Ryotaro SHIBA, wanting to enhance the drama (a young man killed by tuberculosis just as his skill with the sword is becoming legendary) in Okita's life and so made him a handsome young man in his novel "Moeyo Ken", which was followed by many other works, including the movie "Bakumatsu Junjoden" in which Okita was depicted as beatiful girl.
剣技の強さが伝承されながら労咳により夭逝してしまうというドラマ性に富むその生涯から、そのドラマ性をさらに演出する要素として司馬遼太郎は小説『燃えよ剣』をはじめ、その流れを汲んだ『幕末純情伝(映画)』（美少女として描かれている）など多数の作品において沖田を美少年として描いた。