The child evidently communicates pain, fear and desire the way any three month old child does, by crying. While she is a living and breathing girl, she's not cognitive enough to have many feelings beyond hunger, pain and contentment. As for functioning, yes, her body functions but to what degree? She can't walk, talk or even think at the age of 9! I don't know how many of you have ever taken care of an adult invalid but I know from experience, it's not an easy thing. Women are exceptionally difficult due to menstrual cycles and often end up, for a lack of a better word, smelly. They develop yeast infections easily (vaginal and under the breast) because they tend to have to take antibiotics more often. You speak of the hormone therapy causing physical and emotional changes but without the therapy, her natural hormones would do the same thing. Yes, it's more convenient for the family if this child stays child-sized, but it also provides her with a better quality of life, IMO, because she can actually receive better care and doesn't have to go through all the crap that women go through each month.
BTW, I didn't say that this child would definitely end up in an institution but that it often happens as they get older.
I must agree with Doniston here. For all the reasons the parents gave, I believe they made a smart, though admittedly, controversial decision. All too often, these children mature physically and parents find they can no long care for them. Then must then be placed in a long-term care facility where they are often subjected to rape and molestation. With the hormone therapy, Ashley will remain small enough for her parents to manage which will help eliminate the need for a professional facility. However, I'm wouldn't want this treatment for every mentally retarded case because clearly, some can become functional adults.