Truscum!!! A Beginner's Guide To Transmedicalism
Those of you who watch John Oliver might recall "Budgate" happening a few years ago. Or perhaps you're an avid Kid Rock fan. As a refresher or a crash course, Budgate happened in April of 2023. Dylan Mulvaney is a Broadway performer who spent time documenting each day of her transition in a TikTok series she called "Days of Girlhood." The series was so popular that it earned her a trip to the White House to serve as a liaison for the trans community to the Biden administration. Budweiser looking to make inroads into a new community sent her a commemorative Bud Lite can with her face on it to celebrate a year of transition. This was something that never went into circulation; it was a kitchy publicity stunt, gone terribly wrong. Conservative pundits rabidly attacked Mulvaney, making her commemorative can rage bait for the next couple of news cycles. This culminated in Kid Rock resurfacing into public consciousness and shooting stacks of Bud Lite cans with an assault rifle. Conservatives across the nation attempted to boycott Anheuser Busch without realizing they make most of the mass market beer in America. People who followed this event may have recollections of Caitlyn Jenner, perhaps the most well-known trans woman, supporting the conservative backlash.
You may be wondering what was going on with the trans on trans hate. To those of us who are familiar with Jenner, this was no surprise. She has always espoused conservative politics and consistently chooses her conservative community over the trans community. In fact, it was one more installment in a long-running feud between Jenner and Mulvaney, two of the most famous trans women of our time. Early on in her series, Mulvaney had posted a video about "normalizing the bulge." In this video, she discussed getting stares when wearing tight clothes in public, noting that her "bottom" doesn't look like a "Barbie purse" the way cis women do. She then went on to advocate for normalizing trans women having bulges in their pants. It is worth recognizing that she was weighing in on a long-standing controversy in the trans community as to whether trans ladies should "tuck" their genitals away so they make no visible clothing bulges, or whether trans folks should be allowed to be comfortable and skip the involved ritual of tucking. This debate is complicated and worth its own post. Jenner felt a need to clarify things for confused cis people in the comments by posting "He's talking about his penis." She later clarified that an intern was responsible for the post, but stopped short before offering so much as a performative apology.
To outsiders, a trans woman misgendering another trans woman likely seems odd. The point is that Jenner does not see Mulvaney as a trans woman. That is because Jenner is a transmedicalist or, in internet parlance, truscum (pronounced True Scum). She believes that the only valid trans people are those who experience dysphoria and seek medical intervention to transition. In Jenner's mind, Mulvaney's penis made her a man. She would not be a trans woman until after she had undergone bottom surgery. Just as there is an LGB without the T contingency in the wider community, there is a truscum community within the trans community. This is the same old respectability politics played over in a trans way. Essentially, the argument from these folks is that Trans people suffer from a medical condition, dysphoria, that is curable through medical transition. All other so-called "trans" people are pretenders who de-legitimize the truly trans community. I have to stop and point out that this is very much an argument from a position of privilege as surgical interventions, especially bottom surgery, remain out of reach for the vast majority of the community for several reasons including insurance won't cover it, can't pay for it, can't afford to take the necessary six weeks off of work, or don't have people willing/able to provide the needed after care which is extensive and lasts at least 6 months.
As much as I hate it. I also feel the need to point out that there is a certain validity to this standpoint, because it does align with the way the majority of the American community views the trans community. Upon the admission of a trans patient into a psychiatric hospital, it is still not uncommon to hear a nurse or tech ask "what procedures have they had" or "how far are they in their transition." Most of the debate about trans identities focuses on medical transition, and most of the legal focus has been on a minor's right to access affirmative medical care. This mainstream medical focus is so significant that conversion therapy advocates and conservative institutions choose to refer to their trans constituents as "people who experience gender dysphoria." This language game is a tactic that frames trans identities squarely in the truscum mindset, away from being trans as identity to being trans as a medical condition. One they argue is curable or "manageable" without any transition. In their mind that is the trans community's "cross" to bear; they must live life as their gender assigned at birth or risk God's wrath.
This is perhaps the most nefarious aspect of transmedicalism. It robs us of our identities and treats us as if we are unwell. The idea of being unwell can often be heard in the constant refrain that trans people are crazy and need help, or the idea that transition leads to suicide. Any trans person who posts publicly online is familiar with these ideas. Internet trolls actively seek out trans people posting on the internet to leave comments such as "Eww, you're so gross, just kill yourself already", or the ever-popular "what is wrong with you people, you need help." The medical perspective also completely ignores gender euphoria and trans joy. If you listen to trans people as they transition, they will tell you about joy. Not the joy of no longer having dysphoria, but the euphoria of doing things they have always denied themselves. The truth is I never really understood/felt the full force of my dysphoria until I had euphoria to compare it to. I like to compare it to carrying a heavy load - you often don’t realize just how heavy it is until you put it down.
There is no other joy like a trans gal twirling in her first skirt or a trans boy realizing his voice is starting to drop. Gender euphoria is a nearly universal experience among trans people, so much so that "skirt go spinny" has become a widespread meme expressing it. Unfortunately, the current climate places us in a position where people demand we justify the validity of our identity. We tend to resort to discussing dysphoria because more people feel good about an "end their suffering" story than a "this makes me happier than I have ever been" story. Apparently pursuing one's own happiness is not a legitimate reason for transition. That is at least the way it feels when talking to cis people. I know trans people who do not experience dysphoria and transition because of the joy it gives them. Most of the trans community is adamant, dysphoria is not a requisite for being gender divergent. Unfortunately, it feels like the broader community demands that we play the victim before acknowledging us or allowing us to exist in public places. Don't get me wrong, I am not saying dysphoria doesn't exist because that would be denying one of the major forces in my own life - my own dysphoria. I'm simply saying that trans joy doesn't get enough attention. I think this is an intentional ploy to make trans people look miserable so as to discourage "good kids" from turning trans and becoming consumed by their "mental illness." There is a large contingency of people who rather turn trans people into circus freaks than making room for us in their worldview.
The medical model also mischaracterizes trans bodies and trans people's experiences of their bodies. I am not and never have been "a woman trapped in a man's body." I am a woman, therefore my body has always been a woman's body because it was my body. My transition hasn't given me a whole new body. HRT has altered how my hormones work, and my body has taken care of the rest. My DNA has always known how to grow breasts and hips, but it didn't grow them in the past because my hormones were out of whack. You wouldn't look at someone with thyroid issues or other hormonal imbalances and say they are sick people trapped in a healthy person's body? You wouldn't say that a woman with PCOS is trapped in a hairy body or that she is trapped in a man's body. Being transgender is about a mismatch between how you experience yourself and the sexual characteristics you developed at puberty.
For me, the highest crime of the "trapped in the wrong body" perspective is that it reinforces the gender binary. It is the way cis folks conceptualize the world, which does not really speak to the trans experience. The science suggests that gender-divergent folxs are in the middle of a biological spectrum. Biology was never meant to be a binary - nothing in the natural world is a true binary, not even day and night. Gender diverse folks are the dusk and dawn of gender. We know for a fact that intersexed people do exist. There are enough of them; our best estimate is that intersexed people outnumber trans people. So called “intersexed conditions" are not mutations or accidents, they are the natural result of the complex, multifaceted thing we call biological sex. A process that yields a spectrum of results and not a hard binary. (here is a link to an article from the Scientific American that explains this point of view and provides evidence ) From this perspective, you can view trans people as people who are psychologically intersex. The biology that drives their sense of self is mismatched with the body that was produced. Once we embrace this view, which is soundly based in science, then it is easy to accept that some "women" have penisies and some "men have vagina's." Gender-diverse and intersexed people are those who fall in the middle of the biological sex spectrum. People who don't fit neatly into the binary categories imposed on the spectrum by Europeans. My HRT and any surgeries I may or may not get don't put me in a whole new "woman's body"; they help my body to develop the parts that its brain says it should have. The result of my transition isn't a sad imitation of a woman's body that will always be obviously male. The result is a body that aligns with my sense of who I am. Honestly, I'm not concerned about how my body aligns with an outdated and oppressive gender system. Authenticity is my goal. I am not jumping from one gender box to another. I am living authentically outside of the box. Why follow someone else's rules when you can make your own?
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This mischaracterization of the trans experience can have real world potentially fatal consequences. Very few mellennials had language to describe their experience, let alone role models and guidance on how to survive and thrive though the trans experience. There is a large contingent of people who are actively working to make sure the younger generation grows up devoid of role models and road maps. These people are well intentioned and believe they are doing what is best for their children. The unfortunate reality is that this does not stop kids from being trans it just separates them from the people and information that would make being trans less damaging to their mental health. In Transmedicalism is the phone call from within the house. Many trans people already feel significant imposter syndrome. Gatekeeping trans identities and requiring interaction with a difficult and scary medical system only increases the confusion and difficulty for those questioning their experiences. Transitioning is hard enough and there are plenty of gatekeepers. What we need is role models and information not gatekeeping. I understand the fear that visible trans people and widely available information will lead cis children to question their gender. I’m just not sure how scary that really is. Gender is a central part of our sense of self. I imagine a cis kid trying to be trans being as successful as a trans kid trying to be cis. Ultimately experimentation will likely lead to a stronger sense of self weather that is cis or trans. I am also aware of the fear that experimenting children will undergo irreversible medical procedures. I can truly say that this fear is steeped in transmedicalist rhetoric and based on ignorance and misinformation. No one is prescribing cross hormone therapy to kids without years of evidence that it is the right thing to do. And surgeries are more inaccessible for children than adults. WPATH guidelines suggest that surgery only be considered in children over 17. In most clinics starting the process at 17 means you will get surgery when you are over the age of 18.
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