The chapter discusses types of sexual offenses, psychiatric comorbidity, coexisting academic and school problems, social and family environment, the role of sexual victimization in the history of the sex offender and treatment considerations. The overwhelming majority of adolescent sex offenders are male, they are represented in every socioeconomic, racial, ethnic, religious, and cultural group. A number of factors have been found with uncommon regularity in the histories of these youth, including impaired social and interpersonal skills; delinquent behavior; impulsivity; academic difficulties; family instability; family violence; abuse and neglect; and psychopathology. Most adolescent sex offenders combine various features of four behavioral patterns: (1) truly paraphiliac behavior with well-established deviant sexual arousal pattern; (2) sexual offending that is but one facet of the opportunistic exploitation of others; (3) sexual offending related to a psychiatric or neurobiological substrate disorder such that the offender is unable to regulate and modulate his impulses; and (4) impairment of social and interpersonal skills resulting in the offender’s turning to younger children rather than peers for sexual gratification. References