There is something truly and undeniably rotten in the Italian Society of Endocrinology, (Società Endocrinologia Italiana, SEI). The SEI is a small cog in an international medical scandal, which has resulted in irreversible iatrogenic harm to thousands of children throughout the world, including Italy.

This is not breaking news although the release of the Cass review in England, a four-year investigation into the use of puberty blockers by the respected paediatrician, Dr Hilary Cass, former Chair of the Royal College of Paediatrics and Child Health (RCPCH), helped expose the enormous medical and academic corruption in the field of “gender-affirming care”.

The Italian Society of Psychoanalysts has long voiced concern regarding the medicalisation of children suffering from “gender dysphoria” and queried the validity of the claims made by the SEI that children are at an increased risk of suicide, self-harm and depression should they not be put onto a medicalized pathway of puberty blockers.

The professional battle has played out in the mainstream Italian press, with a more sympathetic view being given to the side of the endocrinologists. In January 2023, ONIG, (Osservatori Nazionale Sull’Identità di Genere – a collective group of Italian medical and cultural societies) wrote a public letter to Italian Prime Minister, Giorgia Meloni, defending the use of puberty blockers for dysphoric children, claiming their reversibility and lifesaving properties.

However, in May 2021, Sweden’s world-renowned Karolinska Institute stopped using puberty blockers due to the irreversible adverse effects and, prior to that, in June 2020 Finland took the same decision, preferring a non-medicalized approach to the treatment of paediatric dysphoria.

On February 5, 2024, Sarantis Thanopulos, a psychoanalyst based in Naples and President of the Società Psicoanalitica Italiana, wrote a letter to the Editor of Quotidiana Sanità expressing his concerns that an ideological approach to dysphoric children at Careggi Hospital in Florence was taking precedence over evidence-based medicine. Thanopulos requested evidence supporting the claims that puberty blockers were indeed “lifesaving” and expressed concern at the lack of psychological assessment before starting treatment that, in 98% of cases, was not simply a “pause” but the first step on an irreversible pathway which included cross-sex hormones and surgery.

Despite the very concerning initial findings of the Italian governmental inspection at Florence’s Careggi Hospital’s Gender Department being made public a few weeks ago, the now proven false narrative that puberty blockers are lifesaving continues in the Italian press. Italian mothers whose children have been treated by endocrinologist, Alessandra Fisher and psychologist, Jiska Ristori truly believe that their children will “kill themselves” if they stop taking the puberty blocker, Triptorelin. Not only is the lack of informed consent medically negligent but also unbelievably cruel and a betrayal of the trust between a medical practitioner and their patients. Fisher and Ristori’s young patients and their parents deserve the truth that the evidence base for the use of puberty blockers is built on deceptive practices with medical practitioners referring to each others’ guidelines; in effect a fraudulent circular base of evidence, which is now an international scandal.

I am sure that the Italian psychologist, Sarantis Thanopolus will take absolutely no pleasure in being internationally vindicated. Like many others around the world, he will simply feel immense sadness at the unacceptably high number of children and adolescents who have been irreversibly harmed due to the biggest academic and medical scandal in modern medical history.

An Italian equivalent of the English Cass Review is now urgently needed. The position of the Società Italiana Endocrinologia’s continued use and support of Triptorelin is now completely untenable.

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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. 

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Italian professionals appeal to the new PM, and Spanish parents petition the EU as “Catalan Tavistock” sees an incredible rise in gender dysphoric girls.

Italy

In a first for Italy, a professional mental health body has raised the alarm on the use of puberty blockers in children and called for ‘rigorous scientific discussion’ on treating gender dysphoria in young people.

In a letter dated 12th January, The Italian Psychoanalytic Society (SPI) addressed the country’s new prime minister, the conservative Giorigia Meloni. The letter signed by the Society’s president Sarantis Thanopulos expressed ‘great concern’ about medical interventions given to young people claiming gender distress, as ‘the development of sexual identity is still in progress.’

‘Only a minority of children who state that they do not identify with their sex confirm this position in adolescence, after puberty,’ the letter claims. ‘To suspend or prevent (their) psychosexual development pending the maturation of a stable identity definition is contradictory to the fact that this development is a central factor in the definition process,’ it continues.

The SPI addressed a similar statement to the country’s minister for health, Prof. Horace Schillaci. 

Ms Meloni has expressed her position on gender ideology in the past, declaring, ‘Yes to sexual identity, no to gender ideology.’ As reported by Australian journalist Bernard Lane, the Italian parents’ group Genitori de Gender have said that the debate in Italy is still very lacking. ‘Even the most important information, such as Sweden’s abandonment of the ‘gender affirmative’ (medical) protocol, finds little or no space in the (Italian) media,’ according to a representative. 

AMANDA petition EU policymakers regarding the rise in ROGD 

Meanwhile, the Spanish association AMANDA, which brings together parents of children experiencing rapid onset gender dysphoria (ROGD), have submitted a petition to the European Parliament calling for an end to all types of medical interventions in children until more research has been done. 

While the petition has been accepted by the European Parliament and has been published on their website, AMANDA are appealing to as many people as possible to sign and support it. The petition can be signed here.

The petition demands that EU countries report the number of cases of young people experiencing ROGD to get a complete picture of the phenomenon. Like the letter from the SPI, it calls for debate based on scientific evidence on the consequences of the treatments currently being offered to young people.

‘Mental health professionals should be permitted to carry out their work without interference, with observation over a period of time,’ the petition states. It also demands that exploratory therapy should be used as the first option for children, ‘so that only adults can undergo a social and medical transition, and even then only on a very exceptional basis in those cases where this is the only option for the well-being of the person and always with assessment by a multidisciplinary team, as already required in other European Union countries such as Sweden and Finland.’

It draws attention to the rapid rise of ROGD across European Union countries, which they claim is due to social contagion, noting that these cases are often seen in neurodiverse young people, such as those with high IQ, autism and ADHD, among others, or those with psychological problems due to issues such as sexual abuse, bullying and racism.

AMANDA are fiercely critical of the prevailing affirmative approach, which does not require prior psychological assessment ‘as the gender self-identification is assumed to be correct, even where there are signs that the teenager/young person has issues that could be affecting their self-identification as ‘trans’…’ This affirmative approach, the petition states, conflicts with the free exercise of parental responsibility by fathers and mothers in the case of minors.

At the time of writing, the petition has over 700 signatories.

Catalonia sees an astronomical rise in girls attending gender clinics 󠁥󠁳󠁣󠁴󠁿

This comes as feminists in Catalonia have revealed a dramatic increase in the number of preadolescent and adolescent girls presenting at the region’s gender clinic.

Between 2015 and 2021, the number of young women and girls presenting at the Servei Trànsit clinic grew by 5700%. The Servei Trànsit is a unit of the Institut Català de la Salut specialised in gender dysphoria, which opened in Barcelona in 2012. The figure was revealed in a report titled ‘From adult men to adolescent girls‘, based on a study by Feminists de Catalunya. 

According to the report, ‘While in the initial years, the Servei Trànsit was mainly aimed at adult men, in recent years minors and, specifically, preadolescent and adolescent girls are one of the main demographic groups of the population served.’

According to the anthropologist Silvia Carrasco, it was not easy to get the data ‘(Feministas de Catalunya) had to go to mediation, a democratic body that must guarantee access to public information, who agreed with us,’ she told Cronica Libra on 11th January. ‘But even so, they have not provided us with data on treatments by age, sex and year, and we know nothing about private healthcare and paediatrics. That is why we insist that our data is conservative, the reality is much worse.’

On 20th January, it was announced that the Council of Medical Associations of Catalonia had launched a guide for caring for trans minors that recommends prudence and psychological examination of children with gender distress. Feministes de Catalunya claims the guide cites their findings. 

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