This chapter offers a genealogical account of the discursive repertoires of trans as condition and trans as movement. It describes the negotiation of differing positions on trans condition and movement by health professionals and radical feminists as well as trans patients, activists and academics. In addition to providing a roughly chronological history of ideas, it explores how contemporary trans possibilities have emerged through categorisation and contestation, and explains why medical discourse has played a particularly important role in this process. It looks at how recent sociological studies incorporated condition-oriented identities within broadly movement-oriented accounts of trans community, focusing on Surya Monro's concept of ‘gender pluralism’. It shows how recent interventions from health professionals have sought to acknowledge movement-oriented trans identities and experiences.