Female adolescent sex offenders (FASO) are a complex clinical population because of the sociocultural dynamics that influence the disclosure of and system responses to female-perpetrated sexual abuse; the prevalent duality of FASOs as offenders and victims of sexual abuse; and the gender-specific considerations of the sexual, emotional, and relational development unique to the life cycle of women (Center for Sex Offender Management, 2007). Contributing to the mystery surrounding FASOs, girls represent only about 7% of juvenile arrests for sex offenses (Office of Juvenile Justice and Delinquency Prevention, 2009b), creating obstacles for quantitative studies to determine effective treatment approaches. In addition, there is little literature with clinical case studies illustrating a person-in-environment perspective of female adolescents in sex offender–specific treatment. This chapter aims to examine the complexity of restorative justice approaches when working with FASOs. Furthermore, providers working with FASOs are challenged to consider the implications for treatment when viewing trauma from a larger cultural framework as it applies to urban youth, specifically the impact of rape culture upon young girls of color.