Gunther and Diekema (2006) have described a controversial intervention they provided to Ashley, a 6-year-old girl with profound and multiple impairments, which they refer to as "growth-attenuation therapy." This intervention, approved and apparently promoted by the parents, consisted of high doses of estrogen to bring about a permanent attenuation in her size. Together with a hysterectomy and removal of both breast buds, the intention was to minimize the likelihood of a future out-of-home placement by maximizing the future comfort of this child and ensuring a manageable care-giving burden for parents who wanted very much to maintain their daughter in their loving environment. As the current leadership of the former American Association on Mental Retardation and now the American Association on Intellectual and Developmental Disabilities, the authors view growth attenuation as a totally unacceptable option. They share the concerns raised by Brosco and Feudtner (2006), and add their own to theirs.