“Scar tissue doesn’t bleed”

When it came time to discuss “Therapeutic Phlebotomy” in our editorial meeting where all editors and readers come together to discuss every piece that’s been submitted for consideration, there was universal excitement and universal unease. None of us had ever read anything quite like this before. What would readers think? There was so much blood! Still, we knew we had to publish it, with the attendant content warnings.

When Olivia signed on to our Zoom interview call after agreeing to talk more with me about body horror, it was from her messy bedroom in Brooklyn. A Hitachi Magic Wand hung casually over the closet door knob. Over the course of an hour and subsequent emails, our conversation ranged over blood, pelvic floor therapy, differences between trans and cis body horror, and including pleasure past the end of capitalism. It seems fitting to have this interview launch our new series of interviews with writers in our pages and beyond.

This interview was conducted over Zoom and email between May and June, 2024. It has been lightly edited for concision and clarity.

Cal Angus (CA): Hopefully I’m not reflecting any blindspots in my reading habits, but I don’t think I’ve ever read such a vivid, uncompromising depiction of dilation and post-SRS experience in a work of short fiction before. Can you share a little behind your decision to begin Therapeutic Phlebotomy inside of this intense moment of physical pain for Sophie, the main character?

Olivia Madeline Abigail (OMA): When I started it, I was pretty much exactly where the character is. Maybe a little bit farther out, but still at the point where I was in pain everyday, bleeding everyday. Dilation was really unpleasant. Basically everything that is happening to her in that story is what I was feeling when I started writing it. And then it kind of sat for a while. What I basically started with was this anxiety I had right after surgery, which was like, ‘I’m gonna do something wrong or push my body too hard, and all of these stitches that are holding everything together will burst, and everything that has been so carefully rearranged is just going to flop out.’ Which is what happens in the story. I did have some what’s called “wound separation” or dehiscence, which is when stitches burst. You know, it was like one or two, but it was really freaky because there’s a lot of blood, and it happened more than once. So that all happened in the first month or two after surgery. And after that it was scary! But the kind of total collapse that happens [in the story] is not something that would actually happen. It’s not really physically possible for that to happen. It was kind of just an exaggeration of an anxiety. 

CA: Even though your story approaches Sophie’s experience with care, it definitely doesn’t compromise on the horror. There is a lot of blood! And yet, I wouldn’t call it a violent story by any means, which is so often associated with lots of blood, despite the fact that many of us who are not cis men have spent big chunks of our life dealing with blood and other bloody incidents in relation to our bodies. 

OMA: Yeah, I love blood! [laughter] I think blood is so incredibly cool. And part of that is a bit of a physiology background I have, and just because it has so much symbolism. It’s kind of gorgeous, and it has so many interesting properties, like the way it congeals and the way it hardens. I love when you drop something on your big toe and you get a blood blister and it moves out over the course of a year. I’m a huge fan of blood. But I make a joke that trans women do get periods, we just get them all at once if we have surgery [laughter]. And it kind of just happens for nine months for those of us who get bottom surgery. 

My background is in exercise science, just a little bit, and in physical therapy, and one of the really important things actually to heal an injury is blood flow. So you hear R.I.C.E. – Rest, Ice, Compression, and Elevation, which is meant to decrease blood flow, and that’s good for the immediate days following the injury. But after that you want to do things that increase blood flow without reinjuring, like warm compresses, gentle movement, that kind of thing, because blood actually carries nutrients and proteins from food which are the things that help rebuild tissue, and so if something is bleeding, it’s healing. My pelvic floor PT actually–my surgeon is one of the few I know of who refers to pelvic floor PT, which is quite frankly criminal that it’s not standard, in the same way that it’s criminal that it’s not standard for postpartum people–I would come into her and I’d be six months out, seven months out, and I’d still be bleeding everyday, and she would say “no no no, this is a good thing because that means the healing hasn’t stopped, because scar tissue doesn’t bleed.” So it actually really helped me to have that perspective that ‘yeah, it sucks that I’m bleeding everyday, but it’s actually a sign of healing.’ So that’s a little bit on my blood fascination [laughter].

CA: During the editing process, you shared with me that you love writing and thinking about ‘body horror,’ but that you tend to approach it through a lens of awe. What does body horror mean to you, as a genre or an experience? Why do you think it persists in contemporary speculative fiction, and/or in trans fiction specifically? 

OMA: You know, there’s so many different types of horror. I used to really hate horror as a kid. I hated horror movies, I didn’t want it, I was scared a lot, and if I ever saw something that scared me, one of the things I would do to self-soothe is say to myself, “Well that couldn’t happen to me because X.” So like, if these people were in a haunted house, I’d say, “Well that couldn’t happen to me because I live in an apartment.” But everybody’s got a body, right? You see an alien burst out of someone’s chest–everyone’s got a chest, you know? So I think that’s part of the sticking power and why people have really strong reactions to it. 

Actually, right before we got on this call, I saw a video earlier today of this thing that barbers and dog groomers can get, where they get hair splinters in between their fingers, and they get enough of them and don’t remove them that it forms a sinus, which is like a permanent canal that they can get embedded in. And there’s these videos of them just pulling hair out from in between–I mean, it’s foul, but also I couldn’t stop watching, you know? And there was some disgust in that, like I definitely felt a little queasy and uneasy, so I don’t think it’s like exclusively awe, but I think, you know, I’ve had to deal with a pretty significant, like–my body was pretty fucked up for awhile! And I had to deal with that, and I think one of the ways I dealt with it was finding meaning a little bit, or trying to find meaning and trying to… I don’t know, meaning is maybe not the right word…

CA: I was thinking while you were talking about disgust and awe together. I was thinking if we tease apart the word ‘awe’, and how it connects to other words like ‘awful’ which have sort of lost their nuance of meaning. Like now we think of the word awful as just a horrible thing, but in the etymology of it coming from awe, it’s actually a very complex response to something. It’s amazement, it’s disgust, it’s terror and also can’t-look-awayness.

OMA: I guess what I’m thinking of when I say awe is this tendency we have to think of ourselves as brains piloting meatsuits. Like, ‘we are our brain, and we move our body around and it’s the home for our brain.’ And I think dealing with a surgery and chronic pain in myself and in other people, one of the biggest things I have learned is that we are also our bodies. Our brains and our bodies are not separable. The things that affect our bodies affect our brains and vice versa. And I think the awe is this sort of distortion of the self that comes with body horror, when something is happening to your body that’s not normal it threatens your understanding of how your body functions, and I like how that change in basic function expands from being just this thing that’s happening to my body to this thing that’s happening to me. And sort of dealing with disruptions in the barrier between one’s self and the rest of the world. 

CA: Yeah, totally, I think that’s really beautiful. And having that knowledge of your physical therapy background makes that resonate in a new way for me, too. Maybe to bring it back to the story a little bit, I love how this story swings between extremes of pain, pleasure, and confusion, and yet you still resist an explanation for Sophie’s situation. Does this movement mirror the writing process at all? Did you set out to write the story like this, or were there some similar surprises along the way?

OMA: Yeah, so I think when I started writing this, all I knew was that I wanted her vagina to fall apart. [laughter] And I didn’t really know what was gonna happen after that. So I wrote basically up until that point, and then I got stuck. I was like ’I don’t actually know what comes after this. And it just kind of sat for awhile, and I had this idea that originally what I was thinking would happen was over the night that she’s in the hospital, the kind of tendrils that used to be the vulva start creeping up over the rest of her body and start sealing her inside out. And it would be this kind of like scar tissue that forms the kind of odd lump that she is at the end. So the transition originally was that that would be the action that’s happening on the page: falls apart, goes to hospital, and then just kind of an unnerving description of that happening. But it wasn’t coming out. And then one day I was on the train, and suddenly I was like, ‘oh, I know what’s got to happen.’ I found myself writing this thing where she’s kind of investigating herself and almost going so inward and being absorbed by the wreck of her vagina. And I don’t know, maybe there’s something about that where she’s kind of eaten up and turned inside out by it. 

CA: You’ve mentioned before how the push-pull of body horror is that fear of the body changing and the self changing, or feeling dissociated in the move between the two and what’s happening to yourself that you can’t control, and I’m curious: do you think body horror is important to read or write right now? Is there anything about our particular moment in time that calls for it or pushes it away? And if you don’t have an opinion on that, that’s okay.

OMA: Oh yeah, I have thoughts. I don’t have a simple answer for that because the realities that everyone lives in right now are so stratified, you know what I mean? The concerns for day to day life are so different for like, people in the United States versus elsewhere in the world, and people in wealthy areas etc. So I think it’s interesting because–I saw a video awhile back actually saying that [the HBO series] Succession is a metaphor for climate change, in this way that these uber wealthy people are basically above everything except for their own bodies. The point they make is that capitalists have essentially plundered the world, and in doing so they have decimated the planet for the purpose of bringing profits up to a few people, and they can use those profits to escape most things, but the thing they won’t be able to escape is if the entire Earth ecosystem collapses. So I’ve gone a long way from where we started…

CA: No no, I can see how you would connect that to body horror as tapping into those–

OMA: Yeah, I think it’s just important for people to be reminded that they have bodies. And for some of us, like, we are reminded that we have bodies everyday because our bodies don’t cooperate with what we or what society wants of them. And I think also, in terms of envisioning what new worlds hopefully post-capitalism will look like, we can’t forget the physicality of it. I think we can get caught up in the ideology, and how things should be in terms of larger social structures, but I think at the end of the day you can’t forget how people get fed, how people rest, how people are able to care for their bodies. 

CA: And the pleasure of it, too, yeah?

OMA: Well I would hope so! [laughter] I hope that there’s pleasure, too, beyond just care. I think that a lot of the time so many people are not able to find that much pleasure in their bodies because in a capitalist system your physical existence in your body is your capital, and you are spending it everyday to go to work. Like I work in an office, I sit for eight or nine hours a day, and it wrecks my body in such a specific way. Everything gets tight, my back hurts all the time, my energy is low, and it’s on my mind a lot. Like, I’m not only sacrificing all this time, I’m sacrificing my physical health, and there’s actually not much I can do about it right now because I can’t afford not to [work]. So bringing things down to that kind of base level of ‘what does my body physically need? What do I need around me for my life to feel fulfilling?’ is kind of indispensable in terms of what we might hope for what our lives in the future might look like. 

And I’ll say also, with all of the campus occupations happening now, you notice that as soon as physical space is occupied in a permanent way–you know, in general with all the marches, there was some police violence, but it was nowhere near the level we’re seeing when students are saying ‘this physical space is now ours.’ So I just think the importance of our bodies in space can’t be overstated.

CA: Is there a difference to you between trans body horror and, er, cis body horror (for lack of a better term?) This could also be framed as body horror written by trans writers versus body horror by cis writers, I suppose. 

OMA: I’m hesitant to say there’s any fundamental difference between trans and cis body horror. In practice, I don’t think I’ve read enough body horror by trans writers to make any kind of definitive statement. One of my favorite trans writers, Alison Rumfitt, makes excellent use of horrific things happening to bodies, but the standout instance of that for me is in her novel Tell Me I’m Worthless, in which the physical contortion of a character viscerally drives home a philosophical point about fascism. While transness is definitely in the soup there, the dread that scene creates is not making a statement on transness. On the other hand, Octavia Butler’s short story “Bloodchild” is one of the most transgender stories I think I’ve ever read. Even in its most shocking moments, the story is shot through with tenderness. Certain scenes remind me of the feeling of a needle wiggling in my thigh muscle as I self-inject–painful and repellant but profoundly intimate. Not to mention how the story flips the reproductive capacities of gendered bodies. 

I’m being intentionally vague here to avoid spoiling two really fantastic pieces of writing. But what I think I’m getting at is this: if you were to compare body horror by cis authors to body horror by trans authors, I’m sure there would be trends in each unique from the other. At the same time, I think you would probably find more than a few points of confluence, which is a big part of why body horror feels so powerful to me. Gender dysphoria is often touted as something it’s impossible for cis people to understand because it is diffuse and sort of centerless. But many of the embodiments of transness–for instance, the pain, fear, excitement, and joy that come with gender affirming surgery–are extremely visceral. Body horror disturbs us because it invites us to imagine sensations so immediate that they can’t be obfuscated by ideas of what and how human beings should behave. And while everyone isn’t trans, everyone does have a body and an imagination.

CA: Thank you–that is so great to hear. My last question is: what are you working on now? What shadowy realms will you explore next in relation to the body? 

OMA: I actually had quite a good writing day today, actually! I got a lot done. [laughter] That’s one of the benefits of the office job, is when I have downtime I can write. But of course I would never do it on the clock [laughter]. I’m working on a few things. One that I just started is a story of a woman who becomes a mermaid, but it’s not magical at all, it’s very very grounded in what would it feel like if you started growing scales and your legs fused together and your body felt wrong out of water. So I’m excited about the direction that’s taking. I have a longer idea that I want to try to flesh out over the next few years, surrounding someone who did a lot of black market gender affirming surgery, this guy John Ronald Brown, who had his medical license revoked after he killed a couple of trans women in surgery, and then continued to practice but didn’t get any kind of jail time until he killed a cis guy. So that’s gonna be very physically grounded, and there will probably be some ghosts or something like that involved. And yeah, so as far as the realm of body stuff that’s what I’m working on right now. 

CA: That’s so exciting! I can’t wait to read those, and in the meantime, I’m so excited for everyone to read your story in this issue. 

You can read “Therapeutic Phlebotomy” here.