Introduction

Height is a fundamental and socially salient physical attribute that influences body image, self-esteem, and a range of psychological and social outcomes. Unlike other aspects of body image, such as muscularity or body fat, height cannot be meaningfully altered without invasive or risky medical interventions [1]. For men, taller stature is associated with perceptions of greater masculinity and dominance [2], as well as traits like strength and power [3]. Height also plays a critical role in social and romantic contexts, contributing to perceived attractiveness and suitability as a partner [4,5]. For example, Salska, Frederick [3] found that only 23% of heterosexual men and 4% of heterosexual women would accept a relationship in which the woman was taller, highlighting the persistent gendered norms surrounding height. For women, cultural stereotypes often associate femininity with smaller stature and finer bone structure [6]. However, research also shows that women may express a desire to be taller [7], suggesting that height dissatisfaction is not exclusively a male concern.

Height dissatisfaction refers to the negative evaluation of one’s own height, whether feeling too short or too tall [6]. This form of body dissatisfaction has been linked to a range of negative psychological outcomes, including reduced wellbeing [8], lower quality of life [7], and psychopathology such as disordered eating [9]. Despite these associations, height and height dissatisfaction remain significantly under-researched in clinical psychology.

Given the cultural importance placed on height for both men and women - and the potential consequences for psychological wellbeing - our review synthesizes current research on height, height dissatisfaction, and associated psychological and social outcomes. First, the review explores the relationship between height, height dissatisfaction, wellbeing, and social functioning. Next, it considers theoretical frameworks that explain height-related concerns. Finally, it discusses clinical implications and offers recommendations for future research and practice.

Conceptualizing height and height dissatisfaction

Human height is an intricate trait, influenced by a number of genetic and environmental factors. Research has indicated that around 80% of variation in height is potentially attributable to genes [10,11], making the heritability of height rather high compared to other intricate traits [12] such as weight [13]. Additionally, differences in growth curves have been observed across ethnic groups, for example, African-origin populations in the USA and Europe have a higher mean body height when compared to their white counterparts [14]. While this suggests that height is substantially influenced by genes, there has also been a notable increase in mean height at a population level across the last 150 years [15]. In Western countries, this increase in mean height likely reflects the influence of environmental factors such as increases in health care quality, education, nutrition, and social equality [16].

Height dissatisfaction is a psychological aspect of height. It pertains to negative perception (e.g., I am too short) and affective experiences (e.g., low mood due to short stature) relating to one’s own height, as well as related behaviors (e.g., seeking ways to grow taller) [17]. Typically, height dissatisfaction reflects a discrepancy between a person’s actual height and their perceived height ideal. This notion is further reflected by research that height and height dissatisfaction are negatively correlated [18], meaning that generally, shorter people are more dissatisfied with their height.

Height and men

Perceptions of what is an acceptable or attractive height are shaped by cultural and social norms. For men, masculine norms reflect a dominant set of traits that define what it means to be male within a particular cultural or societal context [19]. In Western cultures, the ideal or cultural norm is for men to be tall [20], and subsequently men are more concerned with their height and how it may be perceived. Social perceptions further amplify these concerns by associating taller men with traits such as dominance [2], assertiveness [21], and greater physical attractiveness compared to men of average or shorter height [22]. For instance, Ridgeway and Tylka [4] asked a sample of college men to describe their ideal male body, with height emerging as a critical component of this, further emphasizing this “tall, dark and handsome” notion amongst men. It seems that for men, height dissatisfaction is unidirectional; men who are dissatisfied with their height want to be taller.

Height and women

For women, height has been less of a consideration in past research. One line of thinking proposes that female-related height concerns work in the opposite way to men; women do not want to be ‘too tall’ [6]. This perspective is rooted in societal ideals of femininity, which often emphasize delicacy, including a smaller frame and shorter stature [23]. It may also reflect a contrast to cultural associations of tallness with masculinity, where greater height is viewed as a symbol of male strength and dominance [2]. Again, this is reinforced by social norms in heterosexual romantic relationships consisting of a taller man and shorter woman [24]. At its extreme this preference for shorter female height has previously manifested in hormonal intervention [25]. In an older study, Barnard, Scialli [26] revealed that one-third of pediatric endocrinologists in the United States had offered growth suppression to taller stature girls as a treatment option in the five years preceding their study.

However, empirical evidence supporting the notion that women are dissatisfied with being too tall remains limited. In fact, existing studies suggest, similar to men, most women who report height dissatisfaction typically wish to be taller, rather than shorter. For instance, Jacobi and Cash [27] found women’s height ideals were significantly taller than their reported height. This was supported by Perkins, Hayes [7] who noted that 61% of their sample reported idealizing a height that differed from their own, and of this, 45% reported wanting to be taller. Additionally, Talbot and Mahlberg [6] found that 33% of women in their sample wanted to be taller, compared to just 16% who wanted to be shorter.

Theoretically, height dissatisfaction among women may be bidirectional: many women may desire to be taller, but not too tall. However, the existing empirical literature predominantly supports the former, with strong evidence indicating that women who are dissatisfied with their height generally wish to be taller.

Measuring height dissatisfaction

Currently, height dissatisfaction is measured through two methods: (i) collecting respondents' actual height and ideal height (i.e., the height they wish they were), and calculating a discrepancy score between the two measures [6,18], and (ii) self-report scales. To the author’s knowledge there are only three published specific measures of height dissatisfaction: the Male Body Attitudes Scale (MBAS) [28], the Male Body Attitudes Scale-Revised (MBAS-R) [29] and Negative Physical Self Scale-Short (NPSS-S) [17].

The MBAS-height subscale consists of two items: “I am satisfied with my height” (reverse scored), and “I wish I were taller”, with higher scores indicating greater height dissatisfaction. However, the validity of this subscale has been questioned due to its brevity, as factors with fewer than three items are generally considered weak or unstable [30,31].

The MBAS-R-height subscale included an additional item “I feel ashamed of my height”, with higher scores once again indicating more prevalent levels of height dissatisfaction. It is important to note that the MBAS and revised version were designed for men, and validated using male samples, and as such their suitability for assessing height dissatisfaction amongst women is questionable. Additionally, the MBAS assumes height dissatisfaction only occurs in the direction of wanting to be taller, and does not accommodate taller individuals who are dissatisfied with their height and may wish to be shorter.

The NPSS-S shortness concern scale consists of 11 items relating to an individual’s perception of their height (“I think I am too short”) and their engagement in height related compensatory behaviors (“I keep trying ways to get taller”). Higher scores on this subscale indicate greater tendencies to experience height-related concerns. The NPSS-S has some advantages over the MBAS, in that it assesses cognitive, affective, and behavioral aspects of height dissatisfaction. However, this scale is also limited as it focuses exclusively on the experiences of people dissatisfied with shorter stature, and does not encompass experiences of taller individuals who wish to be shorter.

Psychological, relational, and functional correlates of height and height dissatisfaction body image related factors

Previous research has shown that height and height dissatisfaction are related to other aspects of body image, including muscularity dissatisfaction, drive for thinness, and self-esteem. Early work by Gupta, Schork [32] found that shorter men were more likely to be preoccupied with dieting and dissatisfied with their weight, highlighting a link between height and body dissatisfaction. More recent research suggests that, similar to height, perceived pressure to conform to masculine ideals increases the risk of muscularity dissatisfaction and disordered eating among men [33].

Further studies have confirmed that height dissatisfaction is associated with muscularity dissatisfaction, general body dissatisfaction [34], and dissatisfaction with body fat [9]. Talbot and Mahlberg [9] also found that muscularity dissatisfaction and stronger idealization of muscularity predicted greater height dissatisfaction. In other words, men who were unhappy with their muscularity or who aspired to be more muscular were also more likely to be dissatisfied with their height.

Additional research by Wang [35] reported that individuals dissatisfied with being short experienced greater body image concerns, increased dissatisfaction with body fat and muscularity, and more pronounced eating disorder symptoms. One proposed explanation is that men who feel unhappy with their height, which cannot be easily changed, may attempt to compensate by focusing on alterable aspects of their appearance, such as increasing muscularity [9,32].

In relation to eating disorders, existing evidence suggests that while height dissatisfaction is modestly correlated with certain subscales of the Eating Disorder Examination Questionnaire [36], eating disorder symptoms do not appear to uniquely predict height dissatisfaction [9]. Nonetheless, observed correlations between height dissatisfaction and disordered eating behaviors highlight the need for further investigation, particularly within clinical populations.

Similarly, for women, preliminary evidence suggests that higher levels of height dissatisfaction are associated with a stronger drive for both thinness and muscularity. Notably, among taller-than-average women, drive for muscularity emerged as a prominent predictor of height dissatisfaction [6]. These findings underscore that although much of the existing research in this area has focused on individuals of shorter stature, taller women may also be vulnerable to experiencing height dissatisfaction. Like men, Favaro, Tenconi [37] found a link between low height and disordered eating symptoms amongst smaller statured women. However, this study utilized a clinical population of women with eating disorders, so the problem of causality makes it unclear whether shorter women are more likely to develop an eating disorder, or whether eating disorders, which onset at a crucial time of physical development, stunt height through malnutrition as a consequence of restricted eating practices. Talbot and Mahlberg [6] also found associations between height dissatisfaction and eating disorder symptoms in women; however, these symptoms did not uniquely predict height dissatisfaction when drive for thinness and muscularity were included in the model. This suggests that specific aspects of body image, particularly muscularity, may strengthen the relationship between height dissatisfaction and disordered eating. Adding to this, Amin, Ly [38] identified associations between dissatisfaction with shorter stature and broader concerns related to body image and weight among women.

Self-esteem

Self-esteem refers to an individual’s subjective evaluation of their own worth [39] and is often described as the sense that one is “good enough” [40]. While several studies have explored the impact of height on self-esteem, no published research to date has specifically examined the relationship between height dissatisfaction and self-esteem.

Early work by Hensley [41] found that self-esteem was not significantly influenced by height in either men or women. In contrast, Booth [42] reported that individuals whose height deviated from the average for their gender tended to have lower self-esteem. In that study, self-consciousness played a mediating role in the relationship between height and self-esteem. More recently, Wang, Ding [43] found that shorter height was associated with lower self-esteem among adolescent girls in a Chinese sample, whereas height had little impact on self-esteem among boys. The authors suggested that cultural beauty standards may explain the gender differences, and that overall body dissatisfaction may be a more important factor influencing self-esteem than height alone. In addition, Leung, Ng [44] used immersive virtual reality to experimentally alter participants’ perceived height. They found that feeling taller led to increases in self-esteem, suggesting that height perception can influence self-evaluation in real time. Together, these findings suggest a potential link between shorter stature and lower self-esteem, although further research is needed - particularly on how dissatisfaction with height, rather than height itself, may affect self-esteem.

Quality of life

Quality of life is a multifaceted concept, encompassing physical, emotional, social and psychological well-being [45]. Griffiths, Murray [18] outlined that height dissatisfaction had a unique association with psychological well-being and quality of life impairment amongst sexual minority men, where higher levels of height dissatisfaction were linked with lower quality of life. Another study consisting of a British adult sample identified that shorter stature was associated with a marked decline in health-related quality of life [46]. In women, Perkins, Hayes [7] found that height dissatisfaction was linked to poorer quality of life, however no associations were observed between height itself and quality of life. Similarly, Coste, Pouchot [47] found no relationship between height and health-related quality of life amongst French adults.

Amongst a sample of adolescent boys and girls, Griffiths, Murray [48] found that greater body dissatisfaction, which included a measure of height dissatisfaction, was associated with greater quality of life impairment. However, since height dissatisfaction was not utilized as an individual predictor of quality of life, it is not possible to garner height’s unique influence in this study. There is also conflicting evidence regarding this relationship in adolescents, Sommer, Daubmann [49] identified that short statured adolescents did not differ considerably from their taller counterparts in health-related quality of life.

Psychological distress: anxiety, depression and loneliness

The association between height, anxiety, and depressive symptoms has also been investigated. Some literature investigating adult height and mortality insinuated that men who are taller are deemed at lower risk of suicide [50], as short stature is linked with psychological and cognitive factors that may elevate the likelihood of suicide [51]. However, Song, Smith [50] noted that unmeasured psychosocial and socioeconomic factors may confound this relationship, alluding to evidence that low adult height is associated with lower socioeconomic position [52] and higher behavioral risk factors [53].

Bjerkeset, Romundstad [54] conducted a study assessing the relationship between height, anxiety, depression, and suicide amongst a cohort of Norwegian men and women. Findings of this study pointed to an inverse association between height and depression and anxiety; taller individuals tended to report lower levels of depression and anxiety. Likewise, it seemed that lower suicide risk corresponded with greater height, with no major differences between males and females. Once again, the authors noted that the relationship between shorter height and higher anxiety, depression, and suicide risk was confounded by sociodemographic factors such as age and education level, as well as psychological characteristics such nervousness, calmness and mood. This aligned with the aforementioned findings of Song, Smith [50].

Related research on youth with short stature suggests that psychological difficulties are more frequently observed in clinical populations, particularly among boys who have been investigated for short stature in pediatric or endocrinological settings [55,56]. In contrast, findings are less consistent in community samples of shorter youth, where height alone does not always predict poorer psychological outcomes [49]. A similar distinction may apply in adults: it remains unclear whether short stature per se contributes directly to psychological burden, or whether distress is better explained by underlying medical or developmental conditions associated with short stature, such as growth hormone deficiency or chronic illness. Clarifying this distinction is important for understanding whether psychological outcomes reflect biological vulnerability, social stigma, or the cumulative effects of health-related challenges.

A single study has examined the relationship between height dissatisfaction and loneliness. Within a Chinese adolescent sample, Mo and Bai [57] found that greater levels of height dissatisfaction were associated with greater reported levels of loneliness, and that height dissatisfaction was a crucial predictor of loneliness. Further enquiry into this association revealed that this relationship was mediated by social anxiety. Underpinning this were feelings of fear from height-dissatisfied adolescents that they were judged through a negative lens by peers, culminating in reduced confidence and more anxiety in social situations [57].

Mo and Bai [57] found that loneliness among height-dissatisfied adolescents was not due to social exclusion from peers as a result of their stature. Instead, they posited that it appeared to stem from avoidance behavior, whereby adolescents deliberately withdrew from social situations due to their own dissatisfaction with their height.

Romantic relationships

Height and height dissatisfaction can significantly shape social experiences, particularly in the context of romantic relationships. Traditional gender norms often influence partner preferences, with women tending to prefer men who display conventionally masculine traits, including greater height [58]. This preference is thought to stem from evolutionary beliefs that masculine features signal desirable heritable traits [59,60].

Taller men are frequently associated with qualities such as resource acquisition [61] and the ability to intimidate rivals [3], both of which may enhance their perceived attractiveness [22]. Yancey and Emerson [24] found that women often cited a desire to feel protected, secure, and feminine - as well as the wish to “look up” to their partner - as key reasons for preferring taller men. These attitudes reinforce a widely held “male-taller” norm, in which the man is expected to be taller than his female partner [3].

Empirical studies support the strength of these preferences. Salska, Frederick [3] reported that only 23% of heterosexual men and 4% of heterosexual women would accept a relationship where the woman was taller. Stulp, Buunk [62] found that women, more than men, were likely to view relationships as unacceptable when the female partner was taller. They also noted that women were more accepting of male partners who exceeded their preferred height than those who fell below it.

Similarly, Perkins, Hayes [7] found that 84% of Australian women preferred a taller romantic partner, and 57% reported they would not date someone shorter than themselves. Swami, Furnham [5] further demonstrated that both men and women tend to prefer partners who conform to this height norm, with taller men and shorter women favoring larger height differences. In contrast, shorter men and taller women typically prefer smaller height gaps and are less inclined to pursue relationships that fall outside of these expectations. Despite the persistence of these norms, some flexibility has been observed. Shorter-than-average men have shown a willingness to date women up to two inches taller [3]. Additionally, Perkins, Hayes [7] found that 56% of women in the tallest quartile of their sample were open to dating a shorter partner. These findings suggest that while cultural norms around height in romantic relationships are strong, they are not absolute.

Additionally, these findings largely reflect Western, industrialized societies where height is linked with socioeconomic and gendered ideals. Cross-cultural research suggests that height preferences and dissatisfaction are not universal; for instance, among the Himba of Namibia and the Datoga of Tanzania, preferences for tall stature are less pronounced or reversed [63,64]. Incorporating non-Western perspectives can therefore help delineate culturally specific from cross-culturally robust features of height ideals.

Further, beyond stated preferences, real-world pairings often reflect assortative mating, wherein individuals tend to choose partners with similar height [65]. This pattern suggests that social norms and biological preferences interact with opportunity structures and mutual attraction dynamics, yielding moderate but consistent positive associations between partners’ heights across cultures.

Variability among sexual minority groups

Although research in this area is limited, emerging evidence suggests that sexual minority men may exhibit distinct patterns in height preference compared to heterosexual individuals. Valentova, Stulp [66] found that taller gay men tended to prefer taller partners, indicating that one’s own height plays a role in shaping preferences. Similarly, Griffiths, Murray [18] observed a positive correlation between a man’s actual height and the height he desired in a romantic partner. These findings suggest that the heterosexual norm of a “taller man, shorter woman” dynamic does not necessarily apply within same-sex male relationships. However, the small number of studies exploring height preferences among sexual minority populations highlights a significant gap in the literature. Much of the existing research focuses on heterosexual dynamics, leaving the nuances of attraction and body image within diverse sexual orientations underexplored. Further investigation is needed to understand the broader social, psychological, and relational implications of height preferences among sexual minority men.

Discrimination and heightism

Beyond romantic relationships, height and height dissatisfaction also have broader social implications, including discrimination and unequal treatment - commonly referred to as heightism [67]. Griffiths, Murray [18] examined this phenomenon among sexual minority men and found shorter height was associated with higher levels of dissatisfaction and increased experiences of negative treatment. Men between 165–175 cm reported mild mistreatment based on height, while men under 165 cm experienced significantly worse treatment, illustrating the social advantage of taller stature. Similarly, amongst women, Perkins, Hayes [7] observed that shorter Australian women perceived they were treated more poorly due to their height compared to their taller counterparts.

Workplace outcomes

Height also plays a role within professional settings. Taller individuals are often

perceived as more persuasive [68] and more likely to be viewed as leaders [69]. These perceptions are particularly influential in workplace environments where leadership and confidence are valued [61].

While job performance may not be linked to height, perceived competence is. Judge and Cable [61] found strong positive correlations between height and income, with taller individuals earning more on average over their careers. For instance, someone 182 cm tall was predicted to earn approximately $166, 000 USD (approximately $258,938 USD today) more across a 30-year career than someone who was 165 cm tall. These findings held when controlling for gender, suggesting that both taller men and women benefit financially.

Additional studies support this trend. Taller women are often viewed as having greater authority in the workplace [70], and more likely to have partners with higher occupational statuses [71]. These findings reinforce the broader patterns that height influences perceived status and success, irrespective of objective performance.

Theoretical perspectives of height dissatisfaction

In this section we have applied height dissatisfaction to established theoretical frameworks, including evolutionary psychology and sociocultural perspectives such as the Tripartite Influence Model. While these frameworks offer useful lenses for understanding potential origins and maintenance of height dissatisfaction, their application to height remains largely untested empirically. Nonetheless, they provide valuable conceptual foundations to guide future research aimed at uncovering the mechanics behind height dissatisfaction and informing intervention strategies.

Clinical implications

Height dissatisfaction is an important but often overlooked component of body image concerns, particularly for individuals of shorter stature, who are more vulnerable to experiencing height dissatisfaction due to the strong relationship between shorter height and negative self-perceptions. Clinicians should be mindful that height dissatisfaction frequently co-occurs with other body image-related factors such as muscularity dissatisfaction [33], drive for thinness [6], and body fat dissatisfaction [9]. This constellation of concerns may contribute to compensatory behaviors (like excessive focus on muscularity) that may increase the risk of disordered eating and related psychopathology. Given its impact on self-esteem and quality of life, height dissatisfaction warrants inclusion in comprehensive assessments of body image and psychological well-being. Therapeutic approaches that target negative self-evaluations related to height, promote adaptive coping, and address internalized sociocultural standards of appearance may be particularly beneficial.

Ultimately, integrating height dissatisfaction into clinical formulations supports a more holistic understanding of clients’ body image struggles and related psychosocial impairments. While further research is needed to develop empirically validated interventions specifically targeting height dissatisfaction, current evidence underscores the importance of addressing this issue to improve self-esteem, reduce psychological distress and enhance social functioning among those affected.

Conclusions and future recommendations

Although research on height and height dissatisfaction has expanded in recent years, this area of body image research is still in its infancy, with several gaps that warrant further investigation. First, as our paper is a narrative review, it is subject to several methodological constraints inherent to this format [93]. Consequently, the inclusion of literature may be influenced by publication bias, and findings should be interpreted as indicative rather than conclusive. In line with recommendations on constraints on generality [94], we encourage readers to consider that many cited studies draw from Western samples and may not generalize across cultures or contexts. Second, most studies on height and height dissatisfaction have been cross-sectional, limiting understanding of how height dissatisfaction changes over time. Longitudinal research is essential to clarify causal pathways and the temporal relationship between height dissatisfaction and psychological outcomes such as anxiety, depression, and body image disturbance. Third, there is a pressing need for the development and validation of a comprehensive scale specifically designed to measure height dissatisfaction. As discussed, existing measures fail to capture the complexity of height-related concerns, as well as associated cognitive, affective and behavioral factors. A multidimensional instrument would enable more precise identification of individuals experiencing clinically significant height dissatisfaction and enhance research consistency. Fourth, much of the existing literature focuses on shorter men, yet height dissatisfaction may also affect taller individuals, particularly women, who may experience pressures related to deviations from culturally ideal female height. Future research should explore the nuanced experiences of height dissatisfaction across genders, sexual orientations, and cultures to provide a more inclusive understanding. Fifth, a key limitation of our review is its sole focus on adult populations. Although height dissatisfaction and its psychosocial correlates are well-documented in adults, these concerns may originate during childhood or, more commonly, in the pubertal years in step with other forms of body dissatisfaction [95]. Indeed, it is in the pubertal years when height differences become more salient [96] and social comparison processes intensify [97]. Future research should therefore examine the developmental trajectory of height dissatisfaction, including how early experiences of teasing, peer comparison, and identity formation contribute to later body image outcomes. Additionally, future research should distinguish between the psychological consequences of short stature itself and those arising from medical or developmental diagnoses associated with reduced growth. Understanding whether distress reflects social stigma, internalized appearance concerns, or chronic health burden will help clarify the mechanisms linking stature to mental health outcomes in both youth and adult populations. Sixth, there is limited empirical evaluation of theoretical models applied to height dissatisfaction, particularly sociocultural frameworks such as the Tripartite Influence Model. Testing these models can clarify mechanisms by which height dissatisfaction arises and is maintained, informing targeted intervention strategies.

Seventh, many foundational studies in this field were conducted over a decade ago, during a period when societal standards, norms, and media exposure differed considerably from today. Given the evolving nature of appearance ideals that are shaped by digital media, shifting gender roles, and increased representation of diverse bodies, it is critical that future research examines whether previously identified trends in height preference and dissatisfaction remain consistent in contemporary contexts. Longitudinal and cohort-based research could help determine whether societal changes have influenced how height is perceived and experienced across time. Last, intervention research is needed to develop and evaluate psychological treatments that address height dissatisfaction and its related psychological impacts. Interventions could focus on reducing maladaptive social comparisons, challenging internalized height ideals, and managing avoidance behaviors. Addressing these priorities will deepen our understanding of height dissatisfaction and support the development of effective prevention and treatment approaches tailored to this unique aspect of body image.