Otoko no ko refers to people assigned male at birth but identify female. They could undergo HRT and gender confirmation surgery to align their physical appearance with their gender identity. Mtf are frequently linked to the crossdressing community and like expressing their femininity through clothing and makeup. Some people might consider themselves 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 enhanced awareness and understanding.