Two-spirit individuals are viewed in some tribes as having two identities occupying one body. Their dress is usually a mixture of traditionally male and traditionally female articles, or they may dress as a man one day, and a woman on another. According to Sabine Lang many tribes have distinct gender and social roles. Some specific roles sometimes held by male assigned at birth two-spirits include:
- healers or medicine persons
- conveyors of oral traditions and songs (Yuki)
- foretellers of the future (Winnebago, Oglala Lakota)
- conferrers of lucky names on children or adults (Oglala Lakota, Tohono O'odham)
- nurses during war expeditions
- potters (Zuni, Navajo, Tohono O'odham)
- matchmakers (Cheyenne, Omaha, Oglala Lakota)
- makers of feather regalia for dances (Maidu)
- special role players in the Sun Dance (Crow, Hidatsa, Oglala Lakota)
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