Mtf refers to people assigned male at birth but identify themselves female. They could undergo hormone replacement therapy and gender confirmation surgery to align physical appearance with their gender identity. Trap are often linked to the crossdressing community and like expressing their femininity through fashion and cosmetics. Certain people may identify as otoko no ko on a part-time or full-time basis, based on their comfort level. In recent years, mtf have more visible and accepted in the community, resulting in greater awareness and understanding.