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y more comfortable and less susceptible to health problems associated with being bedridden. Her body would be "more appropriate and provide her more dignity and integrity than a fully grown female body."

They reasoned that a smaller child would be easier to include in family life and to decrease the chances of medical problems if she became too large for them to move.

They say the hysterectomy was performed to prevent bleeding during her treatment and eliminate the risk of uterine cancers and menstrual discomfort. Her breast buds were removed to prevent her breasts from growing to protect her from possible sexual abuse and to eliminate the risk of a breast disease, of which her family has a history.

Ashley was diagnosed with static encephalopathy, or severe brain damage, after she had feeding problems and developmental delays shortly after birth. The now 9-year-old girl's hysterectomy was part of a series of treatments sought when she was referred in 2004 to Dr. Daniel Gunther at Children's when she showed signs of early puberty.

Assistant state Attorney General Edward Dee who reviewed the case after an unidentified person complained about the treatment, said that though Washington has no specific law forbidding the procedures performed on Ashley, state courts have ruled that sterilization of a developmentally disabled person for birth-control purposes requires court approval.


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