Gender Identity in Italy: The Developing Situation at Careggi Hospital

The explosion of children and adolescents adopting a gender identity over the last decade is not restricted to the Anglosphere. This phenomenon has also been seen in Italy with a marked increase during Italy’s very strict Covid lockdown. 

In January 2024, The Italian newspaper, Il Fatto Quotidiano, published an article reporting on the dramatic increase in children and adolescents, predominantly female, who, with no past history of gender dysphoria, had suddenly declared themselves transgender.  

As a result of this article, the newspaper was inundated with letters from desperate parents who all had a similar story. On February 6th, 2024, Il Fatto Quotidiano dedicated their entire “Letters to the Editor” page to some of these parents. Tragically, there simply wasn’t enough space to publish every letter. The letters all had a similar theme; girls and young women with a rapid onset of gender dysphoria during Covid lockdown after spending a great deal of time on social media followed by a declaration of being transgender and “male”. Depression, suicide threats, social anxiety, general anxiety, falling school grades, eating disorders and desperation were common themes. 

Whilst Italy is not institutionally captured, the marked increase in the number of children and adolescents, especially girls, with ROGD cannot be ignored. Many private clinics have taken advantage of the situation and business is booming.

Careggi Hospital in Florence, Italy, has a dedicated gender identity unit, similar to the now closed and disgraced GIDS unit of the Tavistock Hospital in England, offering support to children and adults suffering from gender incongruence. Endocrinologist, Dr Alessandra Fisher and psychologist, Jiska Ristori, are employed in this department and are both listed members of WPATH, (World Professional Association of Transgender Health), itself now under scrutiny after the release of the WPATH files. In total, there are fifteen members from Italy. 

Alessandra Fisher is also the founder and President of SIGIS (Italian Society of Transgender Health), a WPATH-like organization with a bizarre code of conduct for its members which states, “This code of conduct is based on the principle that gender incongruence is not a form of illness or mental issue, but a normal result of psycho-sexual development.”

The SIGIS Code of Conduct also demands its members “not undertake scientific studies that describe or support clinical interventions not in line with human rights, such as the so-called reparative therapies aimed at imposing gender conformity on gender variances”. Fisher has openly dismissed the possibility of a social contagion being responsible for the dramatic increase in pediatric gender dysphoria despite evidence to the contrary. She also believes that the new cohort of girls presenting with gender dysphoria is simply because girls find it easier to ask for help. 

In January of this year, The Italian Senator, Maurizio Gasparri, a “Capo Gruppo” of the political party, Forza Italia, raised concerns in parliament regarding reports of Triptorelin, a GnRH agonist (puberty blocker), being administered without neuropsychiatric assessment to children at Careggi Hospital in Florence. This is strictly against the guidelines of AIFA, the Italian Medicines Agency. The Minister of Health, Orazio Schillaci, ordered an inspection of Careggi Hospital in order to assess the situation. The preliminary findings were released by Senator Gasparri last week.

It was reported that Triptorelin had indeed been administered to children as young as nine years old, with no prior neuropsychiatric assessment which is a grave violation of established protocol. In Italy, when Triptorelin is used, it is mandatory to report it to AIFA in order to monitor the effects (and side effects) of this powerful medication. This was not done. Senator Gasparri stated that he took absolutely no pleasure in having his concerns proven correct and that “Those who have harmed children and families must be answerable”. 

Urgent corrective action was taken to reinforce the national guidelines for the administration of Triptorelin. In effect, this was the immediate end of the “affirmation only” method that had taken place at Careggi Hospital. 

The Minister of Health, Schillaci, forwarded the Careggi Hospital inspectors’ findings to the Florence Prosecutor after an Italian lawyer, Annamaria Bernardini de Pace, also reported concerns about unethical practices at Careggi Hospital. The Florence Prosecutor subsequently opened a case file and will examine the evidence to see if criminal charges are warranted. 

The media coverage of the Careggi Hospital scandal has now gone mainstream and reaction is mixed. There are Italian parents who believe that puberty blockers truly are lifesaving for their troubled children although, depending on how accurately informed they were when giving consent for their children to take Triptorelin, they could possibly be unaware that up to 90% of children outgrow their dysphoria upon completion of puberty. They may also be unaware that every child whose puberty is blocked at Tanner stage 2 will be sterile and anorgasmic. The Careggi Endocrinologist, Alessandra Fisher, declared puberty blockers as “completely reversible” in an interview with the Italian newspaper, Il Manifesto, as recently as March 2023. 

Other Italian voices are concerned; sterility, osteopenia and an increased risk of cancer are serious side effects of medication for a condition which, in all likelihood, will disappear on completion of puberty. Just as in the Anglosphere, it is an emotive topic with strong feelings on all sides.

The final decision as to whether criminal charges are brought against Careggi Hospital, individual doctors, hospital management and the Tuscany regional health authority is now in the hands of the Florence Prosecutor. There is no indication when that decision will be made.