The word fa'afafine joins fa'a, in the manner of, to fafine, woman, and names Samoans who were assigned male at birth and live in a feminine gender role. The category is part of fa'a Samoa, the Samoan way of life, rather than an import or a subculture: fa'afafine are raised within their extended families, take on much of the domestic, caregiving and service labour that sustains an aiga, and are a visible part of village, school and church life in Samoa, American Samoa and the large diaspora communities of New Zealand, Australia and the United States. Recognition is real but has its limits, and fa'afafine describe both acceptance within the family and censure in other settings, so the category should not be flattened into a simple story of either celebration or persecution.
Ethnographers caution against translating fa'afafine into Western categories such as gay or transgender, because the role is defined by the work a person does and the place they hold in the family rather than by sexuality or by a medical account of identity, and many fa'afafine reject those translations themselves. The word belongs to Samoa alone.
Mahu in Hawaii and Tahiti and fakaleiti in Tonga are distinct categories of distinct societies, and the habit of grouping them all together as one Pacific third gender is a modern construction. Community organisation is active, with fa'afafine associations and annual pageants in Apia serving as public gathering points.