While juvenile courts were originally designed to respond to troubled youth
by providing treatment appropriate to the needs of individual offenders, a
dvocates of a system that "gets tough" on young criminals by meting out pun
ishments based on offense characteristics (both present offense and past of
fense history) have become increasingly influential in recent years. In thi
s article, I examine a special case, that of juvenile sex offenders in a Wa
shington State county, for whom a 1990 law reintroduced treatment as a cent
ral goal. While Washington has been a forerunner in the shift toward a juve
nile justice system in which offending behavior is the central factor in de
cision making, I argue that, largely as a result of this law, juvenile sex
offending has been "medicalized" and that, in this process, distinctions ba
sed on offense characteristics have noticeably diminished. This case study
provides both empirical support for established theoretical arguments regar
ding medicalization and a detailed explication of the differences between m
edical and legal assumptions about social problems.