There are marked differences between men and women in the overall frequency, severity, and type of offences that they commit. However, there is relatively little research into the reasons for these differences. This chapter examines the differences between men and women in the forms of early maltreatment and adversity they experience and its impact, how survivors and communities regard and respond differently to different forms of adversity in men and women, and how these factors can shape the responses of male and female survivors. This chapter uses the Power Threat Meaning Framework as a basis for exploring these factors and illustrates the ways in which the impact of adversity can be mediated by gender with the accounts of a female and a male forensic psychiatric patient.