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the Benjamin scale

Do you recognize yourself among the categories below? They are the 6 types of gender dysphoric people that Harry Benhamin identified during his long and distinguished career. After much self reflection, I have determined that I fall somewhere between the type III and type IV camps.

Unlike Blanchard, Benjamin did not divide his patients by sexual orientation but instead focused on the degree of alienation they experienced vis a vis their birth gender.

The terms may be outdated for our present day but the analysis cannot and should not be ignored.

Type One: Transvestite (Pseudo)

Gender Feeling: Masculine 
Dressing Habits and Social Life: Lives as a man. Could get occasional kick out of dressing. Normal male life. 
Sex Object Choice and Sex Life: Hetero, bi, or homosexual. Dressing and -- more --exchange may occur in masturbation fantasies mainly. May enjoy TV literature only. 
Kinsey Scale: 0-6 
Conversion Operation: Not considered in reality. 
Estrogen Medication: Not interested or indicated. 
Psychotherapy: Not wanted and unnecessary. 
Remarks: Interests in dressing is only sporadic.

Type Two: Transvestism (Fetishistic)

Gender Feeling: Masculine 
Dressing Habits and Social Life: Lives as a man. Dressing periodically or part of the time. Dresses underneath male clothes. 
Sex Object Choice and Sex Life: Heterosexual. Rarely bisexual. Masturbation with fetish. Guilt feelings. Purges and relapses. 
Kinsey Scale: 0-2 
Conversion Operation: Rejected 
Estrogen Medication: Rarely interested. Occasionally useful to reduce libido. 
Psychotherapy: May be successful (in a favorable environment.) 
Remarks: May imitate double (masculine and feminine) personality with male and female names.

Type Three: Transvestism (True)

Gender Feeling: Masculine (but with less conviction.) 
Dressing Habits and Social Life: Dresses constantly or as often as possible. May live and be accepted as woman. May dress underneath male clothes, if no other chance. 
Sex Object Choice and Sex Life: Heterosexual, except when dressed. Dressing gives sexual satisfaction with relief of gender discomfort. May purge and relapse. 
Kinsey Scale: 0-2 
Conversion Operation: Actually rejected, but idea can be attractive. 
Estrogen Medication: Attractive as an experiment. Can be helpful emotionally 
Psychotherapy: If attempted is usually not successful as to cure. 
Remarks: May assume double personality. Trend toward transsexualism.

Type Four: Transsexual (Nonsurgical)

Gender Feeling: Undecided. Wavering between TV and TS. 
Dressing Habits and Social Life: Dresses as often as possible with insufficient relief of his gender discomfort. May live as a man or woman; sometimes alternating. 
Sex Object Choice and Sex Life: Libido often low. Asexual or auto-erotic. Could be bisexual. Could also be married and have children. 
Kinsey Scale: 1-4 
Conversion Operation: Attractive but not requested or attraction not admitted. 
Estrogen Medication: Needed for comfort and emotional balance. 
Psychotherapy: Only as guidance; otherwise refused or unsuccessful. 
Remarks: Social life dependent upon circumstances.

Type Five: True Transsexual (moderate intensity)

Gender Feeling: Feminine (trapped in male body) 
Dressing Habits and Social Life: Lives and works as woman if possible. Insufficient relief from dressing. 
Sex Object Choice and Sex Life: Libido low. Asexual auto-erotic, or passive homosexual activity. May have been married and have children. 
Kinsey Scale: 4-6 
Conversion Operation: Requested and usually indicated. 
Estrogen Medication: Needed as substitute for or preliminary to operation. 
Psychotherapy: Rejected. Useless as to cure. Permissive psychological guidance. 
Remarks: Operation hoped for and worked for. Often attained.

Type Six: True Transsexual (high intensity)

Gender Feeling: Feminine. Total psycho-sexual inversion. 
Dressing Habits and Social Life: May live and work as a woman. Dressing gives insufficient relief. Gender discomfort intense. 
Sex Object Choice and Sex Life: Intensely desires relations with normal male as female if young. May have been married and have children, by using fantasies in intercourse. 
Kinsey Scale: 6 
Conversion Operation: Urgently requested and usually attained. Indicated. 
Estrogen Medication: Required for partial relief. 
Psychotherapy: Psychological guidance or psychotherapy for symptomaticrelief only. 
Remarks: Despises his male sex organs. Danger of suicide or self-mutilation, if too long frustrated.


  1. Interesting list Joanna. I must say I’m a little uncomfortable with the description and content of the types, but provocation always get the little grey cells going. I know I don’t have to decide but as one goes through them one makes a mental tick list none the less.
    As you have been "brave" enough to select, I will also. I think it would be somewhere between type II and III. Maybe it’s too early for me to pigeon hole myself at this time (which goes against my principles as you know). So I’ll look at the list again after a year of blogging with you all at my side and see where I am then.
    I must say carrying out Jack’s survey unearthed some points in my makeup I wasn’t aware of before. In addition, this list has generated a few new thought process as well...

  2. I too had reservations about some of the descriptions and "type comments.' But I'm willing to think about something new to me, like this.

    I'd have to say I'd probably fit somewhere in the range encompassed by Types 3 and 4. The likelihood is low of my moving further, into full-time femininity. However, improving the quality of my "femulation", is both desired and planned.

    Thanks for bringing this exercise to your blog.


  3. Keep in mind that this scale is not perfect but it was an attempt by Benjamin to grade his patients. He had so many that he was able to find enough overlap to allow him to generate this scale.

  4. The hardest thing about any categories are those of us who do not fit into them. What puts me off is the inclusion of sexuality with dressing. Each category has something associated with it. But none of them seem to fit my own. As in dressing is non sexual, libido is quite high, purely heterosexual regardless of gender presentation. So I am not quite sure where that places me within the context of this scale.

    Interesting read though. Quite thought provoking. Thanks Joanna!

  5. Nadine, Benjamin was not associating dysphoria with sexuality he was merely showing the degree to which people feel a disconnect with birth gender. It just so happens that the higher up the scale you the more nebulous about their sexuality were some of his patients. Some were hetero, some asexual, some homosexual, etc. He was not tying sexuality to gender identity he was in fact doing the opposite.

    For him brain gender identity was imprinted very early on and well before any sexualisation took place.

  6. Ummmm... wow, so much misinformation about Benjamin's "scale"... he was describing "intensity" of what Fisk would later describe as "gender dysphoria"... I find it interesting that in this rendering of the "high intensity" type, that the sexuality part has been edited to drop an all important word and a comma, which changed the meaning entirely:

    Sex Object Choice and Sex Life: Intensely desires relations with normal male as female if young. May have been married and have children, by using fantasies in intercourse.

    The original was

    Sex Object Choice and Sex Life: Intensely desires relations with normal male as female, if young. Older, may have been married and have children, by using fantasies in intercourse.

    My point? That Benjamin recognized that there were in fact TWO completely separate populations that have two completely separate etiologies. They have been called various things, but the most recent is "young transitioner" and "older transitioner"... and those "older" transitioners were gynephilic (if MTF, of course) and also, like their compatriots in the less intense catagories, also autogynphilic (the proper term for "fetishistic"), "using fantasies in intercourse"... while the "younger" type is exclusively androphilic and NOT autogynephilic.

    See my FAQ for more info on the two types:

    1. I am perfectly aware of everything you just stated and have read the book several times as well as Blanchard's work, Anne Lawrence and Anne Vitale. They all recognized the same phenomena but came to different conclusions about origin. I tend to go more with the Benjamin and Vitale hypothesis that there is some predisposition in biology and not just psychology of fetish. I have been to your site before and have read your blog. You are clearly in the Blanchard/Lawrence camp. To each his own.


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