Using hormone treatment to reduce the adult height of tall girls: are women satisfied with the decision in later years?

Treatment with synthetic oestrogens to reduce adult height has been available for tall girls since the 1950s. Treatment aims to reduce psychosocial problems associated with tall stature that might occur in adolescence or adulthood, but little is known about the long-term outcomes. This retrospective cohort study identified 1248 eligible women from the medical records of Australian paediatricians who assessed or treated tall girls between 1959 and 1993, and 184 women from self-referrals. They included girls who received oestrogen treatment (diethylstilbestrol or ethinyl estradiol) in adolescence (treated group) and those who had been assessed but did not receive treatment (untreated group). A total of 1243 (86.8%) women were traced and invited to participate in the study, and 67.9% of these women (396 treated and 448 untreated) agreed. This paper reports on women's satisfaction with the decision that was made to have treatment to reduce their adult height. In a postal questionnaire women were asked to comment on a range of issues including how they felt about their current height, the assessment and treatment procedures, and the decision whether or not to have treatment. While untreated women were almost unanimously glad they were not treated (99.1%), no matter how tall they became, 42.1% of the treated women expressed dissatisfaction with the decision that was made. There was no clear association between satisfaction with treatment and the women's final height. However, dissatisfaction was related to: (a) whether or not the girls had an active say in the decision-making; (b) to negative experiences of the assessment or treatment procedures; (c) to side effects experienced during the treatment period; and (d) to later side effects women believed were associated with the treatment. The study finds that qualitative analysis of comments made by treated women helps to explain their dissatisfaction with the decision to have treatment.