In simple, bold strokes of black on white, Emma Grove’s debut graphic novel begins and ends with a scene about a missing book in a therapist’s office.

That missing book sets up the mystery that Grove must solve in “The Third Person” (available now from Drawn & Quarterly), a memoir about how her goal of being approved for feminizing hormone therapy is stymied by a shocking discovery. Grove learns that she has dissociative identity disorder, or DID, in which one’s mind creates alternate personalities as the result of abuse and/or trauma.

While the condition is still poorly understood, cultural awareness of DID is growing in the U.S.; the main character in Marvel’s new Moon Knight series is more or less coded as having the disorder. But back in 2004, when Grove began therapy, the signs and symptoms were much less recognized even by trained mental health professionals.

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The experience of writing the book was “healing,” Grove says. “I thought that for somebody else going through that same experience – of having DID, of facing discrimination as a trans person – seeing what I was going through would maybe make them feel less alone.”

With dialogue remembered from her sessions, Grove narrates the time she spent in the office of an out-of-his-depth therapist named Toby, her transition to living as a woman and the growing understanding of her separate identities, why they might have appeared and their roles in her life.

The following interview has been edited for length and clarity.

Q. How did you decide to start and end your story with the scene about the missing book? 

When I started writing the novel, it was about transitioning. I couldn’t remember much from my months in therapy other than that I had been diagnosed as having dissociative identity disorder, but the thing that really stuck out in my memory was that at one session, I brought in a book. I went to reference it a minute later, and it was just…it just vanished.

So I started to write out the dialogue from that session to try to sort out what happened, and then everything just kind of flooded back to me. And I just started filling up page after page after page of what I remembered. It was almost like automatic writing – once I started writing, all the memories just kind of flooded back. But the memories didn’t come concurrently; I wasn’t remembering them at the same time.

I had to remember everything I could as Emma, as myself. Then I took a break for a day or two. Then I hashed out everything I remembered as Katina (one of Grove’s identities). And then I basically put the two together; I literally cut and pasted them together.

All I remembered was that the book vanished…but when I wrote out the parts that I didn’t remember previously, then I was able to see what happened with the book.

Q. The goal of the journey remained the same, to transition, but it felt like the health care barriers kept changing. Can you talk about that?

Initially, I didn’t know why Toby wasn’t approving me (for hormone therapy). I just had no idea. For the first few months, he kept alluding to the fact that he was seeing something in our sessions, but he wouldn’t tell me what it was. When he finally told me it could be DID, I started to confront it. I thought, “Well, if I can just deal with it and try to get mentally healthier, then he’ll approve me.”

One thing a friend asked me is why, when Toby started saying certain things, I kept seeing him. He did admit that he wasn’t qualified enough to treat me. It was partly because I’d seen him for so long, and I’d spent so much money on the therapy.

Q. Some of the therapy sessions feel like relationship counseling; did you lean into that on purpose? 

One thing I liked about writing about me and Toby was that I could step outside of myself and see things from his perspective, to see what he was thinking and feeling. I found the dynamic between us really, really interesting.

I also tried to show that the relationship between you and your alters is actually very real. At one point, I actually thought of naming the book after my alter Katina, and having the whole book just be about her. It was almost like having a sister and a best friend all rolled into one. I really tried to show in the book our relationship and what she meant to me personally.

That’s why I stopped working on the book that was just about me and my transition. I don’t find myself particularly interesting; what I find interesting is relationships with other people. So the relationships between me and Toby, the relationship between me and other people, the relationship between me and my alters – that was what I found interesting. And I think that’s honestly what other people find interesting, too.

Q. You can convey a lot of emotion in a simple line drawing. How did you develop your art style? 

I’m an animator, so I’m used to drawing really, really quickly. When I was younger, I studied quick-sketch artists that could do an entire drawing in 30 seconds.

For the book, I had sheets of paper folded over to represent panels, and would write out the dialogue and just scribble in the characters. I would not only remember the dialogue but the way that the therapist was sitting, the way I was sitting. I remembered the hand gestures, I remembered what I was wearing – everything came back to me in a flood. The memories were just coming out of me really quickly, so I was trying to just get them down before I forgot what happened. I could sketch out 25 pages in like a half hour.

Me being an animator was so much a part of my identity that I had a whole gigantic section in the book on my animation career, working at a studio in Boston and moving out to Los Angeles. I started to really come out more in Los Angeles and go to transgender-friendly clubs. But I had to eliminate that section because I just really wanted to focus on therapy with Toby and the relationship with my alters.

Q. Will there be a continuation or sequel down the line, with some of the things you had to leave out? 

The book was so personal, so revealing. I was wiped out for months mentally and emotionally after working on it. Immediately after working on the book, it was really hard to look at it because a lot of what happened was so painful. I just needed to take a break. I wasn’t proud of how I acted in a lot of parts. I’m living as a whole person now and trying to own what I said as my alter Katina, because it was still my body and my brain.

I started reading fiction again, and I think for right now, that’s where I’m at. I’d like to move on to writing fiction that maybe has autobiographical elements without having it be that personal.

Q. What would you want someone to take away from this novel, about therapy? About DID? About the transitioning journey overall?

The biggest thing I learned from writing this book is how imperfect everyone is. We’re all flawed. That’s one of the things I’d like people to take away.

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I think as far as dissociative identity disorder goes, there are a lot of people nowadays that still think that it’s a myth. When I was writing the book, I didn’t have explanations in captions of what was going on. I just wanted to show people what happened and let them draw their own conclusions.

The book took three years to finish. If it was just about me, I think I would have given up on it after a year or two. But the one thing that kept me going was that if it helps even one other person to feel less alone or to seek help, then it will have been worth it.

I think the main message of the book that I would want people to take away from it, and that I get from it personally, is that it was really about healing. I hope that the book is healing for somebody else – that it shows people no matter what pain you’re going through, no matter what turmoil, no matter what conflict, no matter how bad things are – that you can heal, and that things can get better. And that there’s always hope out there.