Having breakfast one morning with her daughter, Italian photographer Guia Besana took a sip from her mug. Hot coffee spilled down her. "There's something strange about you, mum, it's your mouth," her 10-year-old daughter said. Sure enough, when she checked in the bathroom mirror, one eye was gaping open, her mouth drooped down on the same side. Terrified she was having a stroke, Guia jumped in a cab to the hospital where the doctors explained she was suffering from Bell's palsy, a temporary paralysis of the facial muscles.

Over the next three months, while her condition was at its most acute, the world appeared to her in a new way. "I had to use a straw to eat and tape my eye closed in order to sleep," says Guia. "It was a nightmare." Suddenly she found herself conscious of other people's gaze – voyeuristic glances from strangers; concerned looks from her family. "I wasn't privileged anymore, and it made me realise what it means to be privileged," she remembers, two and a half years on, and almost completely recovered. "That change of perception interested me."

The Barcelona-based photographer began to research 19th century freak shows, coming across the figure of Julia Pastrana, a Mexican woman born with a genetic condition that meant her face and body were covered in hair. Exploited and ridiculed, Julia appeared in a show, The Ugliest Woman in the World. Here, Guia discusses how her latest project, Strangely Familiar, is inspired both by Julia's story and her own experiences, and how it fits within a wider approach of using fiction to reflect on the realities of being a woman today.

"I can't compare my experience with her life, but it was the spark. I wanted to explore her isolation, her solitude and also her resilience. For me, that experience made me a better person. I remember sitting on a bus where everybody was looking at me. One woman in particular seemed disgusted. This inspired a picture in the series showing a group of people in the fog, which is about the randomness with which you're born into a situation. There is no justice. I wondered about the lives of these other people, of this woman. Freak shows existed to make people feel better by seeing that someone else's life was worse than theirs. That still exists today – in the way we judge each other on social media, and on that bus."

"Yes. Women have this pressure to be perfect, aesthetically. But these are the different ideas that you can bring to the image. My work always starts from me, from a personal situation, and then I slowly universalise it. I don't have one audience or one meaning in mind – it's about creating discussions around the topic."

"She's a Russian friend of mine who's posed for me before. I needed someone to be available as I was shooting this whenever I could fit it in between assignments as a portrait photographer. The other models are street cast. When you use a professional model, they only give you one thing and that's it. People who aren't models can give you much more. Or they give you something less and that's interesting in a different way. Photographically, you become more creative because there's an exchange, they are participating in your creative process."

"Often it starts with the location. I see a place I like that matches up with an idea in my mind and I start working around it. These pictures aren't scenes taken directly from the life of Julia Pastrana; they explore the things that connected us. My process is about composing. It's about trying to find things in the real world – locations, costumes, people, props – that best express my thoughts. I shot these images on a Canon 球探体育比分_欧洲杯足球网乐￥在线直播5 and a Canon RF 50mm F1.2L USM lens, using a tripod. The focus on the R5 is incredible, and the RAW files are huge, which is important for fine art photography, especially as I like to print my work large-scale when I exhibit it. I also find it to be such a customisable camera – you can set it to follow your way of thinking, which makes the process run smoothly. It's like a best friend to me!"

"I showed the work to an Italian photo editor, who encouraged me to continue, and then I won the 2012 Amilcare Ponchielli GRIN award. That recognition showed me there was space for this kind of storytelling that came from reality but was fictionalised. I'd also started to feel that travelling around the world and telling stories of different cultures was problematic. In the 1960s, '70s and '80s, big photographers would have the budget to spend months covering these stories, understanding them. Now, this is rarely possible. If you're travelling to different places, it's hard to truly understand the situation. By telling stories in this other way, I could be honest. I felt freer."

"No. There are photographers that are men who do this. It's more about a need to expel something. My focus on female experience is because I'm a woman. Then again, if I'd been a man, I wouldn't have gone through pregnancy so maybe I would have continued with my journey as a photojournalist. Is it because I'm a woman that I make this kind of work or because being a woman made me see things in a different way? This is up for discussion. If you ask me, 'Do you consider yourself a feminist?', of course I would say yes, but that wasn't the point when I started. The point was to explore the things I was feeling and express them."