Abstract
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.
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Data are available on request directly from the authors.
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Acknowledgments
The authors would like to thank Tamara Poljičanin, M.D., Ph.D., from the Croatian Institute for Public Health, Zagreb, Croatia for statistical support.
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All authors contributed to defining the aim and design of this study, as well as data collection. Statistical analysis was performed by Velimir Altabas and Vesna Galjuf under the supervision of Tamara Poljičanin. Velimir Altabas and Vesna Galjuf wrote the paper draft, while Iva Žegura, Nataša Jokić Begić, Goran Arbanas, Dražen Begić and Davor Moravek participated equally in critically reviewing and editing the original draft. All authors read and approved the final manuscript.
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The study was approved by the local university hospital center’s ethical board (class 003–06/21–03/004, file reference number: 251–29-11–21-01–9) and carried out by the Declaration of Helsinki.
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Altabas, V., Galjuf, V., Žegura, I. et al. Referrals For Gender-Affirming Hormone Treatment in Croatia’s National Network for Transgender Healthcare. Arch Sex Behav (2024). https://doi.org/10.1007/s10508-024-02867-9
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DOI: https://doi.org/10.1007/s10508-024-02867-9