Mtf refers to persons assigned male at birth but identify themselves female. They might undergo HRT and GCS to align physical appearance with their gender identity. Mtf are often associated with the Josou community and enjoyment sharing their femininity through attire and cosmetics. Some individuals may identify as otoko no ko on a part-time or full-time basis, based on their comfort level. In recent years, mtf have become more visible and accepted in society, leading to greater awareness and understanding.