[Caring the Korean Way] Children who inject themselves to be tall under parental pressure

What does it mean to care -- deeply, instinctively, and culturally? In this series, "Caring the Korean Way," we explore the distinct practices, beliefs, and values that shape how Koreans care for themselves and each other. From time-honored folk remedies to modern reinterpretations of healing, each story offers a window into the unique ways care is expressed in Korean life. -- Ed.

Image created by ChatGPT (OpenAI)

Kwon Hyun-joong was a small kid, but not in a way that worried anyone -- at least not until the first day of elementary school. At the opening ceremony, standing in line with his classmates, he looked like he’d wandered into the wrong grade. The other kids weren’t just a little taller. They were a head taller.

That was the moment, his mother said, she realized just how small he was. “He was average height when he was born,” she said. “But as he got older, he just seemed so far behind. I started to wonder if I hadn’t raised him well enough.”

After two years of weighing the pros and cons of growth hormone therapy, his parents decided to go ahead, injecting him with growth hormone six times a week. He was eight. Now, at 12, he does them himself before bed. Over four and a half years, he grew 27 centimeters -- about 10 inches -- but at 147 centimeters, he’s still one of the shortest kids in his class.

“This year,” his mom said, “he asked me if the shots were even working. He said, ‘Should I just stop?’”

He’s not the only one wondering.

What’s a few centimeters worth?

In Korea, growth hormone injections are supposed to be a treatment for a rare condition --- growth hormone deficiency, which affects a tiny percentage of children. But a new government-backed study suggests most kids getting the shots aren’t medically diagnosed at all.

They’re not sick. They’re not stunted. They’re just... short. Or average. Or, in some cases, already taller than their peers.

And still, they shoot up hormones.

A national survey of 991 parents found that 60 percent of children using growth hormone injections in Korea were doing so without any formal medical diagnosis. One in six was already taller than average for their age group.

“This was the number that really stayed with me,” said Dr. Yun Ji-eun, who led the study for the National Evidence-based Healthcare Collaborating Agency (NECA), in an interview. “It tells you something about what’s driving these decisions. It’s not clinical need.”

The Korean growth hormone market reached 480 billion won, or about $345 million, in 2024 -- more than double what it was five years ago. The number of pediatric patients has jumped sevenfold in a decade.

Most families pay out of pocket. Korean health insurance reimburses only for children below the third percentile in height and only with a certified diagnosis. But demand has surged anyway, fueled by what doctors describe as anxiety and what marketers call aspiration.

Kwon’s family has spent nearly 28 million won ($21,000) on hormone treatments. “It’s a lot,” his mother said. “Still, we estimate that without it, he might have grown 2 or 3 centimeters less.”

Which raises the question: how many centimeters is enough?

A society that grows on schedule

For the past three years, Kwon Hyun-joong has injected himself six times a week with Dong-A ST’s Growtropin, gaining 27 centimeters in the routine of bedtime shots.

Kwon’s story is not unusual. Across the country, families are making similar choices -- sometimes earlier, sometimes with more children, sometimes with less certainty about why.

The first time their doctor suggested the shots, the eldest daughter, whom we’ll call Ji-yoo, was in fourth grade. Her bone age, measured through a wrist scan, looked too advanced for her chronological age. That meant her growth plates might close early.

“She wasn’t small,” said their mother, who lives in the affluent Daechi-dong neighborhood of southern Seoul, in an interview. “But we thought, maybe we should act early.”

Ji-yoo didn’t resist. “I had a lot of friends doing the same thing,” she told me. “I didn’t think it was a big deal.”

Her younger sister Ye-rin started even earlier, in third grade, with a cocktail of hormone injections: one to stimulate growth, another to delay puberty. Their mother had heard about the combination from other moms. Both girls complied. Neither remembers being worried about their height before the appointments started.

The youngest son, Min-woo, 11, said he started injections last year “for sports.” He wanted to play basketball. “The doctor said I wasn’t short now, but I might be,” he said. “So we started the shots.”

He quit after a year. “I didn’t feel like I needed them anymore.”

In interviews, most children said they were fine with their height until an adult pointed out they might not be. They remembered charts and scans, not teasing or shame. The stress didn’t start with them.

In Korea, height is not just physical. It is personal. It is status. People apologize for it, brag about it, list it in dating profiles and worry about it during job interviews.

“Height is tied to social competitiveness,” Dr. Yun said. “Especially for boys, it connects to confidence, attractiveness, and even job prospects.”

But in her study, more girls than boys were receiving prescriptions: 53.9 percent. That surprised her.

Part of it is timing. Girls enter puberty earlier, which means their growth window closes faster. But that doesn’t fully explain the shift. “The pressure used to fall mostly on boys,” Dr. Yun said. “Now it feels like it’s on everyone.”

In Gangnam, Seoul’s wealthiest district, clinics offering the injections are packed. Some kids on hormone therapy also take height-boosting supplements, wear orthopedic insoles, or follow growth-optimized diets. Others use traditional Korean herbal remedies alongside their injections. Anything that might add a centimeter.

“We found cases where kids taller than average were still getting the shots,” Dr. Yun said. “That tells you everything about where our expectations are.”

'You’re not a bad parent if you don’t do this'

One thing that makes these stories murkier is that most of the children say they’re fine. They’re not bullied. They’re not anxious. They’re just used to the shots now.

By now, Hyun-joong barely notices the injections. He still ranks among the shortest in his class. But it doesn’t seem to bother him. “He’s always had a lot of confidence,” his mother said. “That hasn’t changed.”

What changed, she said, was something else. In January, he started boxing. His stamina improved. So did his posture. “He looks stronger now,” she said. “Not because of the shots. Because of himself.”

So what should parents do?

Most, Dr. Yun said, are trying to do their best. They read online forums. They compare growth curves. They watch classmates outpace their kids. They feel the future narrowing, centimeter by centimeter.

“I understand the anxiety,” she said. “I’m a parent too.” But the injections, she added, are not vitamins. “This is hormone therapy. And we don’t yet know the long-term effects of giving it to healthy children.”

She does not say never. She says pause.

“I would ask, is this something your child needs? Or is this something you need, because of what society expects?”

And if the answer is the latter?

“Maybe the shot isn’t the solution,” she said. “Not giving your child growth hormone doesn’t make you a bad parent. It might make you a thoughtful one.”