Shea Ralph grew up in Fayetteville, North Carolina, where she attended Terry Sanford High School. She was named Athlete of the Year by the North Carolina High School Athletic Association. The Terry Sanford High School graduate is best known for her basketball prowess, but she also lettered in soccer, cross-country, and track. At the time of the award she held 17 state basketball records, including 39.1 points per game as a junior, a 71.6 percent shooting percentage from the floor as a junior, and 18 assists in one game. A scholar as well as an athlete, the National Honor Society member was a recipient of the 1995 Dial Award presented annually to the top male and female high-school athlete/scholar in the United States, earning a 4.2 grade point average on a scale of 4.0. Ralph was named a High School All-American by the WBCA. She participated in the WBCA High School All-America Game in 1996, scoring twelve points.
In 1996 she was named the USA Today National High School Player of the Year.
While in high school, Shea began a multi-year battle with anorexia nervosa. It began with an offhand comment by a teammate, telling her she looked a "little thick". She cut down her eating so significantly she dropped from 145 pounds (66 kg) to 108 (49 kg), a very low weight for a six-foot-tall (1.83 m) person. Her AAU coach, John Ellington, was concerned about her eating habits. One day at a post-game dinner he placed a hundred-dollar bill next to a plate of mozzarella sticks and told her the money was hers if she would just eat the mozzarella. She turned him down. So he had to up the stakes, and told her to gain weight or she was off the team. The prospect of not playing basketball persuaded her to eat. Despite barely eating, she still managed to score 3,002 points in her high school career.

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