I Will Not Make That Trade

Transmedicalism and the Refusal of Victimhood

The Harry Benjamin Syndrome (HBS) and transmedicalist [1] trap is perfectly designed because it works in two directions at once. It reaches inward and outward simultaneously, and both movements depend on the same broken premise: that victimhood is the price of legitimacy.

Inward, it says this: I suffered because of a medical condition, therefore I am trans. You did not suffer as I did, you did not suffer enough, or at all, and therefore you are not. It takes a legitimate pain, dysphoria, and makes it a requirement for entry. It says that transness requires suffering and shame. That it requires medical diagnosis, and that it requires proving to doctors and strangers that you were damaged and suffered enough to deserve recognition. Only then can you be recognized for the woman or man you are.

Outward, it turns to cis-society (or cisciety - a portmanteau of cis and society, or the society as it predominantly reflects and caters to cis folks) and says this: I am suffering, I am damaged, I needed medical intervention because being born this way is a curse. Please see me as legitimate. Please grant me access, acceptance, recognition - I deserve it because look how much I suffered, how hard I worked and all that I did to overcome. It negotiates for rights from a position of brokenness. It asks permission to exist by demonstrating how much it cost to exist.

And here is the genius of the trap: both directions work perfectly as long as you accept the fundamental lie underneath — that our legitimacy has to be earned, that it has to be bought with pain, that it has to be granted by someone with more power than us, and that our suffering defines us.

I will not accept that lie.

When Brianna Wu says the trans community is "unstable," she is not describing reality. She is describing what happens when you build a hierarchy of legitimacy on victimhood. Someone has to be damaged in a similar way, the right way. Someone has to be fake. And that internal fracture, the one you create by demanding suffering as proof; that is what produces chaos. Not transness itself. The gatekeeping.

But the larger point is this: Wu, and the HBS/Transmedicalist types, are not just gatekeeping internally. They are negotiating externally. They are saying to the world: I deserve your acceptance because I am/was medically broken. And in that moment, they have accepted the terms cis-society sets. They have agreed that our right to exist depends on their understanding, their compassion, their willingness to see us as victims worthy of care and acceptance.

And we do not need their invitation.

We do not need cis-society to approve of our transness. We do not need them to validate the medical framing. We do not need them to understand dysphoria or recognize it as real. We do not need their acceptance. We do not need their recognition. We do not need their permission.

What we need is simple: we need access to healthcare, yes — but that is not something we ask for. That is something we demand, because we are human beings, and healthcare is a human right. We need spaces where we can exist without being hunted, yes - but we carve out those spaces ourselves. We do not negotiate for them. We do not perform our trauma to justify them. We create them because we exist and we deserve safety.

We need the right to live as ourselves, openly and without apology, free from harassment and assault, and justice for when it is not. But that right does not come from cis-society granting it. That right exists because we assert it. That right exists because we stand up and say: I am here. This is who I am. The question is not whether you accept me. The question is whether you will get out of my way.

That is the difference between pleading for rights and demanding them. Transmedicalism, both the inward gatekeeping and the outward negotiation, is built entirely on victimhood, pleading, and misplaced negotiation.

Here is what I see happening: transmedicalists took their own legitimate pain and weaponized it in both directions. They said to other trans people: your different experience invalidates you. And they said to cis-society: my suffering validates me. They created a hierarchy of victims, and they asked the world to respect that hierarchy by validating the ones at the top.

I will not do that. I cannot do that.

Yes, being trans is hard. For some of us it is dysphoria, for others, it is the weight of a world that will not see you as you are. For many of us, it is both. For some, it is something else entirely, something that has nothing to do with shame or medical intervention or the need for permission. It doesn't matter, we are all equally trans. We suffer the same mechanisms of oppression regardless.

But here is what I know: none of that defines me. I am not the sum of my suffering. I am not my pain validated, my trauma documented, my damage certified by people in white coats who get to decide if I am sick enough to deserve recognition and treatment.

I am a woman who transitioned. I am a woman who looked at herself, really looked, and decided who she was going to be. That is not a victim story. That is a story about agency and empowerment. And that is the opposite of victimhood.

The reason I cannot embrace the victim framework that Wu and her cohort are offering is not because suffering is not real. It is not because transmisia does not cause damage. It is because I have seen what happens when you let suffering become the lens from which you view yourself and the foundation of your rights claim. I have watched brilliant, talented, deserving people circle around the same stories, the same confessions, the same pleas for understanding, year after year, waiting for the world to finally acknowledge that yes, they suffered, and therefore yes, they deserve to exist.

And the world never does. It just keeps asking for more proof. It just keeps demanding that you perform your pain convincingly enough.

I made a different choice. I stopped performing my pain for an audience that was never going to validate it anyway. I stopped negotiating with people who did not hold the power I thought they did. I stopped asking for permission and started taking it. I stopped surviving, and I started living.

I am a woman. That is not conditional. It is not contingent on dysphoria or medical diagnosis or suffering or anyone else's acceptance. I am a woman because I, like every other woman, know myself to be one. And that knowledge — that simple, unshakeable knowledge of who I am, is worth infinitely more than any amount of sympathy from people who were going to doubt me anyway.

This is what HBS/transmedicalists cannot understand: empowerment is not the same as denying that oppression exists. I am not saying the world is kind to trans people. It is most certainly not. I am not saying that being trans in a cis world is easy. It is most definitely not. I am not saying that transmisia is not real or that it does not cause damage. It causes profound damage quantified by the dead. What I am saying is this — the only power I have comes from refusing to let that damage be the lens through which I see myself, to refuse to be defined on their terms, to refuse to turn that lens onto my own siblings.

The civil rights movement did not get the wins they did because Black Americans convinced white America to feel sorry for them. They did not seek compromise based on what the polling said was acceptable or unpopular. The disability rights movement did not win because disabled people performed their trauma convincingly enough. Every liberation movement that has successfully shifted power has been won by people who stood up and said: I am not asking for your sympathy. I am not negotiating for your acceptance. I am demanding my dignity. I am asserting my humanity. And if you cannot see that, that is your failure, not mine.

That is what works. That is what builds power, and that is the lever which shifts power.

That is what wins.

But transmedicalism requires you to stay in negotiation. It requires you to perform your victimhood for an audience that holds the keys to the gates. It requires you to prove that you deserve the rights that should have been yours from the beginning just by virtue of being human.

I refuse that negotiation entirely.

Cis-society does not owe us a damn thing. It does not owe us acceptance. It does not owe us understanding. It does not owe us compassion. If it owes us anything, it is this: basic dignity and respect. The same dignity and respect it gives to every other human being. Not pity. Not sympathy. Not conditional recognition based on how much we suffer. Respect. Full stop.

And I am not asking for it. I am demanding it.

I am demanding access to healthcare because I am human and healthcare is a human right, not a privilege granted to people who suffer correctly, or who have the acceptable kind of suffering. I am demanding the right to exist in public without being hunted, harassed, or assaulted. I am demanding the right to use the spaces that are right for me, that correspond to who I am, not what you fear might be. I am demanding the right to justice, legal recognition, dignity, safety, and to be judged by my character, not by my identity.

Not because I am broken. Not because I am damaged. Not because I deserve your pity.

But because I am a human being, and human beings have rights that do not depend on anyone's approval, and that starts with basic dignity and respect we all deserve.

I know that the world will try to make me small. I know that there are people who will look at me and see a problem, a threat, a mistake. I know that transmisia is real and it is vicious and it will not be thought away by any amount of reasonableness on my part. But I also know this: the only way those people get to determine who I am is if I let them. The only way they get power over me is if I negotiate from a position of weakness, if I am convinced to willingly surrender it.

And I will not do that.

I will not wrap myself in the safety blanket of victimhood and call it survival. I will not trade my agency for sympathy and understanding that will never come. I will not make my suffering the price of my legitimacy. I will not hate myself enough to prove that I deserve to exist. I will not try to bargain, beg, plead, or buy what isn't for sale. I will not turn these mechanisms of oppression that weigh me down onto my own community, either in hopes of further bargaining, or to show how worthy I am to be accepted and included in cis-society. I will not punch down on my own in order to elevate myself, be it in the mirror, or to the world.

Instead, I will be a woman who knows herself. I will be a woman who chose to transition and chose to live, not in spite of a hostile world, but in full knowledge of it and defiant anyway. I will be the woman who is going to carry that weight, and do my best to shield my community, who will help you carry yours when it weighs heavy upon the very fiber of our being, with the hopes that should I tread weary, my soul heavy and my head bowed, that my rainbow community will become my shield and my support. Because that is the promise of solidarity.

I will be the woman who stands up and says: this is who I am. I am not asking for your permission. I am not begging for your understanding. I am not negotiating for your compassion or acceptance. I am telling you: I am here. I am real. I am whole. I am not responsible for managing your comfort, and you can get over it or you can get out of my way.

That is the power that transmedicalists do not have, because they gave it away. They traded it for the validation of being properly damaged. They are still performing their pain, still negotiating with people who did not hold the keys all along.

I will not make that trade.

Because the cost of that trade is us.

Power comes from agency. Rights come from people who refuse to apologize for existing. Liberation comes from standing up — not in pain, but in strength. Not in victimhood, but in absolute clarity about what we deserve just by existing.

We did not ask for this hand we were dealt. We do not deserve to suffer for being who we are. And we certainly do not get to demand that everyone else suffer as proof of their legitimacy.

But we do get to choose. We get to choose to be wholly, authentically ourselves. We get to choose to demand our rights without negotiating from weakness. We get to choose to stand up and say: I am human. I deserve respect. I deserve equality. I deserve access, inclusion, recognition. Not because I am damaged. Not because I am broken. But because I am here, and my existence is not contingent on anyone's approval.

And when enough of us make that choice, when enough of us refuse the victim framework entirely, when enough of us stand up and demand rather than ask —that is when the world changes.

Not because we convinced them with science and data - If that were the case, we would already be broadly accepted and protected in cis-society, both socially and legally. Not because we performed our pain convincingly enough, and through the empathy and understanding of our oppressors, we were granted clemency and equality. But because we refused to be smaller than we are, we refused to file ourselves down for other's comfort. Because we refused to hide our history and our existence, no matter how visible or invisible we desire to be. Because we insisted on our own power. Because we reached for what was ours all along.

I cannot be an HBS/Transmedicalist because through all the pain and suffering I have endured to get to where I am today, through all the dysphoria, transphobia, and prejudice I have endured, I do not hate being trans, having a trans past, nor do I hate the experiences I wrestled with both internally or externally. I do not hate myself for being trans. I wouldn't wish it on my worst enemy, but I also know I would not be the woman I am today without them - and perhaps that is a key distinction to make - I like who I am today. I am proud of the woman I am and how far I have come. I was never able to hate my trans experiences or myself enough to accept and internalize the transphobia cis-society says I should feel.

I don't want any trans person to suffer as I have, and I have a vision of a future where trans kids grow up without being subjected to the constant, harsh, and unrelenting transphobia I endured. A world where this is just another natural variation, and where the only challenge all trans folks face is managing their self-exploration, dysphoria if present, and transition as needed. Because that is part of who I am, that is a part of who all of us are, and if we hate that so much we wish to eliminate the natural variances in life that leads to us, beautiful trans and non-binary folks, that is not the dysphoria speaking - that is transphobia, internalized.

[1] If you are not familiar with what Harry Benjamin Syndrome (HBS) or Transmedicalism as concepts or groups within the trans community, then I encourage you to read a quick wiki primer on them here. For most, this can be somewhat inaccurately summarized as "gatekeeping trans folks."

In this essay I will often refer to the two as just "transmedicalism" or "transmedicalists." This is for ease of reading and writing.

For the purposes of this essay, these are two different groups/cliques of trans folks who reject the transgender term and terminology in favor of the term transsexual. They advocate for more/stricter gatekeeping, create a criteria and hierarchy of "transness," and will often invalidate non-binary and other trans folks who do not meet their criteria. They desire to make a clear distinction between them and transgender folks, and in the extreme, advocate for a split and departure from the trans umbrella. Often framed as political survival/expediency, disdain for or difference to transgender folks, and engage in optics/respectability politics. Depending on how extreme the individual is, this also involves historical revisionism and conspiracy thinking.