Akwaeke Emezi’s Freshwater isn’t only a fine debut novel that announces the arrival of an exciting and talented new literary voice, it’s also a book that asks Western readers to reconsider what we’ve been taught to think about gender identity and mental health, not to mention how internal experience might be understood as well as expressed on the page.

Freshwater is the story of Ada, who, like Emezi, is born to a Nigerian father and a Tamil mother. Ada’s father Saul is a doctor, and his wife Saachi is a nurse. They meet and marry in London, but shortly thereafter move to Umuahia, the city where Saul was born, as was his father before him. It’s important for his child to be born here too, we’re told, ‘blood following paths into the soil, oiling the gates, calling the prayer into flesh.’

While her children — Ada has an older brother, and a younger sister — are still young, Saachi leaves them in the care of their father while she moves to Saudi Arabia, ten years of her life ‘contracted away’ in the desert. ‘And this is how you break a child, you know,’ we’re told. ‘Step one, take the mother away.’

Ada begins cutting herself when she’s twelve, boasting to her classmates at school about what she can do: ‘She raised the blade that she had taken from Saul’s shaving supplies, that double-edged song wrapped in wax paper, and she dropped it on the skin of the back of her hand, in a stroke that whimpered. The skin sighed apart and there was a thin line of white before it blushed into furious wet redness.’ At sixteen she’s digging into her arm with a shard of glass from a broken mirror. At twenty she steals scalpels from the veterinary school classroom where she’s studying to keep slicing away at her scarred flesh. By now, she’s living in America. And it’s here, in her dorm room in Virginia, that she has a first damaging sexual encounter:

“You need to get birth control pills.” His voice was calm, a pool of quietly congealing blood with a skin forming. […] He pulled on a pair of shorts as she sat in the cheap Wal-Mart sheets knowledge trickling like warm urine into her head, traveling down to her chilled hands. The words swirled in nausea around her. Birth control pills, because this boy, this boy with the doe eyes and the sad skin, had released clouds into her. But she couldn’t remember any of it and she couldn’t remember saying yes because she couldn’t remember being asked.

The trauma of this event births Asughara — an entity who ‘wasn’t human flesh […] just a self, a little beast, if you like, locked inside Ada’ — a being who finds herself ‘condensing into the marble room of Ada’s mind.’ ‘The first thing I did was step forward so I could see through her eyes,’ Asughara says. ‘There was a window in front of her face and one useless boy beside her. It was cold. I looked around the marble for Ada and there she was, a shred in the corner, a gibbering baby.’

Asughara arrives in Chapter Six, and quickly becomes the dominant narrator. The appearance of a new and strikingly different voice is like a jolt of electricity through the text. Not that Freshwater’s narration has been especially orthodox up until this point. The first five chapters are narrated in the first-person plural, a ‘we’ that both constitutes Ada and exists within her. This ‘we’ refers to Emezi’s protagonist as ‘the Ada’ or ‘she (our body).’ When Ada first begins cutting herself, the ‘we’ describes these actions as ‘sacrifices that were necessary to keep us quiet, to stop us from driving her mad.’

My first instinct was to interpret these different narrators as the manifestation of a mental illness, what we might understand, in line with Western psychiatry, as multiple personality disorder. The fact that Asughara acknowledges that she arrives in a moment of intense pain in Ada’s life — ‘I was a child of trauma; my birth was on top of a scream and I was baptized in blood’ — seems to corroborate this theory. It’s Asughara who gets Ada to cut her long thick hair into an androgynous crop. She stops Ada eating. She has Ada drown her sorrows in tequila, and indulge her appetite for casual sex. She hurts the people around Ada. She drives Ada towards destruction and obliteration.

I found further evidence — as I then saw it — for my theory in the introduction of Saint Vincent, a softer personality who sends Ada ‘to clubs with satin-padded walls and red velvet curtains, where he kissed women with Ada’s mouth.’ Ada begins dating women. She binds her chest so it’s flattened ‘into a soft mound of almost nothing,’ eventually having surgery to significantly reduce the size of her breasts. Such narrative experimentation has the potential to be jarring, but Emezi handles these multiple voices deftly. The ‘we’ is lyrical, almost incantatory; while Asughara’s voice, by comparison, is unaffected, confiding, the speech peppered with foul language and Nigerian colloquialisms. It’s a voice marked by bursts of anger and desire. Meanwhile, on the rare occasion Ada does speak, it’s in a voice that’s exhausted, quiet and deflated. ‘I don’t even have the mouth to tell this story,’ Ada explains, ‘I’m so tired most of the time. Besides, whatever they will say will be the truest version of it, since they are the truest version of me.’ This control is so absolute, it’s tempting to suppose that Emezi is writing from real, firsthand experience.

This is where context becomes integral. Freshwater isn’t memoir, but it does draw on Emezi’s own lived experience of dissonant identities, which include being gender non-binary and trans. And, as in Emezi’s own life, rather than pathologise these experiences, or read them as evidence of demonic possession, Ada’s complex interiority – Emezi has made very clear that her protagonist is a ‘singular collective’ or ‘plural individual’, a single self constituted by this chorus of voices – ought to be understood in terms of traditional Igbo cosmology. As Emezi explained in a personal essay published in The Cut, Ada is an ogbanje. That is, ‘an Igbo spirit that’s born into a human body, a kind of malevolent trickster, whose goal is to torment the human mother by dying unexpectedly only to return in the next child and do it all over again.’ Asughara pushes Ada towards suicide, but Ada survives. Thus, Freshwater explores what it means for an ogbanje to live, something that rarely occurs.

Emezi first considered the possibility they might be an ogbanje at the same time as realising they were trans (they’ve since undergone a breast reduction and had an elective hysterectomy). But it took a while for these two realities to ‘collide’. Initially, Emezi wasn’t sure if an ogbanje even had a gender:

However, being trans means being any gender different from the one assigned to you at birth. Whether ogbanje are a gender themselves or without gender didn’t really matter, it still counts as a distinct category, so maybe my transition wasn’t located within human categories at all. Instead, the surgeries were a bridge across realities, a movement from being assigned female to assigning myself as ogbanje; a spirit customising its vessel to reflect its nature.

It’s a fascinating approach to gender dysphoria, one that animates Freshwater with an intelligence, insightfulness and grace that’s rare to encounter on the page, let alone in a debut novel.

When New Yorker staff writer Hilton Als interviewed transgender activist Janet Mock as part of last autumn’s New Yorker Festival, she spoke about how important it had been having a teacher who was māhū — a third gender that is recognised in Hawaiian culture (Mock grew up in Honolulu) — because it meant seeing people who were trans, who didn’t identity as either male or female, simply existing in the ordinary everyday world around her. Hearing both Mock and Emezi’s stories reminds us that although Western medicine has the wherewithal to physically transform bodies, it still adheres to a reductive paradigm through which these bodies are made to conform. Looking towards other cultures offers us radically new ways of thinking about gender identity, but so too, encountering these ideas through the lens of fiction – as in Freshwater – offers readers a particularly instructive way of decolonising our own understanding.