Recently, across Left-aligned spaces on the Internet, I have observed a disturbing trend: Marxists, particularly those who align themselves with structural Marxism, have come out in droves in support of transmedicalist discourse. Transmedicalists (more commonly known as “truscum,” though I will refrain from using this word as it is little more than a pejorative) believe that sex-based dysphoria is required to identify as transgender.
At first glance, it is easy to see how this ideology can be viewed as “common-sense.” After all, why would someone want to identify as a different gender than the one they were assigned if they didn’t feel some sort of way about it? As such, it’s often difficult for anti-transmedicalists to articulate their criticism, especially in a material manner, in a forum like Facebook. This gives the illusion that transmedicalism is the only ideology coherent in Marxist analysis of the world; anything else must be pure idealism.
I strongly disagree with a transmedicalist analysis of gender. In this essay, I will use multiple loci of theory to outline my full criticism of transmedicalism. I will also respond to many of the so-called “materialist” reasons why transmedicalism is correct. For accountability purposes, if you are unfamiliar with me, this post is being written by a white, transmasculine person who identifies as their gender through sex-based dysphoria as well as other factors (which will be described later on).
Transmedicalism, at a fundamental level, claims that, to identify as transgender, one must experience some level of anatomical discomfort with their primary or secondary sex characteristics (genitalia, chest, hair, voice, musculature, to name a few). This can mean a deperessive feeling, a physical pain, and/or dissociation with that particular characteristic. While some experience dysphoria statically, it waxes and wanes for others. Dysphoria can move across one’s body or stay fixated. Simply put: It’s not as simple as it may seem. Dysphoria cannot be accurately codified by a diagnosis (and, of course, diagnosing transness as a disability only feeds into the medical complex that disability scholars criticize rightfully).
However, the mutability of dysphoria is not the end of transmedicalism’s fundamental flaws. By solely including dysphoria as the locus of transgender identity, transmedicalists fundamentally misunderstand how one interacts with their gender. Here is a brief list of several gender interactions that warrant a transgender identity besides sex-based dysphoria:
- Social dysphoria is a negative feeling (depression, dissociation, etc) associated with the social implications of one’s gender. For example, a cisgender man may experience social dysphoria if he is uncomfortable with the hegemonic masculinity expected of him in his patriarchal society. Many transmedicalists argue that social dysphoria is based in the roles associated with gender, and thus reinforce the stasis of such. This isn’t true because dysphoria isn’t meant to change the world; rather, it’s descriptive of one’s experience with gender in the present.
- Gender euphoria is a positive feeling associated with the social implications of one’s gender. For example, even if an AMAB person does not feel discomfort if they identify as a man, they feel happier when they identify as genderqueer.
- Reclamation describes a POC identifying as a gender outside of the Western gender binary that is denied to them by the binary. For example, some two-spirit indigenous people identify as transgender, and some Black people choose qirl and boi instead of girl and boy to describe how their Blackness shapes their gender.While some do not use transgender to describe this relation, some do, and transmedicalist keyboard warriors ought not invalidate these experiences.
- Coping describes the tactics used by mentally ill and disabled people to live with their condition. This applies to gender in a number of diverse ways, but, for example, somebody may have any number of mental illnesses that prevent them from conceptualizing of a gender identity. This person may identify as agender, for instance, to describe this feeling, and therefore may access transgender identity.
The exclusion of these experiences is not only fundamentally cissexist in its denial of the identities of transgender people, but it holds ableist, racist, anti-black, and settler colonialist implications as it assumes that gender must always stem from one’s relationship to their body. With its roots in the exact Cartesian dualism that justifies anti-blackness and coloniality, transmedicalism is indefensible from a historical context.
Transmedicalism still remains associated with materialism, however, in the context of several incorrect claims. One of the most common transmedicalist arguments (that, sadly, anti-transmedicalists have difficulty cogently answering) is that sex-dysphoric transgender people have different resource needs than others who take the trans identity. In the same breath, they claim that non-dysphoric trans people take resources away from sex-dysphoric trans people. Before I address both claims separately, it’s worth noting the egregious contradiction in this position. If non-dysphoric trans people sap resources from dysphoric trans people, then how do they not have the same resource needs? Similarly, if sex-dysphoric trans people have different resource needs, then how are those resources being sapped by people who don’t need the same thing? Therefore, it stands that either non-dysphoric trans people have the same resource needs (and should logically still claim transness) or they do not, and they don’t sap any resources (and so there is no harmful impact to their claiming of trans identity).
Regardless of the internal contradiction, the claims are both still wrong, or at least incomplete. The claim that sex-dysphoric transgender people have different resource needs implies that non-dysphoric people never want to transition AND that all sex-dysphoric people desire transition. The claim that non-dysphoric trans people take away resources assumes the same. More importantly, both arguments blame the victims: It blames the lack of resources for trans people on trans people themselves. Instead, transmedicalists ought to look to expand the quantity of transgender resources, from therapy to accessible HRT and surgical procedures.
For example, take myself: I am a transmasculine person who experiences sex dysphoria, social dysphoria, and euphoria through identifying as transgender. I wear a binder, and I want to look toward HRT in the future and, potentially, top surgery or at least a reduction. I do not, however, want bottom surgery. The “full transition” rhetoric of transmedicalism would suggest that I’m “faking it” just because of that last little fact, that I don’t want to take on as close to a “male body” (a sketchy notion in and of itself) as I possibly can. Even though I am not the target of transmedicalism, it still calls my identity into question, and so it breaks away completely from its perceived materialist roots.
Transmedicalism is amaterial, and its assumptions about transgender identity re-entrench the gender binary born in white supremacy and gendered domination. It is easy to believe, but analysis shows that it is bankrupt and must be wholeheartedly rejected to truly orient praxis toward transgender liberation and liberation of all oppressed people.
void where inhibited 