North American tribal customs feature “two-spirit” people who combined male and female attributes (anthropologists call these “berdache”, from a French word for catamite).
Septon Cellador spoke up. " This boy Satin. It's said you mean to make him your steward and squire, in Tollett's place. My lord, the boy's a whore … a … dare I say … a painted catamite from the brothels of Old-town" .