Gender Wiki

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Transmedicalism is broadly defined as the belief that being transgender is contingent upon experiencing gender dysphoria or undergoing medical treatment in transitioning.[1][2][3] Transmedicalists, sometimes referred to as "truscum" by themselves or others,[3][4] believe that individuals who identify as transgender but who do not experience gender dysphoria or undergo a medical transition—through methods such as sex reassignment surgery or hormone replacement therapy—are not genuinely transgender.[2][3] Critics of transmedicalism argue that the belief pathologizes having a transgender identity, does not reflect the experiences of all trans people, and creates undue restrictions on access to transgender-related care.[5]

Sample Beliefs

  • Gender dysphoria ("body/physical dysphoria") is necessary is to be trans. (the only universal belief)
  • Transsexuality is a medical (neurological) condition characterized by the experience of gender dysphoria (incongruence)[6]
  • People without Gender dysphoria are, by definition, cisgendered (whether they're gender non-conforming or not)[7][8]
  • Gender "euphoria", when not simply the inverted impression left by poorly understood dysphoria, is BS and not a substitute.[7]
  • Medical transition is significant and carries weight[7]
  • While there are medical contraindications to HRT, cross-sex hormone therapy has significant effects that are meaningful to our lived experiences and the way we perceive and relate with the world around us[7]
  • Anatomy is modifiable surgically and otherwise, but while there are men with vaginas and women with penises, there are no female penises, and there are no male vaginas( Another explanation is that a trans person should have somewhat of bottom dysphoria, and have a desire to eventually get SRS, you don’t need SRS right away.. it’s very expensive, but you should have a desire for it nonetheless)[7]
  • "Trans" is not in and of itself a gender identity; it is a condition of being.[7]
  • Trans is an adjective describing a biological reality; it's not a gender identity by itself[7]
  • You may be e.g. an AMAB trans woman or an AFAB trans man, but trans is merely an adjective describing the disconnect between your birth sex and your gender identity[7]
  • Blanchard's theory on Transsexuality is not looked up to as a source generally and is believed to not hold up today on a logical standpoint . Trans women are not "Super gay men" and sexuality has no barring on your gender.[7]
  • Trans people can have any sexual orientation, as long as they have gender dysphoria they are valid.[7]


Invalidation of Non-Binary Identities

Many transmedicalists are accused of invaliding non-binary identities. However a survey of 100 Internet users, carried out by an anti-transmedicalist activist, potentially shows this notion to be false as transmedicalists will accept a non-binary person's gender if they have gender dysphoria.

Rationalwiki's article on transmedicalism

People have differing beliefs on nonbinary identities, but these beliefs have nothing to do with transmedicalism. For every anti-nonbinary transmedicalist you see, there are three or four pro-nonbinary transmedicalists. We're all different!

Transition is Mandatory

Another common myth is that we reject anyone who doesn't transition. There's this idea that we have this black and white mentality that anyone who doesn't transition, no matter the reason, isn't trans, period. This is completely false. As we recognize that transsexuality to be a medical condition, we also recognize that a condition is present regardless if one chooses to treat it or not. Therefore, it stands to reason that someone who choses not to transition, or cannot transition, may still be trans.

There are many valid reasons one may decide against transition - even if they could - including:

  • Fear of the potential health risks associated with HRT and/or surgery.
  • Fear of social repercussions.
  • Philosophical or religious oppositions against it.
  • Experienced dysphoria is not to such a level that warrants all the pain and hassle of medical transition.
  • Some people feel that transition is pointless because they can never truly become the other sex.

the transmedicalism on r/transmedicalism

While a lot of transmedicalists/truscum believe you should at least /want/, ideally, to have a more masculine, feminine or androgynous body, the VAST, VAST majority of us do not believe medical transition is necessary to be transgender. We recognize there are a huge amount of trans people who can't afford medical interventions, can't handle surgery or hormonal reactions, don't feel dysphoric enough about a certain trait to change it, etc.

Non-Passing & GNC

We do not reject people who are unable to pass. It's true that we do criticize people who are obviously non-dysphoric - who declare themselves as such - who put their birth-sex characteristics on display, but many of us acknowledge that a lot of dysphoric trans people are not in a situation where they have a lot of choice.

We are also not against GNC trans people; trans people who don't conform to the stereotypes of their (neurological) sex. We just tend to be skeptical of those who make absolutely no effort to pass, only to screech about being misgendered. The fact is, if you dress and look like a woman, you will be gendered as one.

the transmedicalism on r/transmedicalism

This is blatantly untrue. Plenty of transmedicalists don't understand /why/ someone would lower their chance of passing, but almost every transmedicalist supports GNC trans people wholeheartedly, and plenty of us ARE gender non-conforming ourselves.

Denial of Gender euphoria/gender incongruence

Every transmedicalist is different. Yes, some transmedicalists don't believe in gender euphoria, but it's not an inherent transmedicalist belief (and definitely not a reason to discredit anyone). The only inherent belief is "dysphoria is necessary to be transgender" and nothing more -- plenty of us simply count gender euphoria and incongruence as part of dysphoria. Heck, the first symptom listed at the top of this post is gender incongruence!

Concerns Raised by Transmedicalist


While moving transsexuality out from under the mental illness category was a good move - transsexuality is not a mental illness, because we are not delusional; there is a physiological basis for dysphoria - the transgender community aims to have "trans identities" completely demedicalised because they are afraid of the stigma associated with having a medical condition.

This is harmful to transsexuals, for whom medical treatment is necessary to survive, as having some sort of medical diagnosis for what we're dealing with is the only way to argue in favour of compelling insurance companies to pay for transition costs.

This kind of classism would make it so only the more well off transsexuals could ever afford to transition. Mainly older rich white people.

the transmedicalism on r/transmedicalism


Many transsexuals are told our very label is a slur and that we should never use it. Often cis people are yelled at for using the term because it's supposedly outdated. In other words, no one can even acknowledge us specifically - all conversations must be inclusive of people with whom we share nothing in common.

We are assumed to prefer the transgender label because it's what the rest of the community prefers; it's treated as the default, when many of us want to be as far away from that label as possible, preferring transsexual specifically for it's undeniably medical roots. The rest of the community co-opts our struggles and the science that validates our existence, but as soon as we voice out own concerns over the threat to access to medical treatment that would surely follow demedicalisation, we're silenced.

This is erasure.

the transmedicalism on r/transmedicalism

On Safe Spaces

Another issue is that transgender "support groups" and "safe spaces" do not serve transsexuals well. Cissexuals do not understand gender dysphoria and often conflate it with body dysmorphia and other self-image issues. They also have this tendency to think it's caused by outside factors, like transphobia. They lack a basic understanding of our condition, and therefore cannot even understand how to help us.

There's also and issue of the language and slogans promoted by the transgender community. Sayings such as "some women have penises" and "some men have vaginas" only serve to trigger dysphoria in those of us who do not want to be reminded of those aspects of our anatomy.

Body positivity and self acceptance, while great concepts on their own, will not cure dysphoria, and along with so-called "inclusive language," can even trigger it, making "trans safe spaces" unsafe for transsexuals.

the transmedicalism on r/transmedicalism

Concerns Raised by Anti-Transmedicalists about Transmedicalism

Harsh comment towards a transmed.

Someone with Transmed beliefs coming forward about the toxic community.

Critics of transmedicalism argue that the belief pathologizes having a transgender identity, does not reflect the experiences of all trans people, and creates undue restrictions on access to transgender-related care.[5]

Use of the word "transtrender"

There’s a lot of problematic implications that go with the term “transtrender.” It implies, for example, that a person’s gender identity is for outsiders to decide. It suggests that there is only one way to transition. It marginalizes a significant number of trans folks who cannot access or do not want to medically transition. And further, it closets trans people who may feel fearful of rejection by the community.

It says to cis and trans people alike, “Your gender identity is for me to decide, not you. And if I don’t like what I see, I don’t have to acknowledge your truth."


On Gatekeeping the Word "Trans"

To sum up, if you identify as trans, or genderqueer, or neutrois(A term used to refer to non-gendered, null-gendered, agendered identities.) but do not suffer dysphoria in any way, you are not the same as me, and your misinforming society is damaging people like me.[9]Anyone deviating from their definition is depriving “real transgender people” of necessary resources and spreading misinformation. "Checking Our Privilege, Working Together: Notes on Virtual Trans* Communities, Truscum Blogs, and the Politics of Transgender Health Care" on theFeministWire]

On the Argument Commonly Happening in White Privileged Spaces

One of the most often cited pieces of "evidence" that TransMeds are connected to white supremacy is the fact that most of us are white. Conveniently, tucutes fail to mention the fact that most of their own group is white as well; a double survey conducted on Tumblr in 2014, found that about 77% of tucutes and 69% of truscum are white, while 83% of tucutes and 73% of truscum are white or white passing. The survey results were posted to [sic] URL, however it appears the OP either moved or deleted. A cached version can be found here[sic].

It is important to note that there were 390 truscum respondents and only 132 tucute respondents. It would be great to see a larger-scale version of this survey done, but I'm pretty sure the racial demographics would ultimately turn out to be fairly even between both groups.

the transmedicalism on r/transmedicalism

(the survey results can be found here)

The debate that’s going on is kind of white-centric, classist and potentially racist.

It’s a bunch of privileged white trans people (mostly men in the case of Truscum) in countries like America, the UK and Australia arguing with other privileged white trans people, for the most part. I don’t deny that people of colour are part of this debate, but for the most part, the loudest voices represented are white. I have not seen a single black, South or East Asian, Middle Eastern, Native American, Latin person visibly involved in this argument.

I almost wonder if some of that is because the arguments some of the the classical transsexual posters use against ‘tucutes’… wouldn’t work for trans people of colour. For example, for black binary trans people, the threat to your life can increase regardless of whether you’re a trans man or a trans woman. In the US, black and Latina trans women are disproportionately likely to be the victim of transphobic hate crimes, including murders. As for black trans men, anybody who’s perceived as a black man is at risk of racial profiling, police brutality and other difficult realities that face black men. (This mostly applies to the US, or at least the police brutality does. But that doesn’t mean that people of colour in other areas can’t experience stereotyping based on both their ethnicity and the gender they’re perceived as in society.) I’ve BEEN racially profiled and I am really fucking terrified of the police. That’s what it means to be a black man in America. And it’s not just about the US, either. There are a lot of trans-related murders in Brazil. To claim that trans people of colour in societies that form many of their social prejudices based on race and on gender would transition just to be ‘trendy’ and ‘different’ is insulting in the extreme.

The ‘Surgery über alles’ mentality of some classical transsexual folk ignores the fact that a lot of trans people, especially poor trans people, trans people of colour and people in countries or regions where trans-related health care is difficult to access, cannot get surgery through no fault of their own. They’re not lesser trans people because of their socio-economic status or their geographic location - I won’t put up with that bullshit here so don’t even think about it.

–[ "Some thoughts on the ‘Truscum’ v 'Tucute’ debate." at

On The word "Truscum"

Some communities of transmedicalists use the word "Truscum" for their community. Example: r/truscum. Others see it as a slur. Example:r/transmedicalism

Truscum as a Slur

When you use the term truscum, what you're actually saying is true transsexual scum. That is literally what the term means. it makes no reference to transmedicalism as an ideology, it merely calls transsexuals scum for suffering from a medical condition and wanting that medical condition treated as such. TERF, in comparison, is a far more respectful term; not a single word in TERF has an inherently hateful meaning being directed at TERFs themselves. So, you literally show more respect for TERFs than you do for actual trans people when you use the term truscum.

the transmedicalism on r/transmedicalism

External links

  1. Error on call to Template:cite book: Parameter title must be specifiedVincent, Ben (2018). . Jessica Kingsley Publishers.
  2. 2.0 2.1 Earl, Jessie (October 21, 2019). What Does the ContraPoints Controversy Say About the Way We Criticize?.
  3. 3.0 3.1 3.2 Fontaine, Andie (August 2, 2019). The New Frontier: Trans Rights In Iceland. The Reykjavík Grapevine.
  4. Error on call to Template:cite book: Parameter title must be specifiedWilliams, Rachel Anne (2019). . Jessica Kingsley Publishers.
  5. 5.0 5.1 Zhang, Christoph M. (August 7, 2019). ["Biopolitical and Necropolitical Constructions of the Incarcerated Trans Body"] (PDF). Columbia Journal of Gender and Law 37 (2): 257-299. . Retrieved April 10, 2020. 
  6. wiki page on transmedicalism from r/transmedicalism.
  7. 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 "Transmedical Information" from r/Transmedical.
  8. "Welcome to /r/truscum!" from r/truscum.
  9. Error on call to Template:cite web: Parameters url and title must be specified.

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