This chapter discusses the assessment of women should be undertaken in the context of a gender-responsive approach, which takes account of societal perceptions of female sexual abuse, what research tells about the common realities of the women’s lives, about their victims, female-specific theories and explanations of the women’s behaviour, and their offence processes. A collaborative approach helps women understand how they came to offend sexually and how to develop an abuse-free life in which they neither abuse others nor experience abuse themselves. Studies frequently show high levels of emotional, physical, and sexual abuse in childhood and adolescence. Sexual abuse of children by women goes against most people’s schema of the world, leading them to feeling insecure, anxious, and disturbed by it, and they struggle to make sense of what has happened within their existing schema. Reconviction rates are low for male sex offenders but extremely low for female sex offenders, so identifying risk levels is difficult.