"Adolescents on file": Why the government's new bill on gender dysphoria in minors is scaring associations

The decree approved by the Government, promoted by Minister of Health Orazio Schillaci and Minister for Family and Equal Opportunities Eugenia Roccella , provides for the creation of a national registry that will collect detailed information on all cases of prescriptions of drugs for gender dysphoria to minors . This registry will be managed by the Italian Medicines Agency (AIFA) and will include data relating to diagnoses, documented outcomes of psychological and therapeutic interventions , and clinical monitoring following administration. The data will be periodically transmitted to the Ministry of Health, which will also use it to prepare reports for Parliament.

The law does not explicitly distinguish between drugs with different purposes, such as puberty blockers , used primarily in prepubertal stages to temporarily suspend sexual development, and hormone treatments (masculinizing or feminizing), intended for people who have already begun pubertal development. This comparison has raised numerous concerns among professionals in the sector and associations for the defense of transgender rights.

Completing the new regulatory framework is the establishment of a technical committee responsible for evaluating the impact of the measures adopted. The committee will be composed of representatives from the Ministry of Health and political figures responsible for family and social issues. Every three years, it will be required to submit a report to Parliament based on the data collected through the registry.

The international context has strongly influenced Italian decisions. In particular, the constant reference is the so-called " Cass Review ," a comprehensive report commissioned by the UK's National Health Service and led by pediatrician Hilary Cass . The document, published in April 2024, concluded that the use of puberty blockers and hormones had been based on insufficient evidence for years, and recommended discontinuing their administration outside of rigorous clinical trials. However, a few months later, it was challenged by a report from the German Society of Child and Adolescent Psychiatry and Psychotherapy (DGKJP), which gave a positive opinion on the use of the drugs and reaffirmed their importance in treating gender dysphoria in minors.

Many Italian LGBTQ+ associations have expressed alarm at the bill's approval. Criticisms of the bill focus on three main aspects: first, a possible national registry containing health information on patients receiving medications for dysphoria is seen as a potential " filing " of transgender minors. The second aspect concerns the fact that the therapies currently prescribed to minors who are already sexually developed (i.e., masculinizing and feminizing hormones) would be essentially equated with those prescribed to pre-adolescents who are not yet sexually developed, i.e., so-called puberty blockers . Finally, the final criticism concerns the prescription of blockers , which would require both a diagnosis and "psychological, psychotherapeutic, and possibly psychiatric" interventions.

Roberta Parigiani , lawyer and spokesperson for the Trans Identity Movement (MIT), emphasized that blockers are often used precisely to suspend the pubertal process , allowing younger people to reflect on their gender identity before making final decisions . According to Parigiani, tying access to these medications to a formal diagnosis can increase distress for minors at an already sensitive age. Furthermore, equating blockers and hormones, which have different uses and purposes, can create confusion in clinical pathways and limit access to even the most appropriate treatments for those who already have a clear understanding of their identity.

Harsh criticism also came from Christian Leonardo Cristalli, national head of transgender policies at Arcigay , who called the registry a "de facto filing system." Cristalli expressed concern about the growing climate of suspicion and the risk that the measure could erode the relationship of trust between doctor and patient , medicalizing and pathologizing a condition that already causes significant social suffering. According to Cristalli, the authorization system introduced by the bill could lead to harmful delays in treatment and worsen the psychological conditions of those living with gender dysphoria , with possible side effects such as anxiety, depression, eating disorders, and self-harm.

The approval of the bill by the Council of Ministers represents only the first step in the legal process : the bill must now be debated in Parliament and may be subject to amendments. Until final approval, the new rules will not enter into force, but their structure already suggests a clear direction: greater state control over the gender affirmation processes of minors , with profound implications both clinically and culturally.

Beyond the technical aspects, the debate raised by the bill touches on broader issues related to the recognition of gender identity, therapeutic freedom, the secular nature of the state, and the right of minors to personalized care. Critics argue that the new legislation does not provide true protection, but rather a surveillance mechanism that tends to discourage, rather than support, transition processes. Supporters, however, argue that it is a necessary precautionary measure, based on the protection of the most vulnerable, while science provides more robust and unequivocal answers.

What is certain is that the measure ushers in a new era in Italy's approach to gender dysphoria in minors. This phase promises to be contentious , complex, and full of legal, ethical, and scientific implications. At its core remains the delicate balance between health care, self-determination, and institutional responsibility . A balance that, for many, still appears far from being achieved.