Transmedicalism is a plague upon all trans people and it must be stopped.
Transmedicalism damages the rights and transitions of all trans people, even those who feel protected by it, and its adherents within the trans community do active damage to every single trans person by continuing to push it.
What is transmedicalism?
Transmedicalism is a belief founded upon the pathologizing white cisgender view of transgender/transsexual* existence.
Transmedicalists believe one or more of the following statements:
- Without the experience of the medical phenomenon known as gender dysphoria, a person is not "truly transgender."
- If one does not wish to medically transition, or to "fully medically transition", including hormone replacement therapy, name changes, and one or more surgeries, that person is not "truly transgender."
- Non-binary identities are not transgender identities.
- Cultural identities (such as two-spirit, tumtum, and others) are not transgender identities.
Transmedicalists are also known as transmeds or "truscum," a neologism which means "true transsexual scum." There is an unfortunate amount of overlap between the transmed community and the radfem community, with many transmeds believing that they are not "truly" their proper gender and accepting a second-class status within their gender.
So, starting from the understanding that transmedicalism as it is currently defined requires the belief in at least one of the above statements, why is being a transmed harmful even to people who follow the binary paths laid out by transmedicalism's most ardent adherents?
Transmedicalism allows cisgender doctors to define our experience.
Okay, let me start by saying that I understand that under the current health care system in the United States, a diagnosis is required in order for insurance to pay for medication and/or treatments, rather than treating medical interventions as "optional" or "cosmetic." This is a separate issue, to my mind, to seeing the transmedicalist line carried by the community end. Yes, the medical system is set up currently to see us fail; that doesn't mean that we need to carry that water for them.
The current medical view of transgender life is predicated upon the idea that our existence is based in pain. Basically, goes the cis thinking, every trans person would be cisgender if only we could manage it, but we just can't, because it's too painful. It's not that we're happier when our gender identities are confirmed, it's not that we live fuller and more complete lives, and definitely no one would ever choose our lives, because being trans is a shitty, hard life compared to being cis. Transition is a sort of "lifestyle of last resort."
Trans people are not "failed cisgender people", and that is the mindset which transmedicalism adopts. We are not one of many ways in which humanity expresses itself and what we are isn't a normal and natural way of being, says transmedicalism, but an aberrant way of being whose existence can only be tolerated simply because there is no other choice for us.
Uprooting the transmedicalist mindset means uprooting the mindset that we define ourselves by pain and allowing our community to define itself instead by the whole of our experience, including our pain, yes, but also including our joy. Trans liberation means the opportunity for kids to be raised without fear or shame about their gender, and what then? If we are ever to achieve true trans liberation, we cannot define ourselves solely by our pain, because that would mean that if we remove the societal sources of our pain, trans people would cease to meaningfully exist in that definition.
Transmedicalism as a philosophy therefore creates a trap which means trans existence will always be defined by its pain. And that? Sucks.
Transmedicalism means imposing a harmful "single true path" on all trans people.
If you've been around the trans community for more than 5 seconds, you know that there are uncountable different trans experiences. Transmedicalism, however, reinforces and underlines the "born this way" and "always knew" narratives, excluding those of us who didn't "always know" and those of us with fluid, complicated, or non-binary experiences. This is incredibly screwed up, especially for those of us who grew up before the advent of the modern internet, grew up in extremely conservative households, or simply changed or developed as we grew. Transmedicalism views a trans person as a static thing, one who "always knew" and "always suffered" from gender dysphoria, and that mindset forces a lot of us to lie or tell half-truths in order to receive support or medical treatment.
(read the entire thread, please.)
Even for those of us with binary trans experiences, pushing an idea that one must follow a single path which includes a set number of medical interventions means that a trans person may feel that they must receive these medical interventions -- whether or not they want them -- to be "really trans" or accepted by the community. To be clear, this should not be taken as me saying that the trans community is the source of this mindset or this belief: transmedicalism comes from outside the trans community, imposed upon us by the transphobic medical establishment and transphobic cisgender society, who view themselves as the arbiters of who is 'really trans' or not. If fault is to be laid at the feet of anyone for trans individuals who feel that they must receive medical intervention to be viewed as 'really trans', it must be laid at the feet of medical establishments, individual doctors, school systems, governments and other cisgender authorities who push this medical-intervention-necessary-or-else-not-trans model.
The decision on the appropriateness of any given medical intervention should be a decision made between an individual person, their parents if underage, and their doctor(s), and as with all other questions of bodily autonomy, should not be interfered with by governments, UK Twitter users with 10 accounts and the suffragette flag in their handle, or the writers of derivative wizard-school books.
Like, really, these standards are set up in order to diminish us and to "discourage people" from coming out as trans -- the harder it is to be 'really trans,' goes the thinking, the fewer of us will exist. It is an outright trans-exterminatory model which we really need to stop buying into as a community.
Transmedicalism as a philosophy pushes medical intervention which may not be appropriate or safe for a given individual.
Whether it's someone with Ehlers-Danlos Syndrome for whom top surgery is not advisable, someone in a conservative area who can't live 'out' full-time and can't start hormone therapy, or someone who just isn't ready yet for whatever reason, transmedicalism imposes a script on trans people, and that one-size-fits-all approach simply isn't appropriate for anyone.
Let me repeat: nothing I say is or should be misconstrued as an argument for laws restricting transition by age, for interference in transition by outside forces, or any other such bullshit.
Likewise, even if we're just talking about binary trans people, a given intervention may not be appropriate or desired by a particular person. Transmedicalism pushes all manner of surgeries and medications, pushes the idea that if you don't do this, you're not trans, and that's not only simply not true but diametrically opposed to the truth of trans liberation. Trans liberation means the ability to experiment with gender and presentation, to begin or desist transition without fear, shame, or reprisal from within or without the community, and to recognize and focus on our joy as the central piece of our experience.
When you add in non-binary, genderfluid, and culturally-gendered people to the equation, it becomes glaringly obvious that a one-size-fits-all approach simply doesn't work.
Transmedicalism pushes the idea that desistence is a sign of not being "truly trans," or that transition was a "mistake" rather than a step along the way toward self-understanding.
I've seen this more than once -- someone transitions to a binary gender and then realizes that they're actually non-binary, or begins transition and then finds that they're in an unsafe situation for transition. (The majority of desisters/detransitioners stop transition due to lack of support, and retransition when they have better support or are able to move to a friendlier/safer situation.) Not only then do they have to deal with the incredibly complicated business of retransitioning, they have to then deal with people calling them a 'faker' or 'not really trans' or whatever else. It's not too different from the experiences of people who come out as gay or lesbian only later to realize that they're bisexual or pansexual, to be honest, with the same sort of social backlash.
We've got enough on our plates when it comes to dealing with our lives as trans people without trying to push the idea that desistence means you "were never trans" or "aren't truly trans." We don't need to do that to ourselves, to each other, or to someone who truly did experiment with gender and realize they were transgender. Trans liberation means the ability to experiment with gender is available to everyone, including those who later determine themselves to be cisgender.
Transmedicalism can be really tempting to trans people who do not have a lot of social support or who do not have contact with other, especially older, trans people -- look, it's scientific! look, you can't deny me this because otherwise I will die! -- and for a lot of binary trans people, following that single path of stereotypical medical interventions will not only provide relief from gender dysphoria but serve to give gender euphoria a wonderful garden in which to blossom. However, as a view of the community, it's absolute poison.
What is right for you need not be right for me: we understand this when it comes to other choices that people make with their bodies as a core tenet of feminist philosophy. One person's decision to have an abortion does not mean another person's decision to carry an unintended pregnancy to term is the 'wrong decision' and vice versa. We understand that a woman is not defined by motherhood or by carrying a child; we understand that a child-free life does not reflect poorly on those who choose to carry a child or to become a mother in another fashion. We understand that cis women who are unable to or do not want to carry children are not "unwomen," and that a single life path determined by natal biology and circumstance, imposed on women by the machinery of the cishetalloperipatriarchy, makes no sense. We understand that we do not require the approval of professionals for our plans for our body, and that we alone have -- ro should by all rights have, fuck you, Texas -- the sovereign ability to determine what we want our bodies to do.
Why, then, do we accept a philosophy within our communities which mandates a single defined path for transgender people and a single definition of transgender identity contingent upon approval from an often-hostile medical establishment which views our existence as a "life of last resort"?
Kinda bullshit, honestly.
*Sometimes viewed as outdated, the term transsexual is still used by many older trans people and has been recently reclaimed by some younger trans people. I include it in the name of greatest inclusivity of our community; there's no need for me to be exclusive while talking about how philosophies damage us.
