His scale is still a useful reference where a transgender person can measure themselves based on the intensity of the dysphoria they experience. Like his predecessor Hirschfeld, Benjamin believed that a gender identity deviation from your birth sex could be measured on a continuum rather than as a yes or no proposition hence the six levels.
His work continues to be the gold standard against which I measure all other research and he had by far the largest patient history.
I know I have referenced his gender disorientation scale before but here it is again in case you missed it the first time. Keep in mind that the categories are broad but I have found that most transgender people can recognize themselves on it.
Type 4 seems to be the one that fits me best (minus the estrogen treatments).
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 symptom relief only.
Remarks: Despises his male sex organs. Danger of suicide or self-mutilation, if too long frustrated.