Gender Dysphoria Bill: what it provides and what changes

Bill 2575, known as the “Gender Dysphoria Bill,” is the government bill titled “Provisions for prescriptive appropriateness and the correct use of medications for gender dysphoria.” Approved by the Council of Ministers on August 4, 2025 at the proposal of Health Minister Orazio Schillaci and Family, Birth Rate, and Equal Opportunities Minister Eugenia Roccella [1][8], the text was filed at the Chamber of Deputies on August 11, 2025 [11]. It is the first comprehensive legislative intervention by the Meloni government on gender identity and represents, according to its proponents, a measure to protect the health of minors. According to the leading Italian scientific societies, however, it is a measure that risks closing the doors of medicine to those who need it most [4][5].

How it came about: the timeline

The Gasparri inquiry and the Careggi case

The path leading to Bill 2575 began on December 18, 2023, when Maurizio Gasparri, leader of Forza Italia in the Senate, filed a parliamentary inquiry directed to the Prime Minister and the Health Minister. The subject: the Gender Dysphoria Center at Careggi hospital in Florence, accused of administering triptorelin — a puberty-blocking drug — to minors as young as eleven without adequate psychotherapeutic and psychiatric support.

The inquiry triggered a chain reaction. In January 2024, the Ministry of Health sent an inspection team to Careggi [9]. The results, leaked publicly by Gasparri himself, highlighted “very significant critical issues in the pathway of care and management” of minors with gender dysphoria [9]. In particular, the inspectors found non-compliance with AIFA ruling no. 21756/2019, specifically regarding the requirement for psychiatric support before initiating triptorelin treatment, and the failure to transmit data to the Italian Medicines Agency.

The Ministry issued eleven recommendations to the Tuscany region, starting with the mandatory neuropsychiatric evaluation for all patients in care [9].

The interministerial technical panel

In May 2024, Ministers Schillaci and Roccella established a technical panel at the Ministry of Health’s Cabinet Office, composed of 29 members including experts and institutional representatives [10]. The panel included officials from both ministries, physicians, bioethics experts, and psychologists, as well as representatives from various scientific societies (SIEDP, SIAMS, SINPIA, SITCC, SIPS, SIGO, SPI, SIP, SIGIS, SIE). The composition was criticized for its gender imbalance: 24 men and 5 women.

The panel’s mandate was twofold: to conduct a survey of how gender dysphoria is treated across the national territory and to reexamine the international scientific literature [10]. The stated objective was to revise guidelines on the use of triptorelin in minors with gender variance.

Ministers Schillaci and Roccella jointly declared that “news reports on the Careggi case, parliamentary inquiries, subsequent inspections, and the changing approaches of other countries that had promoted extensive use of these medications and are now revising their positions” made a comprehensive review “necessary and urgent” [10].

From AIFA to the Council of Ministers

AIFA simultaneously opened a discussion on reassessing triptorelin’s inclusion in the list of medications under Law 648/1996 — the framework that allows its use outside approved therapeutic indications. The technical panel’s work fed into the drafting of the bill, approved by the Council of Ministers on August 4, 2025 [1][8].

What the bill provides: the three articles

The text of Bill 2575 is brief — three articles — but its potential impact is broad [2][3]. It concerns exclusively minors and does not intervene on Law 164/1982 or on the vital records rectification procedure for adults.

Article 1: diagnosis, medications, ethics committee

Article 1 regulates the administration to minors of two categories of medications: puberty blockers (such as triptorelin, a GnRH agonist that reversibly suspends pubertal development) and masculinizing and feminizing hormones (testosterone and estrogen used in gender-affirming hormone therapy).

To access these treatments, the bill requires [1][2]:

• Diagnosis by a multidisciplinary team: composed of psychologists, psychotherapists, psychiatrists, and endocrinologists, which must formally certify the presence of gender dysphoria in the minor.
• Documentation of prior pathways: the outcomes of psychological, psychotherapeutic, and “possibly” psychiatric pathways undertaken by the minor must be documented and attached to the diagnosis.
• Compliance with ministerial protocols: administration must occur in compliance with clinical protocols adopted by the Ministry of Health.
• Ethics committee opinion: pending the adoption of ministerial protocols — that is, until such protocols are defined and published — medication administration is subject to the preliminary opinion of the national pediatric ethics committee, a non-clinical body [2][3].
• National AIFA registry: a registry is established for the prescription and dispensing of medications, which must be supplied exclusively through hospital pharmacies [1][8]. The registry collects detailed data including: the prescribing decision process, outcomes of prior psychological pathways, any diagnosed comorbidities, clinical monitoring, and follow-up. Data is transmitted to the Ministry of Health in a semiannual report.

Article 2: the permanent technical panel

Article 2 establishes a technical panel at the Ministry of Health, composed of experts and institutions, with the following tasks [2]:

• Define clinical guidelines for the treatment of gender dysphoria in minors.
• Develop the protocols provided for in Article 1.
• Provide tools for monitoring treatment appropriateness.
• Evaluate AIFA’s semiannual report and transmit a report to Parliament every three years.

Article 3: the fiscal neutrality clause

Article 3 establishes that the implementation of the law must not result in new or greater costs for public finances [2]. In essence, the entire apparatus envisioned by the bill — registry, technical panel, protocols, monitoring — must function without additional funding.

What would change compared to the current situation

To understand the scope of Bill 2575, it is necessary to compare it with the current regulatory framework.

The situation before the bill

Currently in Italy, triptorelin administration to minors with gender dysphoria is regulated by the 2019 AIFA ruling, which included the drug in the Law 648/1996 list for the treatment of “gender dysphoria in adolescents after the onset of puberty.” The ruling already requires a series of conditions: confirmed diagnosis, neuropsychiatric evaluation, parental and minor consent, and clinical monitoring. The authorized centers for administration are few and unevenly distributed across the national territory, resulting in wait times that can reach months.

The changes introduced by the bill

Bill 2575 does not formally ban any medication, but introduces a series of additional steps [3][7]:

• Centralization through the ethics committee: the most contested requirement. The national pediatric ethics committee is a body that ordinarily handles clinical trial evaluations, not routine clinical practice [4][5]. Its involvement in an individual minor’s care pathway represents an unprecedented step in Italian healthcare practice.
• Registry with sensitive data: the AIFA registry would contain extremely detailed clinical information, including psychological pathways and comorbidities, on a group of minor patients easily identifiable due to their small numbers [7]. Several associations have raised concerns about privacy protection and the risk of de facto “cataloging” of trans minors.
• Hospital-only dispensing: the restriction to hospital pharmacies eliminates the possibility of access through community pharmacies, creating potential logistical difficulties for families far from prescribing centers [3].
• Temporal uncertainty: since the ethics committee opinion is required “pending” the adoption of ministerial protocols, and there is no timeline for such adoption, the additional step could remain indefinitely [7].

Parliamentary proceedings

Filing and assignment

Bill 2575 was filed at the Chamber of Deputies on August 11, 2025, with act number C. 2575 [11]. On September 22, 2025, it was assigned to the XII Permanent Committee (Social Affairs) for review [11]. The bill’s rapporteur is Deputy Maddalena Morgante of Fratelli d’Italia.

Committee hearings

Between November and December 2025, the XII Committee held a cycle of hearings [11]. On November 5, 2025, Dr. Del Giudice was heard. On December 2, 2025, further hearings were held, including those of jurist Antonio Rotelli, the Trans Support Sassari Association, neurosurgeon and psychiatrist Massimo Gandolfini, and Professor Fulvia Signani of the University of Ferrara.

Current status

As of February 2026, Bill 2575 is still in the committee examination stage. Hearings have concluded and the text is nearing floor discussion. No calendar for an Assembly vote has yet been set.

The reactions: a divided country

Eight scientific societies against the bill

On December 9, 2025, eight of Italy’s leading scientific societies with expertise in gender dysphoria published an inter-society statement calling on Parliament for a thorough revision of Bill 2575 [4]. The signatory societies are:

• ACP (Cultural Association of Pediatricians)
• FISS (Italian Federation of Scientific Sexology)
• ONIG (National Gender Identity Observatory)
• SIAMS (Italian Society of Andrology and Sexual Medicine)
• SIE (Italian Society of Endocrinology)
• SIEDP (Italian Society of Pediatric Endocrinology and Diabetology)
• SIGIA (Italian Society of Childhood and Adolescent Gynecology)
• SIGIS (Italian Society of Gender, Identity, and Health)

The main criticisms concern four points [4][5]:

1. Ignoring international guidelines. The bill, in its explanatory report, cites exclusively countries that have adopted restrictive measures on access to care for trans minors, omitting mention of Spain, the Netherlands, France, Belgium, and Germany — countries where healthcare services for minors with gender dysphoria have been confirmed or updated according to available scientific evidence [4].

2. The ethics committee as a de facto barrier. The requirement to go through the national pediatric clinical trials ethics committee would cause a “severe delay in access to treatments, particularly critical in the case of triptorelin” [4][5], a medication with an effectiveness window tied to the patient’s pubertal stage. Every month of delay can compromise treatment effectiveness.

3. Conflating blockers and hormones. The bill places puberty blockers and gender-affirming hormones under a single regulatory regime, despite being medications with profoundly different safety profiles, clinical purposes, and reversibility [4][6]. Puberty blockers temporarily and reversibly suspend pubertal development; gender-affirming hormones induce partially irreversible changes. Treating them as a single normative category, according to the scientific societies, creates confusion in clinical pathways.

4. Violation of European recommendations. The Council of Europe has stated that member states must ensure specific healthcare for transgender people regardless of age [12]. Bill 2575, according to the scientific societies, risks severely limiting this access for minors [4][5].

Transgender and LGBTQ+ associations

Transgender and LGBTQ+ associations opposed the bill with particular firmness on two points.

Arcigay, through Christian Leonardo Cristalli, national policy officer for trans issues, called the AIFA registry a “de facto cataloging” of transgender minors [7]. The concern regards the centralized collection of extremely sensitive health data on a numerically small and socially vulnerable group of patients.

MIT (Trans Identity Movement), through attorney Roberta Parigiani, emphasized that puberty blockers are used precisely to suspend the pubertal process and allow minors to reflect on their gender identity before more definitive decisions [7]. Making access to these medications contingent on a formal gender dysphoria diagnosis can increase distress in minors at an already delicate age. Parigiani also criticized the normative equation of blockers and hormones, which creates confusion in clinical pathways and limits access to the most appropriate treatments.

The government’s position

Ministers Schillaci and Roccella defended the bill as a measure to protect minors’ health [1]. Minister Roccella spoke of a “prudent, transparent, and monitored approach,” emphasizing that the bill “responds to the health needs of minors” by ensuring greater oversight of treatments. The government framed the measure in the context of an international trend toward “reassessment” of approaches to gender dysphoria in minors, citing the cases of the United Kingdom (the 2024 Cass report) and Sweden.

The Authority for Childhood and Adolescence, in the person of Carla Garlatti, later succeeded by Maria Rosaria Terragni, called the bill an “important step forward for the health of minors.”

The European comparison: Italy and self-determination

Bill 2575 moves in the opposite direction from the self-determination model adopted by a growing number of European countries for managing gender identity.

Countries with self-determination laws

• Spain: Law 4/2023 allows the modification of registered gender from age sixteen through a simple declaration of will, without the need for medical or psychiatric diagnosis. For minors between twelve and sixteen, a simplified judicial process is provided.
• Germany: the Selbstbestimmungsgesetz (self-determination act), approved in April 2024 and enacted in August of the same year, allows modification of gender and name through self-declaration at the civil registry, with a three-month reflection period. For minors under fourteen, the request must be submitted by parents.
• Denmark, Ireland, Malta, Belgium, Luxembourg, Portugal, Norway, Iceland, Switzerland, Finland: all have adopted self-determination-based procedures, with variations in age requirements and reflection periods.

Italy in context

Italy, with Law 164 of 1982, was one of the first European countries to regulate gender rectification. Forty years later, the Italian regulatory framework occupies an intermediate position: Constitutional Court case law has eliminated the surgical requirement (ruling 221/2015) and reduced judicial oversight of reassignment surgery (ruling 143/2024), but the legislature has never updated the law in a self-determination direction.

Bill 2575 does not intervene on Law 164, which concerns adults and vital records rectification. However, for the specific segment of minors, the bill introduces a more stringent oversight regime compared to the status quo, moving in the opposite direction from that taken by the majority of Western European countries.

The Council of Europe report

In 2024, the Council of Europe published a report on healthcare access for LGBTI people, recommending that member states ensure specific healthcare for transgender people regardless of age, involve families and transgender organizations in the development of health policies, and base access to care on informed consent and depathologization [12]. The report estimates that at least 27% of transgender people in Europe cannot access the specific care they need [12].

Bill 2575, according to Italian scientific societies, conflicts with these recommendations [4][5].

Open questions

Triptorelin: medication or ideology?

Triptorelin is a GnRH agonist used in medicine for decades for various pediatric conditions, including precocious puberty. In the context of gender dysphoria, it is used to reversibly suspend pubertal development, allowing the minor to gain time to explore their identity without the body undergoing unwanted pubertal changes that can be a source of severe psychological distress.

The 2019 AIFA ruling authorized its use under the Law 648 framework, meaning as a medication prescribable outside approved therapeutic indications, provided that a diagnosis is documented and clinical monitoring is ensured. Bill 2575 does not revoke this authorization, but subjects its application to additional steps that, according to critics, would effectively limit its accessibility [3][7].

Scientific societies have called triptorelin a “life-saving drug” for transgender youth, emphasizing that access delays can have “irreversible psychological and physical consequences” [4][13]. ONIG has pointed out that the effectiveness window for blockers is tied to pubertal stage: every month of bureaucratic delay can render the treatment less effective or pointless [4].

The registry: monitoring or surveillance?

The national AIFA registry envisioned by the bill raises an unresolved tension between two legitimate needs: scientific monitoring of treatments and protection of patient privacy [7]. The data collected — diagnoses, psychological pathways, comorbidities, follow-up — concern a numerically very small group of minor patients (estimates of minors in care at Italian centers range from several hundred to a few thousand). In such a small sample, the possibility of individual identification, even through aggregated data, is not negligible.

The Privacy Authority has not yet formally commented on the measure. Transgender associations have requested specific guarantees on data protection and the exclusively scientific purpose of the registry, but no such guarantees have been included in the text to date.

The fiscal neutrality clause and sustainability

Article 3 of the bill establishes that the measure must be implemented at zero cost to public finances. This clause raises a practical question: how is it possible to establish a national registry, a permanent technical panel, standardized clinical protocols, and a semiannual monitoring system without any additional funding? Italy’s reference centers for gender dysphoria are already severely underfunded, with waiting lists stretching months. Adding bureaucratic steps without additional resources could, in practice, result in further lengthening of access times for care [6].

The big picture

Bill 2575 fits within a broader political trajectory of the Meloni government on transgender rights: from the Piantedosi circular on birth certificates, to the universal criminalization of surrogacy, to the DDL Valditara on “gender relativism” in schools. In this context, the Gender Dysphoria Bill represents the intervention specifically aimed at transgender healthcare for minors.

The parliamentary debate in the coming weeks will determine whether the text will be approved in its current version, amended based on observations from scientific societies, or subjected to substantial changes. Regardless of the outcome, Bill 2575 has already produced a concrete effect: it has made visible — for better and worse — the issue of access to care for minors with gender dysphoria in Italy, a topic until recently confined to specialized medical literature and now at the center of public and political debate.

The eight scientific societies that signed the inter-society statement on December 9, 2025 concluded with a request to Parliament: that the bill be revised “in line with the Council of Europe’s recommendations” and that healthcare for transgender people be considered “care oriented toward their well-being, not influenced by ideologies” [4][12].