So Many Ways to  Sleep Badly, the second novel by radical queer activist and outrageously snappy dresser Mattilda Bernstein Sycamore, comes out this month after several painstaking years in the making. "It's about when you get to a point in your life and nothing is coming together as you expected," says Sycamore, "and you face the overwhelm of the everyday."

Sycamore has edited several anthologies of writing on queer and gender politics, as well as published two works of gloriously disjointed autobiographical fiction. Like her first novel Pulling Taffy, So Many Ways to Sleep Badly offers up the events of Sycamore's own life in a frantically paced stream of consciousness narrative. Her writing swings between poetic and horrifying as her ambiguously gendered central character lies awake in San Francisco's rundown Tenderloin district, disturbed by roaches and rats and the real or imagined pigeons in the ceiling of her apartment, before taking off to service a variety of seedy men in the city's most expensive hotels.

"For me what makes it a novel is not necessarily whether the exact events that happened in the book actually happened to me — most of them did," says Sycamore. "Memoir has become that dominant publishing industry buzz word for anything considered a little different. But, as we know, most of those memoirs are just lies. So I'd rather express my truth in fiction than present lies as if they are something that actually happened to me."

So Many Ways is very different in style from Sycamore's anthologies, but her politics are still present in the characters and their lives. Through the central characters' sexual adventures and fluctuating gender pronouns we glimpse what it means to be radical and queer through clashes between police and activists, yoga and stories the sex industry.

"The narrator in So Many Ways is a hooker, as are many of her friends, and she's gotten to a point where it interweaves every part of her identity in certain ways," says Sycamore. "It's allowed her to have a life that is sort of challenging and liberating, but at the same time it's infused her sexuality to such an extent that it feels like a trap."

The sexual ambiguity of the central character and her friends forces readers to continually amend their perceptions of those characters. "The narrator of the book is a flaming creature of sorts," says Sycamore. "So many of the characters are living lives that are fluctuating between different gender choices and also transitioning between gender identities. And it was really important for me to convey that that's familiar, and to portray people's lives in a very gender fluid transgressive experimental world."

The world she describes exists not only on the fringes of mainstream society, but also on the fringe of San Francisco's queer communities. "The gay establishment has this whole notion of community that doesn't actually mean creating a safe place for queer youth to get away from abusive homes and find their own sexual splendour," she says. "It means having homeless queers arrested in our neighbourhoods for getting in the way of happy hour, or being gay realtors and advising our clients on how to evict all those people with AIDS.

"That assimilationist agenda has a stranglehold over all the dominant representations of what it means to be gay or queer, and is unwilling to allow a conversation between queers. I think that's one of the biggest tragedies."

Another theme that emerges alongside the book's political battles is the struggle the protagonist undergoes with chronic pain, which gradually begins to limit her most basic tasks. Sycamore's own methods of coping with fibromyalgia, meanwhile, informed the novel's structure from its inception.

"I reached a point where I was in so much pain I couldn't write like I used to," she says, "and I thought, 'How can I make this a strength rather than a limitation?' I thought, 'I'm going to write two paragraphs a day and have no intention of plot or structure.' And what was so exciting was I ended up having 400 pages.

"There's this mythology that we have to sit down for six hours in the morning and act like we have a corporate model full-time job and if we aren't sitting there we're just worthless and we're never going to write anything. What I learned from this was that I could write just paragraphs a day and end up having this huge manuscript."

The novel's conclusion will disturb some readers' sense of order. Loose ends are not tidied up neatly in the last 10 pages, and there is no resolution of the central romantic interest.

"We're supposed to have this narrative in novels: beginning, conflict resolution, etc. And I hate that narrative and I don't think our lives have that narrative," says Sycamore. "I wanted it to be less tidy than that, more messy, and to me that's more honest. I'm fine with confusing a few people."

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