Heightened Expectations is a groundbreaking history that illuminates the foundations of the multibillion-dollar human growth hormone (HGH) industry. Drawing on medical and public health histories as well as on photography, film, music, prose, and other examples from popular culture, Aimee Medeiros tracks how the stigmatization of short stature in boys and growth hormone technology came together in the twentieth century.
 
This book documents how the rise of modern capitalism and efforts to protect those most vulnerable to its harmful effects contributed to the social stigmatization of short statured children. Short boys bore the brunt of this discrimination by the mid-twentieth century, as cultural notions of masculinity deemed smallness a troubling trait in need of remedy. These boys became targets of growth hormone treatment, a trend accelerated by the development of effective HGH therapy in the late 1950s.
 
With a revisionist twist, Medeiros argues that HGH therapy was not plagued by a limited number of sources of the hormone but rather a difficult-to-access supply during the 1960s and 1970s. The advent of synthetic HGH remedied this situation. Therapy was available, however, only to those who could afford it. Very few could, which made short stature once again a mark of the underprivileged class.
 
Today, small boys with dreams of being taller remain the key customer base of the legitimate arm of the HGH industry. As gender and economic class disparities in treatment continue, some medical experts have alluded to patients’ parents as culprits of this trend. This book sheds light on how medicine’s attempt to make up for perceived physical shortcomings has deep roots in American culture.
 
Of interest to historians and scholars of medicine, gender studies, and disability studies, Heightened Expectations also offers much to policy makers and those curious about where standards and therapies originate. 

Aimee Medeiros is an assistant professor of the history of health sciences at the University of California, San Francisco. 

“Heightened Expectations offers a lively and engaging discussion of how short stature became a ‘disease’ in need of medical treatment. It convincingly demonstrates that the pathology-making of short stature dates back to the nineteenth century and is intertwined with the rise of modern capitalism.”
—Heather Munro Prescott, author of A Doctor of Their Own: The History of Adolescent Medicine and The Morning After: A History of Emergency Contraception in the United States

“Aimee Medeiros has produced a nuanced and persuasive examination of the origins and evolution of human growth hormone industry in America. Its wider implications for historians of medicine, especially those examining the role of the pharmaceutical industry, are profound.”
—Bulletin of the History of Medicine

“Heightened Expectations is an excellent treatment of a significant subject, the history of American ideas about height and medical approaches to issues of human growth, from the late 1800s onward. Medeiros’s treatment fits beautifully into the powerful and growing literature on the history of medicine, disability, gender, and the body.”
—Amy Sue Bix, author of Girls Coming to Tech!: A History of American Engineering Education for Women and Inventing Ourselves Out of Jobs?: America’s Debate over Technical Unemployment, 1929–1981