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Otoko no ko refers to people assigned male at birth but identify themselves female. They could undergo HRT and GCS to align physical appearance with their gender identity. Mtf are commonly linked to the Josou community and like sharing their femininity through clothing and cosmetics. Some people might consider themselves mtf on a part-time or full-time basis, based on their comfort level. In recent years, otoko no ko have more visible and accepted in the community, leading to enhanced awareness and understanding.
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