Supporters contend the psychological trauma suffered by many ISS children should be a factor in the consideration of growth hormone treatment. But others point out that the issue raises ethical questions.
"Do you treat some children with a very potent treatment when no medical problem exists?" asks Dr. Jeanne Brooks-Gunn, co-director of The National Center for Children and Families at New York's Columbia University.
"It raises a lot of societal issues. Should we do this without knowing the longer-term consequences, given our limited health dollars? adds Dr. Brooks-Gunn. "Size is a genetic lottery. You are 'medicalizing' a natural part of life."
Dr. Brooks-Gunn explains that studies have shown few long-term psychological effects in short children, although she admits they are more likely to be bullied by their peers. And a recent study published in the medical journal Pediatrics found that being very short had "minimal" impact on social behavior, friendship, and acceptance.
Andrews vigorously disputes this finding, contending that most children are unlikely to admit to their true feelings or experiences. "I can't tell you how horrible my childhood was," he says. "I got picked on every single day of grade school and middle school. When I was in fourth grade, I looked like I was in kindergarten." Andrews also adds that he knows many adults who have "never gotten over" the way they were treated as short kids, and that most of the children who come to his clinic are depressed about their size.