Mtf refers to individuals assigned male at birth but identify themselves female. They may undergo HRT and GCS to align their physical appearance with their gender identity. Mtf are frequently linked to the Josou community and like expressing their femininity through clothing and cosmetics. Some individuals might identify as otoko no ko on a part-time or full-time basis, depending on their comfort level. In recent years, otoko no ko are becoming more visible and accepted in society, resulting in greater awareness and understanding.