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The Social Shaping of a Medical Therapy

Joyce M. Lee, MD, MPH; Joel D. Howell, MD, PhD

Arch Pediatr Adolesc Med. 2006;160:1035-1039.

During the latter half of the 20th century, estrogen therapy was administered to prevent otherwise healthy girls with tall stature from becoming tall adults by inhibiting further linear growth. We explore how decisions to treat tall girls with estrogen were influenced by both scientific knowledge and sociologic norms. Estrogen therapy represented the logical application of scientific knowledge regarding the role of estrogen for closure of the growth plates, but it also reflected prevailing societal and political beliefs about what it meant to be a tall girl. We discuss the rise and fall in popularity of this therapy and suggest that insight into the present-day treatment of short stature can be gained by comparing the use of estrogen therapy for tall girls with the use of growth hormone therapy for short boys. We suggest that this case study illustrates how scientific knowledge is always created and applied within a particular social context.

Author Affiliations: Division of Pediatric Endocrinology (Dr Lee), Child Health Evaluation and Research Unit (Dr Lee), and Departments of Internal Medicine, History, and Health Management and Policy (Dr Howell), University of Michigan, Ann Arbor.

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