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Everything old is new again: More Than One Way To Be Trans

In his 1966 book, The Transsexual Phenomenon, Dr. Harry Benjamin’s defined 6 types of (male to female) transsexuals: Transvestite of the pseudo type; Transvestite of the fetishistic type; True Transvestite; Transsexual of the nonsurgical type; Transsexual of moderate intensity; and Transsexual of high intensity. Benjamin considered only the last two types as “true transsexuals” and held the belief that those termed “transvestites” were not gender dysphoric.

These distinctions were perhaps mostly theoretical. There was never much more about that idea in the scientific literature in the 70’s an 80’s, and by the time I became licensed in 1994, the only two remaining categories were transvestite and transsexual. At that time the term transgender was coming more into use to emphasize that even that distinction was becoming less clear due to concepts like autogynephilia and reports of  some cross-dressers (transvestites) eventually identifying as transsexual.

Here we are another 30 years later and again revisiting the fact that there are some distinctions within the community. This time the discussions are not happening among professionals but within the members of the trans community. The current distinction is between those who assert that being transgender is incumbent upon the experience physical/sex dysphoria and those accept that the label transgender can include those who only experience social dysphoria.

The two groups have sometimes been described as transmedicalists and politicization activists respectively. However, the terms that are commonly used to distinguish them on social media are Truscum and Tucute.

“Truscum” came from “true transsexual” and “scum” but has been embraced by the group and is not heard as derogatory. Truscum are transmedicalists who complain about losing the distinction between transsexual and transgender. They view being transsexual as a medical condition in need of medical treatment. Some might even view being trans as a birth defect or an intersex condition. 

Truscum believe that all (truly) trans people experience gender dysphoria and naturally would identify within the binary and use only male or female pronouns. They may be big on “passing” and the expectation that trans people live normal lives as regular men and women, perhaps even stealth.

Truscum want being trans to ideally be recognized as biological or physical a condition by, for instance, showing that trans people have different brains from cis people. They accordingly want medical transition to be restricted to true transsexuals, in order to avoid a rise of de-transition rates that would put at risk access to the medical treatment they need. 

Truscum fear that the de-medicalization of being trans will result in transition not being seen as something that is necessary for trans people. They also fear that tucute views lead to gender non-conforming people thinking that they’re transgender because they don’t fit the “norms”. They refer to this group as transtrenders“. 

The term “tucute” allegedly came from the phrase, “too cute to be cis” and is willingly owned by tucute. Tucute believe that being transgender is a normal variation in gender identity and do not view being trans as a medical condition. They acknowledge that gender dysphoria is a condition but do not see gender dysphoria as a requirement for being trans. 

Tucute support those with gender dysphoria who desire medical intervention, and also support those without gender dysphoria who desire medical intervention. Tucute are also more likely to accept nonbinary or queer identities and are accepting of non-binary and nounself pronouns. 

Tucute want to stop the pathologization of trans people and believe that dismantling the binary is the way to do that. They don’t want being trans to be labeled as a medical condition. The tucute agenda is to increase visibility and normalize gender variance thereby moving the system toward informed consent access to medical care for those who need or want it.

Tucute are more likely to believe that gender identity is not present at birth and that it is purely a social construct. They may even go so far as to state that everyone is transgender given the rejection of the binary idea of man or woman. 

Some tucute view truscum as cis wannabies that have all the oppressive, exclusionary, gatekeeping qualities that come with a cis status. They believe that this is driven by heteronormativity and is therefore a symptom of internalized transphobia.

Tucute prioritize inclusivity at the cost of clarity. Truscum prioritize clarity at the cost of inclusivity. In some respects, the distinction is one of degrees and there is a continuum of trans(gender) experiences and more than one way to be trans.


Antonia Caretto, Ph.D. is a fully licensed Clinical Psychologist and a graduate of the University of Michigan and the Alliant International University California School of Professional Psychology.
Dr. Caretto’s 1991 doctoral dissertation research was on “Familial Homosexuality Among Women and It’s Relationship to Childhood Gender Role Non-Conformity and Adult Sex Role.”

Dr. Caretto has a solo private practice in Farmington Hills, MI, and gender identity development continues to the focus of much of her work.


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