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Douglas Diekema also caused controversy with his participation as chair of the Children's Hospital institutional review board that handled the Ashley case. The Ashley Treatment refers to a controversial set of medical procedures undergone by a Seattle child, “Ashley X”. Ashley, born in 1997, has severe developmental disabilities due to static encephalopathy of unknown etiology; she is, and will remain, at an infant level mentally and physically. The treatment included growth attenuation via estrogen therapy; hysterectomy (to prevent menstruation and possibility of pregnancy), bilateral breast bud removal (to prevent the development of large breasts), and appendectomy (to prevent appendicitis). The principal purpose of the treatment was to improve Ashley’s quality of life by limiting her growth in size, eliminating menstrual cramps and [[bleeding]], and preventing discomfort from large breasts. The combination of the surgery and the estrogen therapy attracted much public comment and ethical analysis in early 2007, both supportive and condemning. The hospital later admitted that the surgery was illegal and should only have been performed after a court order, a position that is disagreed upon by the attorney of Ashley’s family.<ref>{{REFweb