In 1998, Starr was rapidly aged when young actress Kristen Alderson debuted in the childhood role, which retconned the character's birth year to 1992.

[1] Following the cancellation of One Life to Live and its conclusion in 2012, Alderson carried the role over to ABC's last remaining soap opera, General Hospital, winning a Daytime Emmy Award for Outstanding Younger Actress in a Drama Series for the portrayal in 2013.

Alderson is the second One Life to Live actor after Gerald Anthony (Marco Dane) to win an Emmy for a crossover role to General Hospital.

The character's most significant storylines featured her dealing with her parents' volatile relationship, her early adolescent friendship with Matthew Buchanan, portrayed by Alderson's real-life brother, Eddie Alderson, and her close friendship with Langston Wilde, as well as her romantic relationships with Cole Thornhart and James Ford on One Life to Live and Michael Corinthos on General Hospital.

[3] In the spring of 2009, rumors began to circulate that Alderson was about to leave the series due to her not getting along with co-star, Brandon Buddy who played Cole Thornhart.

[17][18] In January 2013, news broke that Alderson and other One Life to Live co-stars who had been airing on General Hospital were to depart or "at least temporarily exit".

A blend of her legendary parents' (One Life to Live’s Todd Manning and Blair Cramer) best and worst qualities, Starr is a willful young woman plagued by the trauma of the deaths of her first love and their child.

[23] Though Starr mellows out during her teen years, a 2010 storyline in which another girl threatens her relationship with Cole forces the character to revert to her old ways.

Though the original musical focused mainly on Starr and Cole, the 2010 revival featured more characters allowing Alderson to share her performance of Benatar's "We Belong" with co-stars, Underwood, Kelley Missal (Danielle Manning) and Meghann Fahy (Hannah O'Connor).

Alderson defended One Life stating that the show had always had a rich musical history, and that what set them apart from the things they were being compared to was the unique characters and storylines.

[29] In summer, 2011, One Life to Live returned to musical themes for the character of Starr by having her develop a friendship with college DJ Baz Moreau (Barret Helms).

When Baz wants to sign a record contract with former adult film producer turned music mogul, Rick Powers (Austin Peck); Starr is hesitant due to his part in blackmailing James's ex-girlfriend, Deanna Forbes (Nafessa Williams) into doing a porn scene with her sister Danielle's boyfriend, Nate Salinger (Lenny Platt).

ABC previously partnered with the campaign for the teen pregnancy storyline featuring Starr's cousin, Jessica Buchanan (Erin Torpey) in 1998 and Lulu Spencer (Julie Marie Berman) in 2006.

Kramer discussed the campaign's history with ABC and also gave some facts about the storyline:[36]Because it [One Life to Live]'s a soap opera, the producers have the luxury of telling it in real time.

Starr and Cole at the time are juggling being parents finishing high school, and their lives appear to be "settling down," — enter Hannah.

Cole's incarceration for his brutal attack on "Todd" allows for the introduction of another love interest, James (Nic Robuck), the younger brother of Robert Ford (David A. Gregory), the man Langston is cheating on Markko with.

[29] When asked if the couple would make it past the next obstacle, Alderson explained, though they love one another and they still have a connection, Cole's friendship with Hannah is what tears them apart.

After causing a bit of trouble for the couple, and breaking up Starr's sister Danielle's relationship with Nate, Deena leaves town.

However, the show is forced to abandon those plans and quickly recast the role with actor Van Hughes due to Buddy being unable to continue taping.

Alderson responded to the decision on Twitter urging fans not to blame head-writer Ron Carlivati revealing that both Buddy and Hughes were unavailable to continue in the role of Cole.

They are found and forced to go back home where Starr ultimately decides let Michael and Marcie adopt the baby, much to the dismay of Todd and Cole.

With encouragement from her former stepmother, Téa Delgado, Starr changes her statement allowing for Todd be exonerated, driving a bigger wedge between her and Cole.

Upon Cole and Hope's deaths in Port Charles, New York, the setting of General Hospital, Starr is rescued by Michael Corinthos.

As she offers supports to Michael, Starr blackmails Todd into helping Sam's sister, Molly Lansing get her book published.

When Johnny is sent to prison, he gives Starr his half of the Haunted Star making her partners with Michael's cousin and sister-in-law, Lulu Spencer-Falconeri.

[36] One Life's Executive producer, Frank Valentini was honored by HeartShare Human Services of New York at their annual spring gala for his work in Starr's pregnancy storyline.

Valentini, Alderson, Kramer along with ABC's Sue Johnson were invited to participate in a symposium at Hofstra University "[highlighting] the unique role entertainment can play in dealing with social and health issues that affect woman in the country and around the world.

[43] Michael Fairman applauded Alderson for her performance during the storyline and expressed how displeased he would be if she didn't win an Emmy for her portrayal of Starr.

"[25] In November 2010, Alderson and costar Brandon Buddy were honored by Michael Fairman giving them the "Power Performance of the Week" when Starr and Cole were forced to say goodbye after he is sentenced to 10 years in prison.

[45] Alderson earned her first Daytime Emmy Award nomination and win in 2013 for her portrayal of Starr on General Hospital in the category of Outstanding Younger Actress.