BioMarin has won the FDA’s go-ahead for its next big launch. But the drug’s arrival may be unwelcome news for those who’ve built a community out of living full lives with dwarfism.

The FDA approved Voxzogo, also known as vosoritide, for a form of dwarfism called achondroplasia. With the FDA nod, Voxzogo becomes the first treatment licensed in the U.S. for achondroplasia.