Trans identities and medical practice in Italy: Self-positioning towards gender affirmation surgery

Aim: Within the international project "Health and citizenship among trans individuals" developed in France, Italy, Brazil and Norway, this Italian study aims at exploring the socio-demographic characteristics and the role that hormonal treatments and Gender Affirming Surgery (GAS) play in gender identifications and transition pathways. Method: A survey assessing socio-demographic information, feelings about one's own identity and transition paths by means of medical/psychological treatments was carried out with 167 Italian trans individuals (71 female-to-male and 96 male-to-female). Two main indicators (sex assigned at birth and gender self-identification) were used to analyze medical and legal pathways. Results: A strong heterogeneous diversity of this population, whose definition cannot be restricted to binary categorization and which differently make recourse to hormonal treatment or GAS, emerged. An increasing trend in self-identifying in non-binary gender identifications was detected, although the majority of the sample still expressed the need of undergoing GAS. Conclusions: These findings shed light on the actual diversity of inner gender stabilizing processes among Italian trans people. If on one hand the centrality of the genitals and the importance of surgery seem to undergo a slow decline, on the other hand GAS still continues to be an important achievement to be pursued.