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A '''Transmedicalist''', also known as a '''Transmed''', '''Truscum''', '''Trumed''', '''Trident Trans (TT)''', or '''Nunchuck Non-Binary''', is an [[exclusionist]] who has a set of beliefs about the transgender identity and the "criteria" or discourse around what's "necessary" to be transgender. The defining belief of transmedicalism is that gender dysphoria in some form is necessary to be transgender. This technically classifies them as exclusionists towards transgender people[[Alterhuman|folkel]] who do not experience gender dysphoria in any form, though most transmedicalists are not exclusionary and are very open to genuine and respectful discourse. There are some extremely exclusionary transmedicalists, but they only represent a small part of the whole community.

One of the reasons many transmedicalists are very adamant about this belief is due to the history of harm that transphobic cisgender rhetoric has caused to transgender peoplefolkel. For example, one of the most harmful misconceptions about being trans is that it's a choice. Being transgender is not a choice, and implying that it is is very harmful. That harm is incapacitated by things like the belief that gender dysphoria as a medical diagnosis is a necessary part of being transgender, as well as the sexed brain theory and the classification of being transgender as a legitimate medical identity. Beliefs of gender dysphoria being necessary to be trans offer validity and support to transgender individuals in the persistent struggle against peoplefolkel claiming their identity is a "choice" and a "lifestyle".

Since gender dysphoria is a diagnosable, actual mental disorder, many transmedicalists believe that being transgender is a condition due to their beliefs that dysphoria is a requirement to be trans. Another common reason for this belief is medical theories about the brain structures of transgender peoplefolkel being different than the brain structures of cisgender peoplefolkel of the same sex, lending credence to the belief that being trans is a medical condition in tandem with the sexed brain theory.

Another one of the most common transmedicalist beliefs is that medical transition of some form is a necessary process for transgender peoplefolkel. This is due to the fact that transmedicalists believe that gender dysphoria is also necessary to be trans, and that, as a medical condition, medical transition is the proper treatment. This belief holds that there's an undeniable and irrevocable correlation between being trans, gender dysphoria, and medical transition, though not everyone with this belief agrees on what "level" of medical transition is necessary for transgender peoplefolkel. Some think that undergoing hormone replacement therapy is enough, while others believe that HRT and gender confirmation surgery are necessary, and still others believe that HRT and all possible forms of GCS are necessary for one to be trans. Some transmedicalists may believe that someone who claims to be trans but does not want to transition medically is not actually trans.

Many transmedicalists support non-binary identities in a variety of ways, through concepts like the intersex brain theory, and many transmedicalists are themselves non-binary. However, while support for non-binary identities is widespread throughout the transmedicalist community, some more radical transmedicalists have harmful beliefs that non-binary peoplefolkel are not real or that they're a "mockery" to binary transgender individuals. Those "radmeds" may believe that being non-binary is medically impossible and that the different ways in which they would experience dysphoria could potentially delegitimize the struggles of binary transgender individuals. However, that exclusionist belief is not a defining feature of the transmedicalist community and is instead a more radical belief among radmeds.

An important conversation to be had around xenogenders is their potential impact on [[neurodivergent]] peoplefolkel and especially neurodivergent cisn't and trans peoplefolkel. Some (but not all) neurodivergent may find it difficult to understand the concept of xenogenders, and some may feel that xenogenders being a sort of "divergent" kind of identity while being associated with aesthetics delegitimizes other forms of divergent experiences like their own. It's important that neurodivergent voices are centered in the discussion around xenogenders and that their opinions be taken seriously and steadfastly and listened to with an open heart, as this Wiki supports xenogenders, but it also doesn't stand for disrespect or intolerance towards neurodivergent communities. As one Reddit user mentioned, xenogenders have been directly harmful to them and many autistic transgender peoplefolkel, and they believe that for that reason, neurodivergence and xenogenders are important discussions to have in tandem with each other, not separately.

One thing many transmedicalists commonly discuss is neopronouns. One relatively common belief about them is that they are ableist due to the difficulty some neurodivergent peoplefolkel may have in understanding them, how to spell them, and how and why to use them. Many neurodivergent peoplefolkel may have troubles with comprehension of neopronouns, and it's therefore a common belief that they're not neurodivergent-friendly and therefore promote ableism. Other beliefs surrounding neopronouns in the transmedicalist community include (but are not limited to) that they are valid because they may be validating to peoplesfolkels' gender identities and there's nothing wrong with that, and that that they're a mockery to trans peoplefolkel because they accompany a rise in non-binary visibility and some radmeds believe non-binary peoplefolkel are mockeries to the trans community.

A large amount of the transmedicalist community is very respectful and kind, but there are some more radical transmedicalists whose ideologies are harmful to the transgender community as a whole, as they're restricting and invalidating, and promote harm to transgender individuals. Some of the more common radical transmedicalist beliefs include that non-binary peoplefolkel aren't valid and are a mockery, that body dysphoria is necessary so trans peoplefolkel therefore can't like their bodies at all, and that transgender peoplefolkel can't be GNC. Most transmedicalists don't believe these things, but the ones that do may contribute harmfully to the trans community, and it's important that that harm be highlighted and uprooted.

'''"Trans peoplefolkel can't like or appreciate their own bodies"-''' Many transmedicalists believe that body dysphoria is necessary to be trans, but some radmeds take that to the extreme and say that no trans person can like their body, claiming that "truly" being trans would make one hate their body so much that they couldn't like it in any way. This belief is harmful because it promotes even more self-hatred in the trans community and invalidates trans peoplesfolkels' attempts to cope with body dysphoria by trying to like their own bodies.

'''"Trans men need to be masculine and trans women need to be feminine"'''- One of the most pervasive radical transmedicalist beliefs is that trans peoplefolkel need to fully present as their gender identity so that they can "prove" that they're dedicated to living as their gender identity. This belief stems from the belief that social dysphoria is necessary to be transgender- due to social pressures placed on stereotypical gender roles (men and women dressing and acting specific ways), many transmedicalists believe that these social gender roles and stereotypes have contributed to trans individuals' harm and that they must therefore be overvigilant when it comes to observing them in order to be perceived as their correct gender. The idea that trans peoplefolkel are used to being mistaken as a different gender because of how they present and behave drives in the idea that gender presentation is tied into gender identity for transgender peoplefolkel.

This belief is harmful because it relies upon the misconception and common transphobic rhetoric that being trans is a performance. Instead of treating the trans identity as the fundamental core identity that it is for some, this belief treats it like it's just an outward performance, which is one of the most common rhetorics used against trans peoplefolkel by transphobic cisgender peoplefolkel. Gender presentation is not determined by gender identity, and acknowledging that cisgender peoplefolkel can be gender non-conforming while holding trans peoplefolkel to the standard of conformity to gender roles and stereotypes is treating trans peoplefolkel like their identities are different than cis peoplesfolkels', like they have to prove something, like they're not ''really'' trans, and they can only convince peoplefolkel they are through a gender performance. This belief is fundamentally transphobic.