A number of contemporary psychoanalytic writers have characterized gay childhood as a profoundly isolating experience. Within a developmentally informed self psychological framework, the loneliness of gay childhood is theorized here as a deficit in requisite twinship experience in early life. A detailed clinical example illustrates how these thwarted twinship needs may reemerge in the transference to the analyst, and how patients may escalate their acting out when the analyst misattunes to, or altogether misses, manifestations of twinship longings in the transference. A bridge between Freud's theory of the repetition compulsion and Kohut's theory of selfobject transferences suggests how specific moments of thwarted twinship needs may be repeated within the analytic relationship in an attempt to master the earlier experience. The experience of the analyst being pulled into the patient's attempts at mastery is detailed. A broader theoretical trend is hypothesized whereby psychoanalytic theories may have a pull toward twinship between each other.