While several European countries have moved toward regulated access to gender-affirming care for minors, Italy is moving in the opposite direction.
What the Schillaci–Roccella Decree Actually Does
Eugenia Roccella – Minister for Equal Opportunities and Family in Italy
In July 2025, the Italian government approved a decree-law that fundamentally changes access to healthcare for transgender minors.
Presented as a technical measure on drug “appropriateness”, the Schillaci–Roccella decree introduces new national controls, registers, and authorisations that significantly restrict gender-affirming care.
This article explains why the decree is not neutral, why it raises serious legal and human rights concerns, and why its impact goes far beyond healthcare—affecting trust, equality, and democratic principles.
The Real Impact on Transgender Adolescents
Mandatory diagnosis by a multidisciplinary team
Documentation of any previous psychological, psychotherapeutic, or psychiatric treatments
Approval from the national pediatric ethics committee as per Article 2, paragraph 9 of Law No. 3/2018
Creation of a national register at the Italian Medicines Agency (AIFA) to monitor each prescription
Periodic transmission of collected data to the Ministry of Health
Although the stated intention is to ensure appropriateness and protection, those with direct experience know that, in practice, this will result in more obstacles, institutional distrust, delays, and regional inequalities in accessing gender-affirming care.
My Position on Gender-Affirming Care for Minors
Let me be clear: I have never supported the casual and indiscriminate administration of hormones or puberty blockers. On the contrary, I believe avoiding drug administration, where possible, is preferable.
For me, a pharmacological approach to gender variance in adolescence or preadolescence must always be an extrema ratio—a last resort—applied only in the face of unbearable distress in the gender assigned at birth, and with full respect for the young person’s lived experience.
Too often, those who support these pathways are portrayed in the media as fanatics eager to indiscriminately give hormones to children and adolescents.
For decades, I have been at the forefront of efforts to depathologise and depsychiatrise the trans condition.
Gender Variance in Adolescence
(Extract from my book “No Going Back” – TEA, 2023)
Requests from adolescents to access gender-affirming care have become an international phenomenon, with recent cases also in Italy.
When a social phenomenon takes shape, instead of imposing bans—as some political forces wish—it is always better to regulate it using available scientific knowledge.
The debate must draw on:
Medical, legal, and social expertise
Direct and documented experience
Intellectual honesty
Scientific literature identifies gender-variant adolescents as at risk of isolation, self-devaluation, school dropout, self-harm, and even suicide. For many, the physical changes of puberty cause severe suffering.
During the public debate on the Zan bill, much was said about adolescent access to hormone therapy. I believe we must avoid ideological positions of being rigidly “for” or “against.”
Twenty-five years after beginning my own gender affirmation process, I can say with certainty that if I had been able to start hormone therapy at sixteen, my life would have been better.
For this reason, I support access for adolescents, but stress that it must come with caution, prudence, and close professional monitoring.
I consider sixteen a reasonable minimum age for accessing such treatments, in line with recent laws in Scotland and Spain. Younger minors, with family support, should at least have the right to a social transition, including use of a chosen name in school and, where distress is severe, access to puberty blockers with proper oversight.
The Importance of a Multidisciplinary Support Network
Experience shows that a robust support network is essential: families, doctors, professionals, trans community peer supporters, educators, and school staff must work together.
Such a network should aim to:
Help the young person address gender incongruence free from socio-cultural bias
Equip them to navigate a binary social system and its pressures
Distinguish between genuine needs to ease dysphoria and socially induced expectations
This requires non-dogmatic approaches and professionals with proven, documented experience. Above all, it requires a secular, questioning mindset.
Improving quality of life for these youth demands multidisciplinary expertise: medical, endocrinological, legal, psychological, and socio-anthropological.
Why This Is Not a Neutral Health Measure
We need politics that listen, not politics that surveil. — Michel Foucault
Gender-variant youth are not an “emergency” to be contained, but lives to be accompanied with respect and adequate tools.
Anyone truly concerned with their well-being should focus on:
Training healthcare professionals
Strengthening multidisciplinary teams across the country
Encouraging dialogue between families, schools, and services
Not on creating registers and bureaucratic filters that complicate already difficult paths.
As Foucault wrote in The History of Sexuality – The Will to Knowledge, sexual identity has been shaped by discourses, disciplinary practices, and institutions that have defined, classified, and normalised sexual behaviours throughout Western history. Medical or legal norms that dictate exactly what a trans person can or cannot do end up reproducing a disciplinary power that discriminates rather than supports.
