Mtf refers to individuals assigned male at birth but identify as female. They may undergo hormone replacement therapy and GCS to align their physical appearance with their gender identity. Mtf are frequently connected to the crossdressing community and enjoy sharing their femininity through attire and cosmetics. Certain people 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 have become more visible and accepted in society, resulting in enhanced awareness and understanding.