The difference between the sexes is a politically dangerous question ! The author explores, with this difference in view, what he calls the evident epidemiological that it would be useless to deny, the particularly delicate interpretation of this information which implies the analysis of the request for care according to sex : man or woman, girl or boy, do not have the same attitudes when they formulate a request for help. Finally, in boy/girl differences, one cannot ignore ideological issues. In all societies the “ masculine ” and the “ feminine ” are cultural and social marker that no individual can escape. Speaking of this difference always leads the author to sail into the rock of the biological within the “ real ” whose uninterpretable can lead to all interpretive fantasies and, on the other hand, the weight of culture, wherein all possible ideologies are easily lumped together ! Dangerous waters then, when one is dealing both with the issue of adolescence and that of sexuality, which touches the very heart of individual privacy. These lines of tension 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 article tries to show that although woman or girl, man or boy, can arrive at the same result, most often they get there by different routes. But 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 dealing with the care of young adolescents, those who are called middle school pupils.