Transmedicalism is a term that has sparked much debate within the transgender community and beyond. It involves specific beliefs about what it means to be transgender and who qualifies as transgender.

For a better explanation, lets take a look at what transmedicalism is.

What is transmedicalism?

Transmedicalism, also known as “truscum,” asserts that being transgender is inherently tied to experiencing gender dysphoria, a belief that their assigned sex at birth does not align with their gender identity, and undergoing medical transition. According to transmedicalists, a person must experience severe distress due to the incongruence between their gender identity and assigned sex at birth and seek medical interventions like hormone therapy or surgeries to be considered truly transgender.

Key tenets of transmedicalism

Transmedicalism has roots in early medical and psychological models of transgender identity. Historically, the medical community often required a diagnosis of gender dysphoria for individuals to access transition-related healthcare. Over time, this requirement influenced broader societal perceptions of what it means to be transgender.

Transmedicalists commonly share the following beliefs:

  • Gender Dysphoria is Essential: Transmedicalists argue that without gender dysphoria, one cannot be genuinely transgender. They view dysphoria as a fundamental aspect of the transgender experience, which can lead to erasure of nonbinary trans folks, or folks who feel less traditional in their gender.
  • Medical Transition: They emphasize the importance of medical transition, including hormone replacement therapy (HRT) and gender-confirming surgeries. This is seen as a necessary step for aligning one’s physical body with their gender identity.
  • Opposition to Self-Identification: Transmedicalists often criticize the notion that self-identification alone is sufficient to be recognized as transgender. They believe that medical evidence should support one’s transgender status.
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Why is transmedicalism controversial?

One primary criticism of transmedicalism is its exclusionary nature. Many argue that it invalidates the experiences of nonbinary and gender non-conforming individuals, those who do not experience gender dysphoria, or those who choose not to undergo medical transition. Consequently, this can lead to feelings of alienation and marginalization within the broader transgender community. This is very problematic since its proven that transitioning can save a person’s life.

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Opponents of transmedicalism emphasize the diversity of transgender experiences. They argue that gender identity is a deeply personal experience that cannot be universally defined by medical criteria alone. The transgender community includes people with varied experiences and perspectives, all of which are valid.

Furthermore, there is concern that transmedicalist views can negatively impact mental health. For individuals unable or unwilling to pursue medical transition, these beliefs can exacerbate feelings of inadequacy and dysphoria. A more inclusive approach would recognize self-identification as the primary criterion for being transgender. Self-identification respects individual autonomy and acknowledges the varied ways people experience and express their gender. The pressure to conform to a specific narrative can hinder self-acceptance and well-being.

There was a previous controversy with Hunter Schafer’s views of transmedicalism back in 2022. She ultimately said she does not align with it though. This video below explains the issues of this practice.

Sociopolitical implications

Transmedicalism has broader sociopolitical implications, particularly concerning access to healthcare and legal recognition. Critics argue that rigid definitions of who qualifies as transgender can influence policy decisions. This can potentially limit access to gender-affirming care and legal protections for those who do not meet transmedicalist criteria.

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Expert insights and perspectives

To provide a balanced view, it is essential to consider insights from experts in transgender health and advocacy. Dr. Johanna Olson-Kennedy, a leading pediatrician specializing in transgender youth, emphasizes the importance of individualized care that respects each person’s unique journey. In a 2019 podcast with GenderGP, she said, “There are so many problems with the way the system is created now. It started from the underlying idea that people who have a gender difference than their assigned sex at birth are mentally ill. And we can’t shed that.”

Similarly, the World Professional Association for Transgender Health (WPATH) advocates for a depathologized and holistic approach to transgender health. WPATH recognizes that not all transgender people require or desire medical interventions.

Moving towards a more inclusive understanding

Transmedicalism remains a deeply divisive topic within the transgender community. While it asserts the importance of medical transition and gender dysphoria in defining transgender identities, it faces significant criticism for its exclusionary stance and potential harm to mental health and inclusion.

Understanding the nuances of this debate is crucial for fostering a more inclusive and supportive environment for all transgender individuals. By recognizing the diversity of transgender experiences and emphasizing the importance of self-identification and autonomy, we can create a more accepting and inclusive community.

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