The tenth percentile is extremely low. Since my daughter wasn't diagnosed until she was three, for many years her height was in the 75-90th percentile. When her meds were too high we often found that she would not grow at all. The ped endo tracked and did tests every third month. It seems you are aware of the issue of oversuppression. I think many of us on this board have at one time or another seen times when our kids were getting too much medication. I often think it would be great to have a "cortisol meter" similar to what diabetics use. One quick pin prick and we would immediately know if the dose needs to be adjusted....wishful dreams. I noted that none of the doctors you listed were specifically ped endos. There are four endos in the city where we live but none are ped endos. For us it is worth the two hour drive to see the ped endo. I can attest to the fact that the ped endo is more in tune with proper suppression and growth issues than an endo treating CAH adults. We had one episode where my daughter was in our local hospital for pneumonia. She was seen by a regular adult endo. After a week, she was released when she no longer had a fever and was doing well. At the time of her release, she was given a prescription for cortisone that was 3X the normal amount and the instructions said to continue this for 1 month. When I contacted the ped endo (120 miles away) regarding this change in meds, she quietly stated that she was hoping we were not giving her that amount. The reason I was grilling you over your son's type of deficiency was because there are several other types of CAH depending on the enzyme that is lacking. You can check out the medical sites on the bar at the top of the message board. Both of the following CAH types are "extremely extremely" rare but can cause some feminization in male genitals. It is not the medication that causes the feminization but rather it is a break in the hormone connections even before the adrenals even get to make the progesterone (androgens). The male development is therefore sometimes incomplete. I was surprised myself about this. But when I mean rare it is very very very very very rare. They are 1. cholesterol desmolase deficiency 2. 17 alpha hydroxylase deficiency I know there are even several other types of CAH but in all honesty I'm not at all familiar with them other than that they are uncommon and can be more difficult to treat. As an aside................ This book is not related to CAH but you may find interesting. It's called "As Nature Made Him". It is a true story. It was just published this year. I'm waiting for a copy to be returned into the local library. I saw the young man being interviewed on a Canadian program a short while ago. His parents agreed with doctors to raise him as a girl after a botched circumcision. He was brought to the US for surgery (one of the NE states known for its research on gender) It was a time when the current thought on gender identity was your environment was more important than nature.... but even as the doctors were proclaiming a success (even publishing it in journals), it never was. (This US doctor is still practicing and proclaiming it a success - a scary thought) In his teens he found out the truth and after many turbulent years, had reconstructive surgery and assumed his rightful male identity. He is married and while unable to father children, is a supporting and loving husband/father to his wife and her children from a previous marriage. While watching him in this TV interview ...what totally amazed and humbled me about this young man was his willingness to forgive and get on with life. Happy Easter!