Welfare reform in the United States is associated with “metaphorical medicalization,” a process involving increased reliance on monitoring and “technologies of the self,” such as life skills counseling focused on the personal problems, habits, and attributes of welfare recipients, rather than on job skills and training or educational needs (Schram 2000, Social Text, 18 [162]: 82–107). Metaphorical medicalization is also a feature of the dynamics of contemporary neoliberalizing welfare reform initiatives in Canadian jurisdictions. In this paper, however, we argue that medicalization has become more than metaphorical for lone mother welfare recipients in British Columbia and Ontario. In exploring the development and extent of this medicalizing trend in the two provinces, and its more intensified form in British Columbia, we shed light on the critical gendered effects of ostensibly gender-neutral welfare reform.