Harry Benjamin Syndrome (HBS) is a medical term popularized by transmedicalist activist Charlotte Goiar. It frames transness as a specific neurological condition distinct from the broader transgender community and calls for distinction from it. Often adopting the label “HBS Type VI.” This typology, based on the Harry Benjamin Sexual Orientation Scale, is also used to invalidate others as a “lesser type” or not a “true transsexual.”
Transmedicalism is the belief that being transgender requires either experiencing gender dysphoria and/or undergoing medical transition (like hormone therapy or surgery). Transmedicalists, sometimes referred to as some variation of “trutrans” or “truscum,” argue that people who identify as transgender without these criteria aren't genuinely trans. They will sometimes use derogatory terms for transgender folks, such as “transtrenders.”
Both groups will generally prefer to call themselves as transsexuals to differentiate them from the transgender moniker, and will say they are just women with a transsexual history. Both will claim that non-binary folks are “not real” or “made up” as, in their view, non-binary folks are “merely spicy cis folks” or will attempt to use biological essentialism, and other conservative and/or TERF rhetoric, to invalidate the transgender community as a whole. This often includes conspiracy theories or thinking.
Why are these bad? Ultimately, adopting these ideological takes inevitably leads to adopting a hierarchy of who is and isn't “valid” or “really trans,” the advocacy for the return to, or stricter/enhanced medical and clinical gatekeeping policies. At the extreme, it leads to transsexual separatist movements. All of these hurt all trans folks equally.
It is important to understand that these are two distinct, if related, communities that overlap quite a bit. One could argue that HBS Types are an extreme subset of transmedicalism, or that the latter was an evolved and slightly more progressive version of the former, but that could be its own essay. In the future, I will have separate articles for each. Keep in mind that there is a bit of nuance I am lacking here in this quick primer and defintion. Not all transmedicalists will hold others to these standards or hold exclusionary/judgmental views, but this is quite rare.
