A Modified Harry Benjamin Scale
Original Version: Harry Benjamin © 1966, Julian Press
Modified version: Anne Curr © 1995, Basic Books
Sex and Gender Disorientation and Indecision
(Persons Born Genetic Males)
List of Types:
Type 0
Normal sexual orientation and identification, heterosexual, bisexual or homosexual. The
ideas of “dressing” or “sex change” are foreign and unpleasant. Includes the vast majority of all
people.
Type 1 – Transvestite (Pseudo)
- Gender “feeling”: Masculine.
- Dressing Habits and Social Life: Normal male life. May get a “kick” from “dressing.” Not truly
TV.
- Sex Object Choice and Sex Life: Usually heterosexual. Rare bisexual. Masturbation with fetish.
Feels guilt. “Purges” and relapses.
- Conversion Operation (SRS): Not considered in reality.
- Hormone Therapy/Estrogen Therapy: Not considered. / Not indicated.
- Psychotherapy: Not wanted. Unnecessary.
- Remarks: Only a sporadic interest in “dressing.” Rarely has a female name when “dressed.”
Type 2 – Transvestite (Festishistic)
- Gender “feeling”: Masculine.
- Dressing Habits and Social Life: Lives as a man. Dresses periotically or part time. Dresses under
male clothes.
- Sex Object Choice and Sex Life: Usually heterosexual. May be bisexual or homosexual. “Dressing”
and “sex change” in masturbation fantasy mainly.
- Conversion Operation (SRS): May consider in fantasy. Rejected.
- Hormone Therapy/Estrogen Therapy: Rarely interested. / May help to reduce libido.
- Psychotherapy: May be successful in favorable environment.
- Remarks: May imitate male and female double personality with male and female names.
Type 3 – Transvestite (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 a woman. May dress under male clothes.
- Sex Object Choice and Sex Life: Heterosexual except when dressed. Dressing gives sexual
satisfaction, relief of gender discomfort. Common to purge and relapse.
- Conversion Operation (SRS): Rejected but the idea is attractive.
- Hormone Therapy/Estrogen Therapy: Attractive as an experiment. / Can be helpful as a
diagnostic.
- Psychotherapy: If attempted, almost never successful as to cure.
- Remarks: May assume a double personality. Trend may be toward Transsexualism.
Type 4 – Transsexual (Non-Surgical)
- Gender “feeling”: Uncertain wavering between TV and TS. May reject “gender.”
- Dressing Habits and Social Life: “Dresses” often as possible with insufficient relief of gender
discomfort. May live as man or as a woman.
- Sex Object Choice and Sex Life: Libido low. Genrally asexual or autoerotic. May be bisexual.
- Conversion Operation (SRS): Attractive but not required.
- Hormone Therapy/Estrogen Therapy: Needed for comfort and emotional balance.
- Psychotherapy: Only as guidance, most often refused and unsuccessful.
- Remarks: Social life dependant on circumstances. Often identifies as “transgenderist.”
Type 5 – Transsexual (Moderate Intensity)
- Gender “feeling”: Feminine “trapped” in a male body.
- Dressing Habits and Social Life: Lives and works as a woman if possible. Insufficient relief from
“dressing.”
- Sex Object Choice and Sex Life: Low libido. Asexual, autoerotic, or passive homosexual activity.
May have been married and have children.
- Conversion Operation (SRS): Requested.
- Hormone Therapy/Estrogen Therapy: Needed for a substitute for or preliminary to SRS
operation.
- Psychotherapy: Rejected. Unless as to cure. Permissive psychological guidance.
- Remarks: Operation hoped for and worked for, often attained.
Type 6 – Transsexual (High Intensity)
- Gender “feeling”: Feminine. Total “psycho-sexual” inversion.
- Dressing Habits and Social Life: Usually lives and works as a woman. No relief from “dressing.”
Gender discomfort intense.
- Sex Object Choice and Sex Life: Intensly desires relations with normal male as a “female” if
young. Later libido low. Heterosexual, bisexual or lesbian identification. May have been married and have
children.
- Conversion Operation (SRS): Urgently requested and usually attained.
- Hormone Therapy/Estrogen Therapy: Required for partial relief.
- Psychotherapy: Psychological guidance or psychotherapy for symptomatic relief only.
- Remarks: Despises her male sex organs. Strong danger of genital self-mutilation or even suicide if
too long frustrated before SRS is attained.
