The Transgender Dictionary

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Transmedicalism

(also: HBS, Harry Benjamin Syndrome, t3, transmed, truscum, true trans, true transsexual)

Table of Contents

Introduction

Transmedicalism is a harmful ideology often perpetuated by transgender people trying to appeal to transphobes in an effort to seek validation. It is an attempt to justify the existence of some transgender people at the expense of throwing others under the bus. The path to true acceptance is not and will never be based in harming others in your own community. Putting down the most vunerable members of the transgender community in an effort to make yourself seem like you are more acceptable in society will not change the mind of those who will never truly accept anyone who is not cisgender. Infighting is never acceptable, regardless of your reasoning.

The concept of transmedicalism is intertwined with the concept of the medical gatekeeping of gender-affirming care, though most modern-day medical facilities disregard these ideas as being outdated and inaccurate. Gender dysphoria can present itself in numerous different ways, as the spectrum of gender is a lot more complex than what the outdated concept of the gender binary may make it out to be. Though gender-affirming care can still be difficult to access in some parts of the world, any legitimate medical facility will follow the WPATH standards of care.

The core ideas of transmedicalism dismiss or misrepresent the concepts of gender euphoria, or being nonbinary. The discussion of transmedicalism, as well as relevant external links at the bottom of this page may contain content that is triggering to some people. If you come across any terms for which you are unfamiliar, please consult the alphabet menu buttons at the top of this page. Feel free to click on any underlined words to jump to other pages of this website containing relevant definitions and further explanations of the terms.

General Information

To put it basically, transmedicalism is the belief that you must have gender dysphoria to be transgender. This idea sounds reasonable on the surface, as the vast majority of transgender people do experience gender dysphoria (Why else would anyone inject testosterone or seek out intense surgeries like vaginoplasty?) but figuring out your gender identity can be a bit tricker than that.

The ideas of transmedicalism are rooted in permanent self-loathing, and in obsession over passing. You must hate yourself, and be in the maximum possible level of distress regarding your gender identity and presentation without exception. To become a proper transsexual, according to a transmedicalist, you must have (or desire) every possible relevant hormonal treatment and surgery available. You must dress and act perfectly in accordance to gender roles.

Transmeds such as Kalvin Garrah are infamous for bullying anyone who is nonbinary, gender non-conforming, or simply disagrees with their hateful rhetoric. They cause more harm than good, and should be ignored and disregarded. No one is helped by being forced into the closet simply because they do not wish to be the pinnacle of masculinity or femininity.

Please note that it is perfectly valid to wish to be this pinnacle of masculinity or femininty. Many (if not most) transgender people are binary (or wish to be). However, encouraging insecurities and harassing others is not ok.

Nonbinary People

While transmeds have varied views on nonbinary people, there is a general underlying current of exorsexism within transmedicalist rhetoric. Some transmedicalists do respect some level of nonbinary identity- but this tends to be limited to nonbinary people with strictly androgynous presentations and relatively "normal" identities. This acceptance, however, pretty consistently stops when the person does not fit into their conception of what a nonbinary person should be. This can include using neopronouns and/or binary pronouns (or any pronouns other than they/them), having a very masculine or feminine gender presentation, and/or using xenogender terms for one's gender identity. Many transmeds, however, do not accept even the most androgynous nonbinary people.

One notable and influential example of transmedicalist views of nonbinary people is that of the YouTuber Kalvin Garrah and his videos created during the late 2010s. While Garrah has since denounced his transmedicalist views, he spent several years as a very prominent member of the online trans community, making YouTube videos and other online content. These videos often focused on mocking gender non-conforming and nonbinary trans people, with long sections devoted to going through various trans tags on tumblr (especially those about xenogenders & nonbinary identities) and making fun of those who used them. In many ways, Garrah was a creator who drew largely on "cringe" for his content.

Many transmedicalists claim to accept "real" nonbinary people (those who they see as actually trans). A very stereotypical example of the "type" of nonbinary person that a transmedicalist might accept is that of someone who was afab seeking to transition into skinny, white, flannel-wearing androgyny; regardless of how desirable or attainable that image may be for any given person. It is important to recognise that acceptance which is conditional on specific gender presentation and experiences is not actually acceptance, and transmedicalists are very conditional in their acceptance.

The Origin of "Truscum"

The meaning of the word "truscum" is simple enough to figure out - the word is a shortening of the phrase "true transsexual scum" - but where did the usage of this word actually originate from? The most popular theory seems to be that tumblr user "idislikecispeople" (formerly known as "softcisphobia") came up with the term. I mean, kit came up with the term "tucute" (meaning "too cute to be cis") back in January of 2015 to mean the exact opposite of truscum, so why couldn't the same person coin two terms at once? Makes sense, right?

Wrong. Turns out that the most popular theory about who coined the word "truscum" (so popular that the myth has appeared in multiple sources as well as on r/truscum numerous times) is incorrect. While kit did coin the word "tucute" - this coining seemed to be a reaction to a preexisting and well-established word. While the blog "idislikecispeople" seems to have been deleted (most likely in response to being pressured to leak nudes after being accused of being a cis woman pretending to be a transgender woman) I have determined that kit was most active on tumblr around 2014 & 2015, around when "tucute" and "truscum" discourse started picking up steam, but the word "truscum" is clearly a bit older.

Even back in March of 2014, a tumblr user by the name of "broknhands-blog" was trying to come up with a term to be the exact opposite of "truscum" (the proposed term was "cuckoos" in a post that had only 73 notes when I found it, so clearly it didn't take off, but was in response to a preexisting term). I also found a joking mention of a "truscum reunion" in response to a cute image of pandas from all the way back in October of 2012.

The earliest mention of the word "truscum" that I could find (after scrolling through old tumblr discourse posts for hours on end - anything posted prior to 2017 cannot be properly searched due to changes in tumblr formatting around that time) appears to be August 1, 2012. On this date, I found multiple reaction posts to the proposed word, but not to the original usage.

These reactions are seeming to parse the meaning of the word, as proposed by tumblr user "transstingray" who is now "technowitch-rat-deactivated2015". As is the nature with a deactivated account, none of the posts made by that user are available to be seen. Based on how few notes these original posts had (none of these old posts from 2012 had even 20 notes when I found them), I doubt that I'll ever find any screenshots or reblogs of the original usage of truscum. "Truscum" itself seemed to be a response to "cisscum" a term that was being thrown around during 2012 tumblr discourse to refer to cisgender people.

But wait - what is a "true transsexual"? The term was first introduced in 1966 by German-American sexologist and endocrinologist Harry Benjamin. Harry Benjamin proposed a seven-point scale with three different types of transvestite on one end and three different types of transsexual on the other. With the "true transsexual" being the "highest intensity" on this scale, this was used as a method to determine who should or should not receive gender-affirming surgical care. This proposed scale also led to those who would be ranked lower on the scale (such as nonbinary people) to lie about the nature of their gender identities in order to recieve gender affirming care; due to having unconventional transition goals.

From this scale, the idea of "Harry Benjamin Syndrome" emerged. People who claimed to have this disorder refered to themselves as "HBSers". HBSers claimed to have an "intersex brain condition" - a concept that is pseudoscience at best. This idea was meant to justify the idea of being a transsexual to cis people who could not possibly understand the complex feelings of gender... but might understand treatment for a medical disorder. While medical care often is the treatment for being transgender; obsessing over perfectly adhering to the gender binary and whether or not you pass is not.

So there you have it. From "HBS" came "true transsexual". From "true transsexual" came "truscum". From "truscum" came "tucute". From "truscum" came "transmedicalist". All different ways of trying to judge who is or isn't a "valid" transsexual.

Click to jump to external links with old tumblr posts regarding truscum.

Click to jump to external links regarding Harry Benjamin Syndrome.

External Links

The following links are provided for entertainment, research, intrigue, and information sourcing. The views, ideas, and beliefs found in the content that these links lead to may not represent those of The Transgender Dictionary. These resources are not sponsored nor endorsed.

Attempts to track down the original usage of the word "truscum" and other old discourse.