Heightened Expectations: An Examination of Scientific Knowledge

University Of California-San Francisco, San Francisco CA

Investigators

Abstract

Today, more and more parents of children (especially young boys) are told that they may want to consider human growth hormone to increase their children's height. Some critics may assume that this practice is primarily the result of pharmaceutical companies' marketing tactics while others may assume it reflects sound science. In contrast to these views, this dissertation shows that the actors and contexts that help create and normalize human growth hormone use are more complicated than either one of these explanations suggests. While ample attention and judgment has been given to so-called marketing campaigns of biomedical powerhouses, including Genentech's relationship with public health school programs during the 1990s and Eli Lilly's pursuit to convince the FDA to allow human growth hormone therapy for children with idiopathic short stature in the 2000s, these endeavors need to be contextualized. Such contemporary efforts are not the first attempts by medicine to treat short stature, nor are they solely examples of how the pharmaceutical industry profits from inventing maladies. This doctoral dissertation examines the relationship between the rise of the human growth hormone industry and the development of the modern notion of short stature, its stigmatization, and science's mission to quantify and fix it. This dissertation begins with an analysis of the origins of the stigmatization of short stature in contemporary America. The doctoral student performing this research examines how late 19th and early 20th century anti-child labor campaigns, public health projects, anthropometry, school reform, and clinical guidelines for physicians all played notable roles in manufacturing the cultural perception of normal height and the perceived need for the medical treatment of short stature, especially in young boys. She also explores scientific endeavors to discover, isolate, use, and manufacture human growth hormone and examine the relationship between social anxieties over short stature and the supply of available human growth hormone. Resources selected for this research project reflect the breadth of the dissertation as the list of archives includes collection material pertaining to growth surveys, federal attempts to establish population standards and clinical guidelines in regards to height, governmental efforts to regulate human growth hormone, and collaborations between the pharmaceutical industry, public health projects, scientific research, and academic ventures in establishing human growth hormone therapy. Taking into consideration the dynamic relationship between public health, scientific medicine, cultural norms, and pediatric care, this project answers why, when, and how height matters. The dissertation contributes to a growing body of work that examines the values that infuse scientific knowledge and practice. It adds, for example, to literatures in medical anthropology, medical sociology, and the history of science; such literatures critically investigate the creation and use of scientific categories to create standards for normal bodies.