It refers to ‘women who act like men' and ‘men who act like women' and from the context it is clear that both male and female same-sex relationships were known about and were generally accepted.
It is a given, in the Kama Sutra, that feelings towards a partner will change over time, on either side. Women, having given birth, might not be interested in sex anymore, whether short term or long term. Men, as they age, might lose their fiery libido, leaving their female partner high and dry. Therefore, the text details ways of breaking up with an unsatisfactory lover.
There is a large section on courtesans: how to find and engage them, how much and when to pay them, and what to expect for your money. Although this could be construed as a misogynistic chapter, the text recommends being polite and respectful to the courtesans for no other reason than civility and good manners. Courtesans are not at all looked down on for their career choices, instead, they are mentioned as being providers of a vital service.
Sexual Union
Before going on to detail the many forms of touching and sexual congress, the text gives a list of women who should not be considered as suitable partners: these include female relatives, close female friends, lepers, women who smell bad, a mentally ill woman, women who are too fair or too dark-skinned, and the wives of kings, friends, relatives and aristocracy. Read more