The "hijra" in India are born physically male, but live as women, including dressing and socializing as female. In the past they used to castrate themselves and even remove the penis in order to urinate through a small hole. Now, with the arrival of western medicine, many hijari choose to take hormone therapies and sometimes have sex reassignment surgery. Many of these people still call themselves "hijra", but some now call themselves "transsexuals" or "transgender women". The role of hijari in society is complex and varied throughout all of India.