In early 2020, Maia Kobabe (e/em/eir) was wrapping up promotion for eir memoir Gender Queer when e received an email out of the blue from Sarah Peitzmeier, a social epidemiologist working in LGBTQ+ health at University of Michigan in Ann Arbor. Peitzmeier, a fan of Kobabe’s work, wanted to collaborate with em on an illustrated guide based on her research on current chest-binding practices. The resulting book became Breathe: Journeys to Healthy Binding (Dutton, May).
Since the two began working on the project, Gender Queer has become the most challenged book of 2021, 2022, and 2023, and the demand for reliable health care information for transgender people has grown. American Libraries spoke with Kobabe and Peitzmeier about their new title, their collaboration, and the importance of making evidence-based information about trans health care widely available.
Sarah, what made you want to turn your academic research into a comic?
Peitzmeier: I do a lot of different types of research on topics like cancer prevention and gender-based violence prevention. But this work on binding has received the most public interest. I’m often getting emails from trans teens who, for example, want to show an article on the binding process to their parents but can’t read the academic journal. I heard from a high school marching-band teacher whose students were binding, but these students were overheating in their uniforms, and these conversations made me realize that there’s a lot of interest in this work. But the information is not published in a way that’s accessible to people who could really use it. I came across this idea of using comic books to explain scientific research and make it more accessible.
Kobabe: At that time [when Peitzmeier reached out], I had been binding off and on; I was never someone who bound every single day. I also had friends who’d had more issues with binding—some of the shortness of breath, overheating, rib pain, and so on. And as Sarah and I went back and forth discussing the project, I agreed that a comic or zine format would be more accessible to readers than an academic article, especially since many scientific articles are paywalled.
What was it like working together on the project?
Kobabe: This topic is very interesting and relevant to me. As we worked on it, the scope of the project expanded, giving us more space for character narratives and research data. For instance, we worked with a massage therapist and a physical therapist on stretching and breathing exercises to help with lung, rib, spine, and shoulder health, and it’s been wonderful to include these different resources. It makes me hopeful that other scientists might think of comics as a way to bring their research to the public.
Peitzmeier: The process of collaborating across our disciplines has synergistically expanded how we’re able to have an impact. It definitely feels like something that’s bigger than us, and that’s also been a joy to discover as we continue to work on it.
Why is it important to publish this book right now?
Peitzmeier: There were 300 anti-LGBTQ bills—many of them anti-trans bills—introduced in legislatures across the country in just the first month of 2024. So it’s increasingly clear this kind of work is really needed. And I was seeing some anti-trans groups twist my research and use it out of context as a reason why trans people shouldn’t bind. That didn’t sit right with me. I was really interested in a comic book and arts-based approach to resist that kind of manipulation, to be a resource in which one number can’t be taken out of context and put into a tweet.
I’m hopeful that this will help our research be read in context and in a way that will humanize the experience of binding for folks who otherwise have not been exposed to that viewpoint.
Kobabe: Any moment is an important moment to publish a book that presents accessible health care information. But the moment has also become more dire since we started working on the book. Book bans were not the same issue they are now when we started this in 2020. State-level bans on trans health care were not at the same level of severity as they are now. We started this because we’re passionate about the information, and as we’ve worked on it, it has felt more and more and more urgent the deeper we get into the project.
It feels very timely to talk about binding as a way of affirming gender presentation that does not need to be prescribed by a doctor. At the same time, a person experiencing negative effects might feel uncomfortable or unable to bring it up to a health care provider. We wanted to talk about ways to bind that are gentle to your body and will maximize mental health benefits and minimize any potential risks. We also tried to emphasize that, while chest binding is a very valuable tool, it should be one of many. Ideally it’s not the only thing you’re resting on to make you feel good in your body or in your gender or to get through your day.
Hopefully this can happen in the context of a supportive community. And if you don’t have that supportive community, the book can be a place to get information about how to do it in a way that will really work for you.
Peitzmeier: I also have a hope that in places within the US where you’re not allowed to mention gender identity in schools, trans youth will be able to go to their library and see our book. We also hope to publish a free abbreviated version online so that the maximum number of people—no matter what’s going on at your school or your library in your state—have access to the information they deserve to help make empowered and informed choices about their own bodies.
Apart from advice about healthy chest-binding practices, what do you hope readers will take away from this book?
Peitzmeier: That it doesn’t have to hurt to be you. In the absence of evidence-based information on binding, some of our research participants assumed that binding has to hurt and that is just the price to pay to express their identity. And we want to come out clearly and say that’s not true. If it’s not working for your body, there are other options, and we want to help you get the information and support you need.
How can libraries be a safe and affirming resource for transgender and nonbinary people seeking information like this?
Kobabe: I am so grateful to librarians. Just stocking the books and defending them if they’re challenged, as well as trying to make sure that these books are available in both the teen section and the adult section. Perhaps highlighting them with bookmarks, posters, or displays but also having them tucked in the shelves so browsers can come across them as obtrusively or unobtrusively as they need to.
Peitzmeier: I live in Michigan, two hours from a town that voted to defund their own library for stocking Gender Queer as well as several other books. I have so much respect and admiration for librarians who are standing up for these issues and believe young people deserve access to this information, and I hope they’ll showcase our work as well.
Kobabe: It’s hard for me to even think about how many human-effort hours have been put into fighting to keep Gender Queer on the shelves. I am deeply grateful for that work and also frustrated that it’s contested that libraries would have books for every type of reader. I’m very, very grateful to librarians, and I hope they will keep stocking trans books but also not at the risk of their jobs. Do everything you can, but don’t lose your job, and do what you have to do to keep the library open.
