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Okama began his career by publishing various dōjin works (usually hentai themed), and made his debut in the professional world in 1998, with most of his early work also being hentai erotica themed. In late 1999, he began his first non-adult orientated serialization Cat's World.
Currently, Okama is involved in a multitude of works and projects, including the serialization of Cloth Road, association with several animation projects, illustration for various magazines, as well as minor dōjin activities. His most recent work was with the video game No More Heroes as costume designer and artist for the fictional anime 'Bizarre Jelly' featured in the game. Okama is also the illustrator of Vocaloid Nekomura Iroha.
Okama also means a transvestite or homosexual. The artist's explanation for his name is that he always plays female characters in online games.