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[TW: Spoilers Contain Transphobia, Abuse, Exclusion, Enbyphobia]

Transmedicalists, sometimes shortened to "transmeds" or often more negatively referred to as "truscum" (though many have reclaimed this term), often state that the transmedicalist position is only bound together by one talking point: the belief that gender dysphoria (and generally, by extension, medical transition) is the only requirement for someone to validly be transgender.

This talking point is often argued against by many transgender people who oppose transmedicalism, and that's great because that premise in and of itself is very flawed. There are some transgender people who transition on the basis of "gender euphoria" rather than gender dysphoria, which, simply put, operates more from a mindset of "I don't hate being a man, but I'd sure much prefer being a woman!" rather than "I dread being a man so much, it's pure pain and suffering, and I will not be able to see even a sliver of happiness unless I undergo extensive gender transition.".

I must say that both are valid ways to feel gender identity, but transmedicalism is often born through trans people in the latter group projecting their idea of being trans as the one and only, truly correct way to experience gender incongruence. They also tend to base being trans explicitly on suffering and leave very little room for gender euphoria themselves. I've faced a lot of dysphoria in my life and celebrated the moments where I've progressed towards alleviating it, but transmeds more often tend to see it as just "another condition to treat", which isn't bad in and of itself, but that mindset, as you can see, will expand to toxic beliefs in many instances.

In order to answer your questions:

The people who are living a different gender identity than was assigned to them at birth are trans. Trans-itioning their outward gender…I mean, right? What am I missing?

This is generally how the term "transgender" is defined, but I'd like to add a tiny caveat. It's not necessarily based on "living" as such or even "transitioning" itself, nor does the "trans" prefix in the word even etymologically have anything to do with the word "transition". Many trans people will undergo procedures to achieve the life as the gender they identify with, but that's not necessarily what defines being trans in and of itself. It is typically more common to associate the definition of trans with just the general state of having a gender identity that does not align with your assigned sex at birth.

Is it people that didn’t get diagnosed by a clinician with gender dysphoria? Or that they don’t have gender dysphoria at all and became trans?

I have seen some transmedicalists assert that you need to go as far to have a diagnosis of GD to adequately consider yourself trans (and funnily enough, with that in mind, I definitely should be considered trans to them), but the pushback is usually about the notion that you can be trans without having dysphoria at all, as explained earlier.

To wrap this up, the issue is that transmedicalists are often liars. The whole "aLl we beLIeve Is tHAT YOU NEED dYSPhorIa TO BE TRAns" shit they try to hide behind is just a bluff they use to pretend that their views are based on "logic, reason, rationality, and science" in an attempt to masquerade the fact that their views are actually just rooted in hypocrisy, bigotry, and disgust that is fundamentally no different than the typical transphobic drivel you'd get from your average American conservative.

How do I know this? The meme I made says it all. I have been diagnosed with gender dysphoria by multiple different doctors, have gone through, and continue to go through, so much financial, social, legal, and medical struggle to further my gender transition, and on top of all that, in the process of suffering through gender dysphoria,

When I have tried to reason with transmedicalists who try to assert things like "nON-bINaRy pEOplE ArE NotHinG lIKE me", they don't have a change of heart and learn to grow some fucking empathy. They will either commit one of two fallacies:

1. A goalpost movement: "You're dysphoric and a non-binary person? Well, fuck, I guess I gotta change my criteria for being trans now."
2. A no true Scotsman: "You're dysphoric and a non-binary person? You're either lying about your dysphoria or you're lying about being non-binary."

You can't win with these people, and they only exist to push hate which has frightened me to the point of isolating myself from trans people for a long time. Overcoming that fear of a community that I am a part of was a huge bitch. It was doubly frightening because I live in Florida, a state where I'm already at so much risk of losing access to gender-affirming care,

And that's the long response.