| abstract
| - Transmedicalism is a term for a wide range of beliefs in the transsexual community that are critical of transgender people who are not, or do not desire to be, transsexual. According to a self-definition by the subreddit /r/transmedicalism, the term describes trans people and allies who believe that only those who experience gender dysphoria are transsexual / transgender, and that gender dysphoria (transsexualism) is a medical condition. Although the debate has been going since the '60s, it has gained more notoriety in the Internet age, particularly on Tumblr. On Tumblr, anti-transmedicalists often refer to transmedicalists as truscum and to themselves as "tucutes", whereas transmedicalists often refer to "tucutes" as transtrender. The existence of a medical condition known variously as transsexualism, gender identity disorder or gender dysphoria is not medically or scientifically controversial, although it is widely opposed by various religious groups, trans-exclusionary radical feminists, MRAs, the anti-psychiatry movement and Illuminati conspiracy theorists. Rather, the controversy in this case is a social debate rooted in identity politics over the equivalence (or lack thereof) between people who have such a condition and people who have no such condition but still identify as transgender. Participants in this social controversy may run the gamut between extreme reactionaries who want to return to the medical definitions of last century (e.g. the infamous Benjamin scale) to weekend crossdressers who live and identify as their assigned sex but want to be recognized as transgender or even transsexual. Perhaps the reason why truscum exist is because their transgender experience is so wrapped around gender dysphoria they cannot comprehend the notion of a transgender person without it. Thus the lack of understanding and transphobia from society both result in fear and distrust of these "alien" transgender people. It is also possible that transmedicalists see nothing good or inherently valuable about the experience of gender transition, and even view it as something they would rather not ever have to go through, but see their dysphoria as a materially disadvantageous and mentally debilitating biochemical aberration. Because dysphoria is, by definition, an experience that is not even anywhere close to enjoyable, people who have it see gender transition as a necessary evil and the only way out of an already-cruel existence, other than suicide. So transmedicalists feel contemptuous of people who are going through transition when they do not apparently need to, much as a person who accidentally loses their legs might feel contemptuous of someone who appears to have chopped off their legs on purpose. They see transtrenders as relatively privileged cis people who are appropriating the trans identity while further stigmatizing "actual" trans people, who are already marginalized as it is and who are urgently in need of help and resources, as "scum" whenever they speak up about this appropriation.
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