This term refers to (mostly binary) trans people who completely physically transition or want to do so. It can be used to be precise about a person’s medical transition status and goals, but is sometimes viewed as outdated and too focused on the medical aspects of transition. Transsexuals may or may not identify as transgender specifically, but categorically are under the transgender umbrella. Not all people who identify as transsexual are transmedicalists, but there is significant overlap for obvious reasons.
e.g. Jin identifies as a transsexual because she is a trans woman who intends to undergo vaginoplasty, as well as breast augmentation and HRT.
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