1. MEN WHO HAVE SEX WITH MEN (MSM) & ARAVANIS in INDIA
Dr. Venkatesan Chakrapani, MD
FLD Fellowship grantee of the MacArthur Foundation

2. MEN WHO HAVE SEX WITH MEN (MSM)

3. Terminology Used Men who have Sex with Men (MSM)
Denotes all those men who have sex with other men regardless of their sexual identity.

4. MSM in India – Identities/labels/behaviors
MSM who don’t have any specific identity
Kothi-identified homosexual males (Kothi = “feminine and mostly receptive”)
The masculine partners of kothis who are called ‘Panthis’ (Panthi = “real men who only penetrate”).
Double-decker (“who penetrate and receive”)

5. MSM in India – Identities/labels/behaviors (Contd.)
Gay-identified homosexual men
Bisexual identified men with same-sex/bisexual behavior
Note:
“Panthi” and “DD” are labels and usually not ‘identities’
Identities may not correlate with the presumed sexual behavior.

6. ARAVANIS/
ALIS/HIJRAS

7. Aravanis/Alis/Hijras
Born as biological/anatomical males who reject their 'masculine' identity in due course of time to identify either as women, or not-men, or in-between man and woman, or neither man nor woman.
Aravani – recently coined ‘political term’
‘Ali’ – considered derogatory
Most Aravanis identify as ‘kothi’

8. ACKWA & NIRVAN KOTHIS (ARAVANIS)
Nirvan Kothi: Those who had undergone "Nirvana" ('Salvation' - as castration is known) i.e., removal of both testes and penis (voluntarily/willingly) and who are in woman’s attire.
Aquwa/Ackwa Kothi: Those who wear women’s or men's attire, but who have not yet undergone castration but may or may not want to undergo castration in the future.

9. TERMINOLOGIES & CONCEPTS

10. Biological sex – physical and genetic sexual make-up
Sexual orientation – sexual attraction to members of a particular sex
Gender identity – psychological sense of being male or female
Gender expression and Social sex role – adherence to the cultural expectations for feminine or masculine behavior

11. SEXUAL ORIENTATION
One’s erotic, romantic, and affectional attraction to people of the same sex, to the opposite sex, or to both sexes.
Heterosexuality:Erotic,romantic, and affectional attraction to people of the opposite sex.
Bisexuality: Erotic, romantic, and affectional attraction to people of both sexes.
Homosexuality: Erotic, romantic, and affectional attraction to people of the same sex.

12. GENDER IDENTITY Whether a person identifies as man, woman or other.
(This is distinct from sexual orientation)

13. Traditional Binary Gender Model
Biological Sex: Male Female Hormones, genitalia secondary sex characteristics
Gender Expression Masculine Feminine Dress, posture, roles, identity
Sexual Orientation Attracted Attracted to Women to Men
Courtesy: Sam Lurie (

14. Revolutionary Gender Model
Biological Sex: Male Intersexed Female Hormones, genitalia secondary sex characteristics
Gender Expression Masculine Androgynous Feminine Dress, posture, roles, identity
Sexual Orientation Attracted to: women men both neither other
Courtesy: Sam Lurie (

15. Revolutionary Gender Model Many configurations are possible
Biological Sex: Male Intersexed Female Hormones, genitalia secondary sex characteristics
Gender Expression Masculine Androgynous Feminine Dress, posture, roles, identity
Sexual Orientation Attracted to: women men both neither other
Courtesy: Sam Lurie (

16. SEXUAL IDENTITY
Identity: How one thinks of oneself, as opposed to what others observe or think about one.
Sexual Identity: An inner sense of oneself as a sexual being, including how one identifies in terms of gender identity and sexual orientation.

17. GAY
One who has significant (to oneself) sexual or romantic attractions primarily to members of the same gender or sex, or who identifies as a member of the gay community.
(Is “gay” and “homosexual”synonymous?)

18. LESBIAN
A girl or woman who has significant (to oneself) sexual or romantic attractions primarily to members of the same gender or sex, or who identifies as a member of the lesbian community.

19. BISEXUAL
Bisexual is someone who has romantic and/or sexual relations with other people of more than one sex
A bisexual may be more attracted to one sex than the other, attracted equally to both, or find people's sex unimportant. The strength of their attractions to men and women may vary over time.

20. TRANSSEXUAL
Individual whose gender identity is that of the opposite gender
Male-to-female transsexuals
Female-to-male transsexuals

21. KINSEY SCALE

22. HETEROSEXISM other sexualities are abnormal and immoral.
The assumption that only heterosexuality is normal and
other sexualities are abnormal
and immoral.

23. HOMOPHOBIA
Homophobia is the irrational hatred and fear of lesbian and gay people that is produced by institutionalized biases in a society or culture.

24. People tend to hate or fear what they don't understand
WHY HOMOPHOBIA?
People tend to hate or fear what they don't understand

25. SEXUAL ORIENTATION COUNSELING
Make the person to be comfortable with his/her homosexuality or bisexuality
Assist in coping up with pressures – from families, friends, etc.
Look at individual’s attitude toward own homosexuality. Assist in improving his/her self-worthiness - importance of valuing oneself.