ABSTRACT
The most recognizable manifestations of patriarchy occur as power differences between cisgender men and cisgender women. Yet the force of patriarchy is felt just as strongly in the LGBTQ community, in the form of prohibitions against ambiguous or “confusing” expressions of gender and sexual identity. Such prohibitions were the source of trouble for Duarte's patient Alex, a young transgender gay man who desperately longed to live out his “faggotry” but felt prohibited from doing so. Using his work with Alex as an illustration, Duarte offers a psychoanalytic framework for addressing the patriarchal forces impacting our LGBTQ patients. This chapter describes how Duarte uses Stern's (2010) notion of “chafing,” to detect and articulate patriarchy's enactment within the analytic engagement. He further addresses how patriarchy can be challenged clinically through the constructive use of play and the fostering of ambiguity and chaos.
