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The Sex Orientation Scale (SOS) was Harry Benjamin's attempt to classify and understand various forms and subtypes of transvestism and transsexualism in people assigned male at birth, published in 1966.^[1]^[2] It was a seven-point scale (with three types of transvestism, three types of transsexualism, and one category for typical males); it was analogous to the Kinsey Scale as it relates to sexual orientation, which also had seven categories.^[3]

Much like Kinsey's understanding of sexual orientation, Benjamin understood the nature of gender identity and gender expression not as a discrete scale, but as a spectrum, a continuum with many variations. However the Benjamin scale does not reflect a modern understanding of gender identity,^[4] and is not useful as a contemporary diagnostic tool,^[5] especially due to its conflation of gender identity with sexual orientation.

Benjamin feared legal consequences for surgeons who performed sex reassignment surgery, and focused on the patients being able to pass and unlikely to regret their decision when deciding whether to recommend someone for an operation—in addition to possessing an unchanging gender identity.^[6]

Sex Orientation Scale (S.O.S.)

Sex and Gender Role Disorientation and Indecision (Males)

Group	Type	Name	Kinsey scale
1	I	Transvestite (Pseudo)	0–6
1	II	Transvestite (Fetishistic)	0–2
1	III	Transvestite (True)	0–2
2	IV	Transsexual (Nonsurgical)	1–4
3	V	True transsexual (Moderate intensity)	4–6
3	VI	True transsexual (High intensity)	6

Benjamin noted, "It must be emphasized again that the remaining six types are not and never can be sharply separated."^[1]

Benjamin added a caveat:

It has been the intention here to point out the possibility of several conceptions and classifications of the transvestitic and the transsexual phenomenon. Future studies and observations may decide which one is likely to come closest to the truth and in this way a possible understanding of the etiology may be gained."^[1]

Benjamin's Scale references and uses Alfred Kinsey's sexual orientation scale to distinguish between "true transsexualism" and "transvestism".^[7]

Modern views

Contemporary views on gender identity and classification differ markedly from Harry Benjamin's original opinions.^[8] Sexual orientation is no longer regarded a criterion for diagnosis, or for distinction between transsexuality, transvestism and other forms of gender variant behavior and expression. Modern views also exclude fetishistic transvestism from the spectrum of transsexual identity/classification, this type of transvestism is not related to gender expression or identity but is a distinctly sexual phenomenon most commonly practised by people who are neither transsexual nor homosexual. Benjamin's scale was designed for use with heterosexual trans women, and trans men's identities do not align with these categories.^[9]

References

^ ^a ^b ^c Benjamin, Harry (1966). The Transsexual Phenomenon. The Julian Press, ISBN 9780446824262
^ Heath, Rachel Ann (2006). The Praeger Handbook of Transsexuality: Changing Gender to Match Mindset. Westport, Conn. [u.a.]: Praeger. p. 4. ISBN 978-0-275-99176-0.
^ Pomeroy, Wardell (1975). The diagnosis and treatment of transvestites and transsexuals. Journal of Sex & Marital Therapy Volume 1, Issue 3, 1975 doi:10.1080/00926237508405291
^ Kumar, Anish; Amakiri, Uchechukwu; Safer, Joshua (15 February 2022). "Medicine as constraint: Assessing the barriers to gender-affirming care". Cell Reports Medicine. 3 (2): 100517. doi:10.1016/j.xcrm.2022.100517. PMC 8861822. PMID 35243420.
^ Coleman, E.; et al. (15 September 2022). "Standards of Care for the Health of Transgender and Gender Diverse People, Version 8". International Journal of Transgender Health. 23 (Suppl 1): S6-7. doi:10.1080/26895269.2022.2100644. PMC 9553112. PMID 36238954. S2CID 252127302.
^ Velocci, Beans (2021). "Standards of Care". TSQ: Transgender Studies Quarterly. 8 (4): 462–480. doi:10.1215/23289252-9311060. S2CID 244064667.
^ Frayser, Suzanne G.; Whitby, Thomas (1995). Studies in Human Sexuality: A Selected Guide. Englewood, Colo.: Libr. Unlimited. p. 368. ISBN 978-1-56308-131-6.
^ Ekins, Richard (2005). Science, politics and clinical intervention: Harry Benjamin, transsexualism and the problem of heteronormativity Sexualities July 2005 vol. 8 no. 3 306-328 doi: 10.1177/1363460705049578
^ Hansbury, Griffin (2008). The Middle Men: An Introduction to the Transmasculine Identities. Studies in Gender and Sexuality Volume 6, Issue 3, 2005 doi:10.1080/15240650609349276

External links

[benjamin1966-1] Benjamin, Harry (1966). The Transsexual Phenomenon. The Julian Press, ISBN 9780446824262

[2] Heath, Rachel Ann (2006). The Praeger Handbook of Transsexuality: Changing Gender to Match Mindset. Westport, Conn. [u.a.]: Praeger. p. 4. ISBN 978-0-275-99176-0.

[Pomeroy1964-3] Pomeroy, Wardell (1975). The diagnosis and treatment of transvestites and transsexuals. Journal of Sex & Marital Therapy Volume 1, Issue 3, 1975 doi:10.1080/00926237508405291

[4] Kumar, Anish; Amakiri, Uchechukwu; Safer, Joshua (15 February 2022). "Medicine as constraint: Assessing the barriers to gender-affirming care". Cell Reports Medicine. 3 (2): 100517. doi:10.1016/j.xcrm.2022.100517. PMC 8861822. PMID 35243420.

[5] Coleman, E.; et al. (15 September 2022). "Standards of Care for the Health of Transgender and Gender Diverse People, Version 8". International Journal of Transgender Health. 23 (Suppl 1): S6-7. doi:10.1080/26895269.2022.2100644. PMC 9553112. PMID 36238954. S2CID 252127302.

[6] Velocci, Beans (2021). "Standards of Care". TSQ: Transgender Studies Quarterly. 8 (4): 462–480. doi:10.1215/23289252-9311060. S2CID 244064667.

[7] Frayser, Suzanne G.; Whitby, Thomas (1995). Studies in Human Sexuality: A Selected Guide. Englewood, Colo.: Libr. Unlimited. p. 368. ISBN 978-1-56308-131-6.

[Ekins2005-8] Ekins, Richard (2005). Science, politics and clinical intervention: Harry Benjamin, transsexualism and the problem of heteronormativity Sexualities July 2005 vol. 8 no. 3 306-328 doi: 10.1177/1363460705049578

[Hansbury2008-9] Hansbury, Griffin (2008). The Middle Men: An Introduction to the Transmasculine Identities. Studies in Gender and Sexuality Volume 6, Issue 3, 2005 doi:10.1080/15240650609349276

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+{{Short description|Transsexualism typology}}
-'''Harry Benjamin's Gender Identity Scale''' was a first attempt to classify and understand various forms and subtypes of gender variant behaviors and expressions, made by Dr. [[Harry Benjamin]]. It was a 6-point scale, similar to the [[Kinsey scale]] of [[sexual orientation]], which had 7 categories. Much like Kinsey's understanding in the field of sexual orientation, Dr. Benjamin understood that the nature of gender identity and gender expressions is not a discrete scale, but a spectrum, a continuum with many variations, much more than those featured in the scale. But the scale he developed seemed to be an easy, rational and clinically useful way to diagnose different forms of [[transsexualism]] and to distinguish between those who needed surgical and/or hormonal treatment and those who didn't.
+The '''Sex Orientation Scale''' ('''SOS''') was [[Harry Benjamin]]'s attempt to classify and understand various forms and subtypes of [[transvestism]] and [[transsexualism]] in people [[Sex assignment|assigned male at birth]], published in 1966.<ref name="benjamin1966">Benjamin, Harry (1966). ''The Transsexual Phenomenon.'' The Julian Press, {{ISBN|9780446824262}}</ref><ref>{{cite book|last=Heath|first=Rachel Ann|title=The Praeger Handbook of Transsexuality: Changing Gender to Match Mindset|year=2006|publisher=Praeger|location=Westport, Conn. [u.a.]|isbn=978-0-275-99176-0|url=https://books.google.com/books?id=YQldwi3LVYoC&q=%22Sex+Orientation+Scale%22+Harry+Benjamin&pg=PA4|page=4}}</ref> It was a seven-point scale (with three types of transvestism, three types of transsexualism, and one category for typical males); it was analogous to the [[Kinsey Scale]] as it relates to [[sexual orientation]], which also had seven categories.<ref name="Pomeroy1964">Pomeroy, Wardell (1975). The diagnosis and treatment of transvestites and transsexuals. ''[[Journal of Sex & Marital Therapy]]'' Volume 1, Issue 3, 1975 doi:10.1080/00926237508405291</ref>
+Much like Kinsey's understanding of sexual orientation, Benjamin understood the nature of [[gender identity]] and [[gender expression]] not as a discrete scale, but as a [[spectrum]], a continuum with many variations.  However the Benjamin scale does not reflect a modern understanding of gender identity,<ref>{{cite journal |last1=Kumar |first1=Anish |last2=Amakiri |first2=Uchechukwu |last3=Safer |first3=Joshua |title=Medicine as constraint: Assessing the barriers to gender-affirming care |journal=Cell Reports Medicine |date=15 February 2022 |volume=3 |issue=2 |page=100517 |doi=10.1016/j.xcrm.2022.100517 |pmid=35243420 |pmc=8861822 }}</ref> and is not useful as a contemporary diagnostic tool,<ref>{{cite journal |title=Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 |journal=International Journal of Transgender Health |date=15 September 2022 |volume=23 |pages=S6-7 |doi=10.1080/26895269.2022.2100644 |last1=Coleman |first1=E. |last2=Radix |first2=A. E. |last3=Bouman |first3=W. P. |last4=Brown |first4=G. R. |last5=De Vries |first5=A. L. C. |last6=Deutsch |first6=M. B. |last7=Ettner |first7=R. |last8=Fraser |first8=L. |last9=Goodman |first9=M. |last10=Green |first10=J. |last11=Hancock |first11=A. B. |last12=Johnson |first12=T. W. |last13=Karasic |first13=D. H. |last14=Knudson |first14=G. A. |last15=Leibowitz |first15=S. F. |last16=Meyer-Bahlburg |first16=H. F. L. |last17=Monstrey |first17=S. J. |last18=Motmans |first18=J. |last19=Nahata |first19=L. |last20=Nieder |first20=T. O. |last21=Reisner |first21=S. L. |last22=Richards |first22=C. |last23=Schechter |first23=L. S. |last24=Tangpricha |first24=V. |last25=Tishelman |first25=A. C. |last26=Van Trotsenburg |first26=M. A. A. |last27=Winter |first27=S. |last28=Ducheny |first28=K. |last29=Adams |first29=N. J. |last30=Adrián |first30=T. M. |issue=Suppl 1 |pmid=36238954 |pmc=9553112 |s2cid=252127302 |display-authors=1 |doi-access=free }}</ref> especially due to its conflation of gender identity with sexual orientation.
-Benjamin noted: "It must be emphasized again that the remaining six types are not and never can be sharply separated." <ref name="benjamin1966">Benjamin H (1966). [http://www.symposion.com/ijt/benjamin/chap_02.htm The Transsexual Phenomenon]''</ref>
+Benjamin feared legal consequences for surgeons who performed [[sex reassignment surgery]], and focused on the patients being able to pass and unlikely to regret their decision when deciding whether to recommend someone for an operation—in addition to possessing an unchanging gender identity.<ref>{{cite journal |last1=Velocci |first1=Beans |title=Standards of Care |journal=TSQ: Transgender Studies Quarterly |date=2021 |volume=8 |issue=4 |pages=462–480 |doi=10.1215/23289252-9311060|s2cid=244064667 }}</ref>
+==Sex Orientation Scale (S.O.S.)==
+'''Sex and Gender Role Disorientation and Indecision (Males)'''
 {| class="wikitable"
 |-
-! Group !! Type !! Name
+! Group !! Type !! Name !! [[Kinsey scale]]
 |-
-|1 || I || Pseudo TV
+|1 || I || Transvestite (Pseudo) || 0–6
 |-
-| 1 || II || Fetishistic TV
+| 1 || II || Transvestite (Fetishistic) || 0–2
 |-
-| 1 || III || True TV
+| 1 || III || Transvestite (True) || 0–2
 |-
-| 2 || IV || TS, Nonsurgical
+| 2 || IV || Transsexual (Nonsurgical) || 1–4
 |-
-| 3 || V || TS, Moderate intensity
+| 3 || V || True transsexual (Moderate intensity) || 4–6
 |-
-| 3 || VI || TS, High intensity
+| 3 || VI || True transsexual (High intensity) || 6
 |-
 |}
+Benjamin noted, "It must be emphasized again that the remaining six types are not and never can be sharply separated."<ref name="benjamin1966"/>
-Benjamin added a caveat: "It has been the intention here to point out the possibility of several conceptions and classifications of the transvestitic and the transsexual phenomenon. Future studies and observations may decide which one is likely to come closest to the truth and in this way a possible understanding of the etiology may be gained." <ref name="benjamin1966"/>
+Benjamin added a caveat:
-Dr. Benjamin's Scale references and uses Dr. Alfred Kinsey's sexual orientation scale to distinguish between "true transsexualism" and "transvestism". But it should be noted that the strict relationship between gender identity (Benjamin's Scale) and sexual orientation (Kinsey's Scale) was just a result of the researcher's biases, not his scientific findings.
+{{quote|It has been the intention here to point out the possibility of several conceptions and classifications of the transvestitic and the transsexual phenomenon. Future studies and observations may decide which one is likely to come closest to the truth and in this way a possible understanding of the etiology may be gained."<ref name="benjamin1966"/>}}
-At the time when Dr. Benjamin practised, any transsexual couldn't qualify as eligible for transition if he/she wasn't completely ''homosexual'' (relative to his/her birth sex), thus, ''heterosexual'' after transition. It was just because at the time it was believed that '''obviously''' a ''real'', ''normal'' [[female]] should be completely heterosexual, and a lesbian female was perceived as somewhat deviant, wrong or abnormal. So it seemed to doctors (including Benjamin himself) to be an absurd to help transition a MtF which was attracted to women. As transsexuals discovered this bias, they started to lie in order to get hormones and surgery. Today most gender clinics presume sexual orientation and gender identity are distinct.
+Benjamin's Scale references and uses Alfred Kinsey's sexual orientation scale to distinguish between "true transsexualism" and "transvestism".<ref>{{cite book|last=Frayser|first=Suzanne G.|title=Studies in Human Sexuality: A Selected Guide|year=1995|publisher=Libr. Unlimited|location=Englewood, Colo.|isbn=978-1-56308-131-6|url=https://books.google.com/books?id=ZArPH0nFGo0C&q=%22Sex+Orientation+Scale%22+Harry+Benjamin&pg=PA368|author2=Whitby, Thomas|page=368}}</ref>
-The scale was referring only to MtF transsexuals (transwomen), and male transvestites, since Dr. Benjamin had relatively little experience with FtM transsexuals (transmen).
-== The classification ==
-Benjamin's classification follows:
-=== Type One: Pseudo Transvestite ===
-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: Fetishistic Transvestism ===
-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: True Transvestism ===
-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: Non-op Transsexual ===
-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 or Core Transsexual (with gender dysphoria of 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 or Core Transsexual (with gender dysphoria of 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.
 == Modern views ==
+Contemporary views on gender identity and classification differ markedly from Harry Benjamin's original opinions.<ref name="Ekins2005">Ekins, Richard (2005). Science, politics and clinical intervention: Harry Benjamin, transsexualism and the problem of heteronormativity ''[[Sexualities (journal)|Sexualities]]'' July 2005 vol. 8 no. 3 306-328 doi: 10.1177/1363460705049578</ref> Sexual orientation is no longer regarded a criterion for diagnosis, or for distinction between transsexuality, transvestism and other forms of [[gender variance|gender variant]] behavior and expression. Modern views also exclude fetishistic transvestism from the spectrum of transsexual identity/classification, this type of transvestism is not related to gender expression or identity but is a distinctly sexual phenomenon most commonly practised by people who are neither transsexual nor homosexual. Benjamin's scale was designed for use with heterosexual [[trans women]], and [[trans men]]'s identities do not align with these categories.<ref name="Hansbury2008">Hansbury, Griffin (2008). The Middle Men: An Introduction to the Transmasculine Identities. ''[[Studies in Gender and Sexuality]]''  Volume 6, Issue 3, 2005 doi:10.1080/15240650609349276</ref>
-More modern views on gender identity issues differ from original Harry Benjamin's view not only in that they exclude sexual orientation as a criteria for diagnosing and distinguishing between transsexuality, transvestism and other forms of gender variant behavior or expression. Modern views also exclude fetishistic transvestism from this spectrum, as it is a distinct phenomenon, not related to gender identity but related to sexual arousal and fetishism.
 == See also ==
+* [[Classification of transgender people]]
-* [[Harry Benjamin]]
 * [[Harry Benjamin International Gender Dysphoria Association]]
-* [[Transsexualism]]
-* [[Transvestism]]
 * [[Transgender]]
-* [[Homosexuality and transgender]]
 == References ==
+{{Reflist}}
-<div class="references-small"><references/></div>
 == External links ==
+* [https://web.archive.org/web/20111015004456/http://www.genderpsychology.org/transsexual/benjamin_gd.html Harry Benjamin's Gender Scale]
+* [https://web.archive.org/web/20060717210820/http://www.symposion.com/ijt/benjamin/chap_02table.htm The Scale in the Harry Benjamin's book "The Transsexual Phenomenon"]
+[[Category:Transgender studies]]
-* [http://www.genderpsychology.org/transsexual/benjamin_gd.html Harry Benjamin's Gender Scale]
+[[Category:Scales]]
-* [http://www.symposion.com/ijt/benjamin/chap_02table.htm The Scale in the Harry Benjamin's book "The Transsexual Phenomenon"]
-[[Category:Gender]]
-[[Category:Transgender]]
 [[Category:Sexology]]
+[[Category:Cross-dressing]]
-[[ru:Шкала Бенджамина]]