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The difference between the sexes is a politically dangerous question. Concerning this difference, the author explores what he calls the evident epidemiological realities that would be pointless to deny, and the particularly delicate interpretation of this information, which implies that the request for care be analyzed according to sex: man and woman, girls and boys do not have the same attitudes when they express a request for help. Finally, one cannot ignore ideological issues in boy/girl differences. In all societies the “masculine” and the “feminine” are cultural and social markers no individual can escape. Speaking of this difference always leads the author to run aground on the “rock” of the biological aspect of the “real,” whose uninterpretable nature can lead to all interpretive fantasies and the weight of culture, in which all possible ideologies are easily lumped together. Dealing both with the issue of adolescence and that of sexuality, which touch the very core of individual privacy, therefore amounts to fishing in troubled waters. These stress points find an excellent illustration in the different types of treatment offered to adolescents. Do these take into account the issue of sexual difference? This is not at all certain. This paper argues that although woman/girl and man/boy, can arrive at the same result, most often they get there by different routes. However, these differences are rarely taken into account when a certain treatment is recommended or during the course of the treatment. These remarks give an account of the difficulties encountered by all treatment structures caring for young adolescents (middle school age).