What is transmedicalism and why is it harmful?

There are plenty of held beliefs surrounding being trans and what identifying as transgender really means, but none are as so fundamentally controversial as transmedicalism.

Over the past few years, with the sudden shift of mainstream media outlets covering trans people more closely, the term has risen in popularity.

Its usage as a justification for why certain people within the community shouldn’t be defined as trans – especially non-binary and gender-non-conforming individuals – has made it rightfully criticised as gatekeeping or even a form of bigotry. But the term is so broadly defined that it can often be difficult to fully know what transmedicalism is or looks like, which makes it equally difficult to mitigate.

What is transmedicalism?

So, what actually is transmedicalism, and why should trans people throughout the community be wary of it?

Broadly speaking, it is the idea that being transgender is reliant upon a medical diagnosis of gender dysphoria and a fundamental incongruence between an individual’s assigned birth sex and their gender identity.

Often, self-proclaimed transmedicalists will, falsely, claim that a portion of the community are “legitimate” trans people, under a vaguely defined list of requirements such as gender dysphoria or desire for surgery. Anyone who does not fit that criteria, to a transmedicalist, is does not have a true trans identity.

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While there is no definitive timeline for how the belief has developed, a 2021 research paper from the University of Iowa said it developed on social media following an article in Time magazine 10 years ago, which argued that we were reaching the “transgender tipping point“.

A partially pixelated transgender Pride flag edited into a graphic of trans identities.
The basis of transmedicalism is harmful to the trans community. (Getty)

From there, intra-community debates on what being trans is legitimately began, with those who deemed gender dysphoria to be a fundamental element of identifying as transgender calling themselves transmedicalists.

The belief has since spawned a long list of exclusionary sub-beliefs, such as the idea that non-binary people do not exist and are not valid, and that over the past few years some influencers have begun identifying as trans to keep up with a “trend,” insultingly called “transtrenders”.

Neopronouns are also a particular point of irreverence for transmedicalists, who profess that they are made up and illegitimate, which is not true.

Because of their controversial presence in the community, opponents of transmedicalism use the derogatory term “truscum” – a portmanteau of “true transsexual” and “scum” – to refer to transmedicalists.

Why is transmedicalism harmful?

Fundamentally, transmedicalism is harmful because, as a belief, it is built on a foundation of exclusion and gatekeeping that is not only hurtful, but also built on misinformation about what being trans even is.

The idea that dysphoria is an immutable pillar of identifying as trans is an outdated belief built from misinformed ideas of “transexualism” in pre-2000s academic papers and medical documents.

The Diagnostic and Statistical Manual of Mental Health Disorders: Third Edition (DSM-III), written in 1980, listed gender dysphoria under its list of “psychosexual disorders” and was only used for a childhood diagnosis.

This was changed in subsequent volumes of the DSM, but the belief that being trans or experiencing gender dysphoria are analogous to a mental-health disorder persisted.

Transmedicalism hinges itself on this belief and, as a result, often intersects other problematic beliefs such as autogynephilia – defined as a male’s propensity to be sexually aroused by the thought of himself as a female – and rapid-onset gender dysphoria (ROGD).

More importantly, however, is that transmedicalists often argue that non-binary people either don’t exist or are “transtrenders”, who simply want to feel special. This is simply untrue and harmful to suggest.

Non-binary people do exist and you do not need gender dysphoria to be transgender. Plain and simple.

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