any way. Of course there's a point at which day-to-day life is physically difficult for an extremely short person, and that's where appropriate use of GH comes in. But for shortness that's not pathological and not a physical handicap, just on the extreme end of normal...I agree with Dr. Parikh this time; we need to be careful about medically redefining upwards what "normal" is, and pathologizing anything that might cause any difficulty just because it isn't average.

You've warmed my heart for the evening. : )

And cute is good. It is not the only kind of good, but it is one valid good thing. Tall can be bad. Have you ever met a tall person who does not play basketball, and who is sick and tired of being asked about basketball, every day, by every single person he or she meets?

A short person in the land of the tall is king or queen. These gross nasty drugs are much worse than being short. The great love of my life was short and beautiful. If she had been an inch and a half taller, she would have been an inch and a half less beautiful.

Please stop with this child abuse.

As someone who is unemployed and without health insurance, elective medicine disgusts me. Being 6'1", maybe I'm not the best person to comment on this particular issue but on the other hand maybe it shows that height doesn't help that much in the first place. I long for the days before every commercial break had an ad for ED prescriptions. What happened to going to the doctor when something was truly wrong and letting them diagnose you instead of asking if such and such is right for you, even if you have no idea what it is? Big Pharma has way too much influence in D.C. They push through unsafe drugs and keep relatively safe ones illegal. Money equals free speech and that is a sad state of affairs. What a country.

Happy to do it!

Perhaps the teaser for this article should be more transparent. As a person who has taught children with GH deficiency and is currently working with two, this article is at best misleading. A girl in the seventh grade who is 3'11 and does not have Turner's syndrome, but does have a GH deficiency, should be able to get the drug. A four year old, who was born on the growth chart at 50th%tile, but has been off the chart since 6 months, and is still no where near the 3rd %tile, should be able to get the drug. I have a friend who also has a 7 year old daughter, she is the size of the average four year old. She is very cute, and has an outgoing personality. When she meets strangers she says hello, sometimes they ask her how old she is, and when she tells them, they all say, "No you aren't, you are really four, [or three] aren't you?" This result often leads to tears. She is frustrated because her older sister is of regular height and does not get the same reaction. Honestly, if the title was inappropriate use for GH; or short in stature long in money how a regular kid can pay to grow higher, then it wouldn't be so bad. I like to read Salon, and usually the articles are presented in a balanced way. As a physician you should know that innuendo often serves a purpose, and if that purpose is to bend others to your will through veiled truths, what does that say about a person.