A Transmedicalist, also known as a Transmed, Truscum, Trumed, or Trident Trans (TT), 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 transphobic cis people.