A Transmedicalist, also known as a Transmed, Truscum, Trumed, Trident Trans (TT), or Nunchuck Non-Binary, is an exclusionist who believes that some form of dysphoria is required to be transgender. According to the American Psychiatric Association, "not all transgender people suffer from gender dysphoria and that distinction is important to keep in mind;" however, many (but not all) truscum think that non-dysphoric trans people are actually mislead cis people or dysphoric trans people who don't fully understand their dysphoria. Transmedicalists believe surgery for non-dysphoric people is non-essential and purely cosmetic for them due to them not having gender dysphoria.