This chapter discusses the concept of reality or realities in which the subject is immersed; and the concept of subject with which people work, both in theory and in clinical practice, especially in relation to processes of sexuation. It focuses on the relation between these two concepts: subjects and their realities, since people may separate them only for the purpose of discussion. The discussion of realities enters a complex field in which people inevitably refer to the relation between psychic reality, material reality, and historical reality. It becomes indispensable to think about the relation between construction of subjectivity and sexual and gender difference. The concept of a subject in process also implies that there is no single act of constitution of sexed subjectivity but instead multiple foci and areas of production of subjectivity. The “subject at intersections” is also a subject in relation to otherness.