NTR Games Collection by NTRISM itchioOtoko no ko refers to individuals assigned male at birth but identify as female. They may undergo HRT and gender confirmation surgery to align their physical appearance with their gender identity. Mtf are commonly linked to the Josou community and enjoy sharing their femininity through attire and makeup. Certain individuals may consider themselves otoko no ko on a part-time or full-time basis, depending on their comfort level. In recent years, mtf have become more visible and accepted in society, leading to enhanced awareness and understanding.