A Transmedicalist, also known as a Transmed, Truscum, Trumed, Trident Trans (TT), or Nunchuck Non-Binary, is an exclusionist who believes that dysphoria is necessary for being 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, truscum think that non-dysphoric trans people are actually mislead cis people. Transmedicalists believe surgery for non-dysphoric people is non-essential and purely cosmetic for them due to them not having gender dysphoria.