Indian MSM include self-identified gay men (Western acculturated), kothis (men who tend to be the receptive male partner in anal and oral sex and typically have more effeminate mannerisms), panthis (men who tend to be the insertive male partner in anal and oral sex), and double deckers (men who are both receptive and insertive partners). While MSM may self-identify as kothi, the terms panthi and double-decker are generally given by kothis to their male partners based on their sexual roles.