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While kothis are usually distinguished from hijras as a separate gender identity, they often dress as women and act in a feminine manner in public spaces, even using feminine language to refer to themselves and each other.
The usual partners of hijras and kothis are men who consider themselves heterosexual as they are the ones who penetrate.
The Indian lawyer and author Rajesh Talwar has written a book highlighting the human rights abuses suffered by the community titled 'The Third Sex and Human Rights.' Few employment opportunities are available to hijras.
As with transgender people in most of the world, they face extreme discrimination in health, housing, education, employment, immigration, law, and any bureaucracy that is unable to place them into male or female gender categories.
Male devotees in female clothing are known as Jogappa.
They perform similar roles to hijra, such as dancing and singing at birth ceremonies and weddings.
The word kothi (or koti) is common across India, similar to the Kathoey of Thailand, although kothis are often distinguished from hijras.
Kothis are regarded as feminine men or boys who take a feminine role in sex with men, but do not live in the kind of intentional communities that hijras usually live in.
These male partners are often married, and any relationships or sex with "kothis" or hijras are usually kept secret from the community at large.