It can also be used as a masculine name, in the anime Hanako-kun the main character is named Hanako and he's a boy!.
― Anonymous User 5/1/2020
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This name is so out of fashion in Japan it's considered a joke name. It's because of Hanako the toilet ghost - plus "ko" names are old hat now. Plus, it's kind of a stereotypical name for Japanese characters in American media, kinda like Pierre is for French characters. Not totally unusable, but it might be better to skip this one.