Mtf refers to people assigned male at birth but identify as female. They might undergo hormone replacement therapy and GCS to align physical appearance with their gender identity. Otoko no ko are commonly associated with the Josou community and enjoy sharing their femininity through clothing and makeup. Some people might consider themselves otoko no ko on a part-time or full-time basis, based on their comfort level. In recent years, mtf are becoming more visible and accepted in the community, resulting in increased awareness and understanding.