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In India, some Hijras do not define themselves by specific sexual orientation, but rather by renouncing sexuality altogether. However, these notions can come in conflict with the practical, which is that hijras are often employed as prostitutes.

Furthermore, in India a feminine male who takes a "receptive" role in sex with a man will often identify as a kothi (or the local equivalent term).

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.

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.