Co-parenting is difficult enough when children are healthy. However, when children have medical issues, this creates additional parenting challenges. Most parents, following a divorce, can make aligned decisions regarding their children’s medical care. It is generally rare for parents to disagree over issues such as surgical intervention for a broken bone or cancer treatment. However, issues that are arguably non-essential, such as orthodontics and circumcision, often bring conflict. Now, the fairly recent advent of physicians prescribing human growth hormone (HGH) treatments has created new co-parenting controversy.
HGH treatment has long been touted as a modern-day “fountain of youth,” allegedly increasing longevity and physical health. Professional athletes have dabbled with the use of HGH because of the treatment’s positive effects on muscle building and recovery. In the 1950’s, however, HGH first became known for its potential medical benefits when it was administered to children with abnormally slow growth patterns. Almost immediately, physicians began to embrace the treatment in spite of its side effects and oppressive cost.
In recent years, the development of synthetic HGH treatments has significantly reduced the frequency and severity of side effects (most of which resulted from the fact that HGH was originally harvested from human cadavers). That said, the cost of HGH treatments for children still can range anywhere from $10,000-30,000 per year, with some children requiring several years of treatment to reach normal growth percentiles.
You may be thinking to yourself: “Why bother? Being short isn’t so bad.” Severe cases of growth hormone deficiency notwithstanding, you may be right. But, for many children in today’s world of vanity and bullying, height is often closely related to self-esteem. So related, in fact, that some pediatric endocrinologists and psychologists recommend HGH treatments to address what may be a prominent cause of low self-esteem and all of the problems it can bring into a child’s life. Although countless studies have demonstrated the effectiveness of HGH treatments in children of certain ages, prescribing the treatment solely to improve the child’s self-esteem remains a hot button issue. Disagreement over whether to prescribe HGH treatments can pose a problem for parents with joint custody arrangements.
Parents with joint custody are expected to make mutual agreements regarding medical care. Usually the associated child support order requires that the parents divide the cost of uninsured medical expenses. Frequently, HGH treatments are not covered by insurance policies unless the child suffers from a severe growth hormone deficiency. Using the treatments to improve a child’s self-esteem may be considered an unreimbursed expense.
If the parents disagree about the necessity of HGH treatments for their child and cannot settle the dispute themselves, they may petition a court to determine an outcome. An unfavorable decision by the judge may leave the higher-income parent paying a larger proportion of the $10,000-plus cost for a procedure with which they may not even agree!
Furthermore, even if both parents agree that the child should have the HGH treatment but cannot agree on how to split the cost, it may take several months for a family court judge with a crowded docket to determine the size of each parent’s payment obligation. Because the effectiveness (and cost) of HGH treatment is substantially affected by the child’s age, waiting for a court ruling may not be an option. If the child’s growth plates have closed, which can occur as early as twelve years, it may be too late for HGH treatments to have their desired effects. In such scenarios, negotiating a resolution or involving a Parenting Coordinator can be much quicker and can facilitate the parties’ agreement with less expense.
Ultimately, the decision regarding HGH treatment rests with the parents. Understanding the contours of how family law and medicine interact, though, can be arduous and complex even for experts. For family court judges, emerging trends in medicine and child psychology can pose problems which are difficult to solve, especially given the technical issues and time constraints surrounding HGH treatment.