SARAH Kane's reputation for the singular and extreme now goes well before her. And she doesn't disappoint. After Blasted, Cleansed. After rape and buggery now comes drugs, incest, mutilation, trans-sexual gender transplant, and the phallus repudiated.

She puts us through it, no question, uncompromising both in language and in attitude - one-liners that shriek of banality yet acquire, by repetition, a certain lurid poetry. Is this the way the world ends, not with a bang but a new box, a new set of genitalia?

Kane's scale of imagery is ferocious and bleak, a Titus Andronicus for our day, if you will, but given, in James Macdonald's extraordinary Royal Court production a very Euro-glossy detachment and precision.

Beds, concentration camp fencing, hospital walls fly in at perilous angles. Suzan Sylvester and Martin Marquez's brother and sister, caught in incestuous passion, dangle like floating angels before being spattered by bullets. Reality and fantasy fuse, merge. Naked bodies are everywhere.

Love, passion, and betrayal is clearly Kane's game but prejudice is the real target of Cleansed - a full-frontal metaphor of rage against homophobia and a phallocentric society prepared to go to any lengths to silence non-conforming forms of love.

Actually, it's not that simple. Kane's message seems confused and complex - both desirous of the phallus (to the point of acquiring it surgically) and damning; a Freudian nightmare. And she over-states her case.

The unremitting brutality of Kane's vision (Stuart McQuarrie's Tinker is the most evil twister since Mephistopheles) triggers its own law of diminishing returns. None the less both play and production remain a break-through; a decade ago, Kane's outrage would have been consigned to the fringe ghetto.

Cleansed runs at the Duke of York 's to May 30