After extensive consultation between parents and physician, a plan was devised to attenuate growth by using high-dose estrogen and to reduce the long-term complications of puberty in general, and treatment adverse effects in particular, by performing pretreatment hysterectomy. Because a growth-attenuating treatment regimen is unconventional, and bound to be controversial, the case was referred to our institutional ethics committee. The committee met with the family, the patient, and the patient's physicians and carefully explored the family's reasons for their request. After a lengthy discussion, the committee reached consensus that both the requests for growth attenuation and hysterectomy were ethically appropriate in this case. The committee also recognized that, although justified in this patient, growth attenuation should be considered in future patients only after careful evaluation of the risks and benefits on a case-by-case basis. Toward that end, plans were instituted to convene an interdisciplinary review panel that includes pediatric specialists in endocrinology, neurology, development, surgery, and ethics.