This article presents the findings of a historical, qualitative thematic analysis of archival clinical records of 24 men convicted of child sexual abuse and referred for civil commitment to the Massachusetts Treatment Center between 1959 and 1984. Drawing on the perspective of Cicourel, the study examined the differential ways men convicted of child sexual abuse were constructed by various criminal justice actors based on the gender of their victims. Overall, the study found that men with male victims were constructed as more deviant than men with female victims. The study’s findings thus contribute to the research literature on the historical pathologisation and criminalisation of homosexuality.