Transmedicalism

Transmedicalism, also called transmed for short, is a contested view that understands being trans primarily through a medical framework. It often includes the belief that being trans must involve gender dysphoria and that medical transition, such as hormone therapy or surgery, is a necessary or especially important part of a “real” trans identity.

Many trans people and professionals criticize this view because it narrows the range of trans experiences. Not all trans people experience gender dysphoria in the same way, not all want medical interventions, and some cannot access them for health, financial, legal, or personal reasons. Non-binary people are also sometimes excluded by transmedicalist positions, especially when they are based on a strictly binary understanding of gender.

The derogatory term truscum is usually used for people who hold transmedicalist views; in English-speaking contexts it is likely derived from “true transsexual scum” and may be intended as an insult, though some people also use it for themselves. The key point is that being trans is not, in itself, a mental illness. Medical diagnoses and treatments can be important and relieving for some trans people, but they do not by themselves determine whether someone is trans.