Is it possible for transgender medicine — which is already being pilloried over puberty blockers and mastectomies — to turn up the dial on controversy? Yes, it is.

What about height dysphoria? Females who transition to males are usually shorter; males who transition to females are usually taller. The disparity can make transgender people uncomfortable, according to an article on the Everyday Health website. “I don’t feel like short masculine people receive the full respect they might have if they were five inches taller. That lack of respect feels solely based on height,” one transman said.

The article reports:

Eli Lawliet, PhD, is a gender doula in the Bay Area who coaches people through their gender explorations and transitions. Previously he researched transgender people’s access to healthcare at UCLA and UC Berkeley. He says about the individuals he coaches: “Height will almost always come up as part of the conversation, unless they’re in a neutral range.”

Research suggests that bottom dysphoria and chest dysphoria tend to be more significant drivers of gender dysphoria among transgender people than height; but the data bears out that height still led to moderate distress levels.

Is a medical fix possible to alleviate height dysphoria? Yes, but it is very painful: surgical limb lengthening. The ethics of performing such operations for people with height dysphoria were discussed in the journal Strategies in Trauma and Limb Reconstruction. The authors were sceptical: “additional work is required to establish ‘height dysphoria’ as a true pathology in order to ethically justify stature lengthening as a legitimate form of treatment.”

However, it is easily to imagine that height-altering could become part of the range of treatments offered to transgender people. Already gender-affirming facial surgery, with all of its discomfort, pain, and risk, is an accepted part of the trans journey.