A network of healthcare professionals specializing in transgender care was established in Croatia in 2011, and legal advancements were subsequently made in 2014. Both achievements made gender transition more transparent and thus more attainable in Croatia. This observational study was conducted to assess the number of transgender individuals initiating gender-affirming hormone treatment (GAHT) in Croatia and describes trends in age and sex assigned at birth. Between 2011 and 2022, a total of 111 transgender individuals initiated GAHT. Within the cohort, 52 were assigned male at birth (AMAB) and 59 were assigned female at birth (AFAB). The overall annual incidence rate of transgender individuals initiating GAHT was 0.52 per 100,000 age-adjusted individuals. There was a statistically significant increase (p < 0.01) in transgender individuals commencing GAHT before the COVID-19 pandemic. Furthermore, a rising trend toward masculinizing rather than feminizing treatment was identified (p < 0.05), particularly among younger transgender individuals. The COVID-19 pandemic disrupted these trends in 2020, except for the trend of initiating therapy at a younger age (p < 0.01). The annual incidence and age distribution trends of transgender individuals initiating GAHT in Croatia closely mirrored those in other European countries, with a higher prevalence of individuals assigned female at birth. The study underscores a significant rise in the number of individuals initiating gender-affirming hormone treatment, emphasizing the need for proper legal regulation and healthcare system response.

克罗地亚于 2011 年建立了专门从事跨性别护理的医疗保健专业人员网络，随后在 2014 年取得了法律进步。这两项成就都使性别转变更加透明，从而在克罗地亚更容易实现。这项观察性研究旨在评估克罗地亚开始性别肯定激素治疗 (GAHT) 的跨性别者人数，并描述出生时年龄和性别的趋势。 2011年至2022年间，共有111名跨性别者发起了GAHT。在队列中，52 名出生时被指定为男性 (AMAB)，59 名出生时被指定为女性 (AFAB)。开始 GAHT 的跨性别个体的总体年发病率为每 100,000 名年龄调整个体中 0.52 例。 在 COVID-19 大流行之前开始 GAHT 的跨性别者数量显着增加 ( p < 0.01)。此外，还发现了男性化治疗而非女性化治疗的上升趋势（p  < 0.05），特别是在年轻的跨性别者中。 2020 年，COVID-19 大流行扰乱了这些趋势，但开始治疗的年龄更年轻的趋势除外 ( p  < 0.01)。在克罗地亚开始 GAHT 的跨性别者的年发病率和年龄分布趋势与其他欧洲国家的情况非常相似，出生时被指定为女性的个体的患病率较高。该研究强调开始性别肯定激素治疗的人数显着增加，强调需要适当的法律监管和医疗保健系统应对措施。