In a direct letter to the author Kathleen Miller (this issue), I take up her radical invitation to “call and respond, or call and call, respond and respond” to her rich, poetic writing in hopes of further “queering” her ideas that emerged from clinical work with her genderqueer patient, K (this issue). Such authentic exchange at the margins has the potential to “queer,” as verb: to keep critically unsettling conventional psychoanalytic thinking, dialogue and practice through clinical activism and (alter)theory. Further, I map Miller and K’s lived “radical openness” which makes “queer use” of poetry, performance and personal injury, onto the phenomenon of “queer environ-mentalization,” a term that emerged in my own clinical work with trans and genderqueer people who bring their lived experiences from the margins—between their internal experience and society’s normativizing of gender—into focus in the treatment encounter with them, skin-to-bone, which radically opens my mind and heart to the full authenticity of their being and our engagement.