Mtf refers to individuals assigned male at birth but identify themselves female. They could undergo HRT and GCS to align physical appearance with their gender identity. Otoko no ko are commonly connected to the Josou community and like sharing their femininity through attire and cosmetics. Some individuals might consider themselves otoko no ko on a part-time or full-time basis, based on their comfort level. In recent years, mtf have become more visible and accepted in society, leading to greater awareness and understanding.