In the spring of 2020, comic book author and illustrator Maia Kobabe (who uses e, em, and eir pronouns) was in search of a new project. E had just published Gender Queer: A Memoir (Oni Press, 2019), which, for the past three years, has been the most challenged book in America. In the memoir, e talks about binding, a gender-affirming practice that the University of California, San Francisco’s Transgender Care Navigation Program defines as “the use of tight fitting sports bras, shirts, ace bandages, or a specially made binder to provide a flat chest contour.” Social epidemiologist Dr. Sarah Peitzmeier, who currently works at the University of Michigan, had enjoyed Kobabe’s book and, noticing the content on binding, emailed em asking if e wanted to collaborate on translating the results of Peitzmeier’s research about binding into a comic. Maia agreed, and the result is Breathe (Dutton, May 7), which uses composite characters to translate Peitzmeier’s findings into practical, inclusive language accessible to those who need the information most.

Over Google Meet, I spoke to Kobabe about eir love of locations and homes, eir experience collaborating with an academic, and eir feelings about the struggles against censorship and for gender-affirming care. Our conversation has been edited for length and clarity.

What was your initial vision for the project?

Sarah [Peitzmeier] has done studies on many queer health–related topics, but she realized that her academic papers were not accessible to the communities she was trying to reach. Our first idea was to make a zine that we’d release online for free or print inexpensively for use by LGBTQ centers, therapists, and doctors’ offices. It was only after we’d been working on [the project] for almost three years that my agent suggested pitching it as a book.

The text is taken directly from Dr. Peitzmeier’s interviews. What was it like working with existing words rather than your own?

I’ve done some journalism and nonfiction comics in the past. But it was a new experience to work with a co-author who’s a researcher, not a fellow artist or a writer.

Sarah sent me a compilation of quotes from interviews she and her team had done with 25 trans and nonbinary folks who had bound at various points in their lives. Her research team had compiled the quotes into thematic groups in a 35-page Word document, so I wasn’t reading just one individual’s transcript. Sarah’s team had grouped the quotes by people who had run into a specific health issue, or had similar insights about gender euphoria and mental health, or people who had been binding on and off for decades and had had really different experiences over time.

If you never met the participants, how did you come up with sketches for the characters?

We invented people around the stories. The research encompasses people from, I think, 18 years old into their 60s, and people of different body types, people of different races. It was a diverse group, and we wanted to reflect that while also showing some of the common threads that many people experience. Looking at the demographics of the participants, I thought one of the characters should be white, one should be Black, one should be Latinx. One should be a high school student and one should be in their 50s. Some should want top surgery, while others should feel unsure about it. We wanted to be able to show those different experiences.

I came up with eight different character options, and we talked about which ones seemed like the best fit for each storyline and how to get the best range.

The character you called “C” felt Asian American, which made me feel represented.

That was the intention, so that’s great!

The characters all inhabit such distinct visual settings. How did you illustrate their worlds, considering you couldn’t meet them and visit their spaces?

I really enjoy designing locations and homes, and I also think it’s important for visual storytelling. I found a gallery online on Autostraddle where over 150 queer people had submitted pictures of their bedrooms. There were all these beautiful pictures of queer spaces, sometimes empty, sometimes with people, couples, pets. I remember picking specific bedrooms for inspiration. The first character in Breathe is in their early 20s and is a recent college grad. I decided their bedroom was going to have posters and fairy lights, and they’re also really into fashion, so they’ve got a big closet.

For the youngest character, who’s 19, I have a friend who’s the parent of two nonbinary high schoolers. I actually snapped a picture of one of these high schooler’s beds that was covered in Squishmallows and stuffed animals and had a pride flag on the wall. I was like, All right, this is the bedroom for this character!

This book is coming out at a time when gender-affirming care is under unprecedented attack. How does it feel to see the work go to print at this moment?

Trans health care in general is a deeply under-researched topic. So many people who are not trans, not doctors, and not experts will make wild claims about which kinds of health care procedures should and should not be allowed for trans people, without ever having spoken to a trans person in their life. It’s very frustrating.

As someone in the trans community, I know people who describe having gone on hormones as quieting this loud, annoying sound in their brain, like an alarm bell they hadn’t realized they’d been living with their whole life. Suddenly they feel like they can think more clearly, because their brain isn’t screaming at them all day. This is just one anecdotal example, but I can promise you that the ability to transition deeply improves people’s lives. It has improved mine.

This particular project gained more and more urgency the longer we worked on it. Sarah reached out to me before the challenges to trans health care we’re seeing now. We started this book feeling it was important, but as we worked on it, the book felt more and more necessary. Binding is one gender-affirming tool that’s very hard to ban, since it’s not prescribed by a doctor. It’s important to teach people about binding safely, especially if it becomes the last resort left to trans and nonbinary teens in states that have banned trans-affirming care for minors.

What can readers do to support you and other authors of banned books?

The main thing I would say is, “Please utilize your public library.” It’s especially helpful to put books on hold before they come out. If libraries get a lot of these pre-order holds, they’ll know that the book is going to be in demand, and they’ll buy additional copies. If a book you want isn’t available in the library, suggest that they purchase it!

Even though I’ve been the most challenged author in the U.S. for the past three years, I’m not as close to the front lines of this [issue] as public librarians and school librarians are. People come into their workplaces and accuse them of unbelievable things; they’re under so much pressure and are working so hard to keep libraries open, books on shelves, and information available. So please use your library, thank your librarian, and, if a book is challenged in your area, please show up and support the freedom to read.

Mathangi Subramanian is a novelist, essayist, and founder of Moon Rabbit Writing Studio.