The word kothi (or koti) is common across India, similar to the kathoey of Thailand, although kothis are often distinguished from hijras. They perform similar roles to hijra, such as dancing and singing at birth ceremonies and weddings. Male devotees in female clothing are known as jogappa. In South India, the goddess Renuka is believed to have the power to change one's sex. In North India, the goddess Bahuchara Mata is worshipped by pavaiyaa. In Konkani, they are known as hizddem or hizdô. In Bengali, hijra is called হিজড়া, hijra, hijla, hijre, hizra, or hizre. In Odia, a hijra is referred to as hinjida or hinjda, in Tamil as ali, aravanni, aravani or aruvani (often considered derogatory, and have been supplanted by in-community terms rejecting the concept of hijra for a broader trans identity, such as thirunangai ( திருநங்கை, tirunaṅkai 'respected woman'), thirunambi ( திருநம்பி, tirunampi 'respected man') and thirunar ( திருனர், tiruṉar 'respected person') for trans woman, man and person respectively), in Punjabi as khusra or jankha, in Kannada as mangalamukhi (ಮಂಗಳಮುಖಿ), in Sindhi as khadro ( Sindhi: کدڙو), and in Gujarati as pavaiyaa (પાવૈયા). While these are rough synonyms, they may be better understood as separate identities due to regional cultural differences. Ī number of terms across the culturally and linguistically diverse Indian subcontinent represent similar sex or gender categories. Another such term is khasuaa (खसुआ) or khusaraa (खुसरा). Khawajasira is sometimes seen as a more respectable term and has been reclaimed by the community given its precolonial origins and revered status within Islamic spirituality. This term is generally considered derogatory in Urdu and the term Khwaja Sara is used instead. The Hindustani word hijra may alternately be romanized as hijira, hijda, hijada, hijara, hijrah and is pronounced Hindustani pronunciation. Nepal, Pakistan, India and Bangladesh have all legally accepted the existence of a third gender, with India, Pakistan and Nepal including an option for them on passports and certain official documents. In India, the Supreme Court in April 2014 recognised hijras, transgender people, eunuchs, and intersex people as a 'third gender' in law. Hijras have successfully gained this recognition in Bangladesh and are eligible for priority in education and certain kinds of low paid jobs. Since the late 20th century, some hijra activists and non-government organizations have lobbied for official recognition of the hijra as a kind of 'third sex' or ' third gender', as neither man nor woman. Some hijras undergo an initiation rite into the hijra community called nirvaan, which involves the removal of the penis, scrotum and testicles.

However, in general hijras have been born male, with only a few having been born with intersex variations. It has traditionally been translated into English as 'eunuch' or ' hermaphrodite', where 'the irregularity of the male genitalia is central to the definition'. These communities have consisted over generations of those who are in abject poverty or who have been rejected by or fled their family of origin. Many hijras today live in well-defined and organised all-hijra communities, led by a guru.

Hijras identity evolved during the Delhi Sultanate (1226-1526) and Mughal Empire (1526-1707). Hijras are officially recognised as a third gender throughout countries in the Indian subcontinent, being considered neither completely male nor female. They are also known as aravani, aruvani, and jogappa, In Pakistan, they are known as khawaja sira, the equivalent of transgender in the Urdu language. In the Indian subcontinent, hijra are eunuchs, intersex people, or transgender people who live in communities that follow a kinship system known as guru-chela system.

Kathoey in sanscrit