Trans Men in Italy

When discussing transgender people in Italy, media narratives tend to focus on trans women. Trans men are often invisible: less represented in the media, less present in public debate, and less recognized in the collective imagination. This invisibility does not mean absence. It means society has not yet learned to see them.

This article explores what it means to be a trans man in Italy: the specific experiences, unique challenges, available paths, and the contradictions of a visibility that is still entirely to be built.

Who trans men are

A trans man is a person who was assigned female at birth but whose gender identity is male. The term FtM (Female to Male) is used in medical and community contexts to describe this experience, though not all trans men identify with this acronym—some find it reductive, as it defines the person based on their starting point rather than who they are.

Not all trans men have the same journey. Some undergo a full medical transition (hormones and surgery). Others choose only specific steps. Still others do not undertake any medical pathway. Being a trans man does not depend on how many procedures you have had: it depends on who you are.

Invisibility: a specific problem

Why trans men are less visible

The invisibility of trans men has specific causes, different from those affecting trans women:

Passing as a double-edged sword. Many trans men, after a few months of testosterone therapy, achieve an outward appearance that makes them indistinguishable from cisgender men (the so-called “passing”). Their voice drops, their beard grows, their features change. In a way, testosterone “works well”—and this makes them invisible. A trans man who goes unnoticed in a bar, at the office, or on the street is a trans man the world does not know it is seeing.

Media narratives. Italian media, when talking about trans people, almost always talk about trans women. News focuses on violence against trans women; talk shows invite trans women as guests; cinema tells stories of trans women. Trans men are off the media radar, and consequently, out of the collective imagination.

The lack of role models. Internationally, Elliot Page is probably the most visible trans man in the world [7]. But in Italy, male trans role models are very few. While figures like Vladimir Luxuria and Marcella Di Folco have given visibility to Italian trans women, there is no male equivalent with the same level of public recognition.

The consequences of invisibility

Invisibility is not neutral. It has concrete consequences:

• Isolation: a young trans man who does not see people like him in the media, politics, or culture may feel alone in his experience.
• Lack of information: specific resources for trans men—about testosterone therapy, mastectomy, fertility, sexuality—are less widespread and accessible than those for trans women.
• Social misunderstanding: many people, including well-intentioned ones, do not know what a trans man is. The idea that “trans people are men who become women” is still widespread, and completely excludes the FtM experience.

The body: testosterone and surgery

Testosterone therapy

Testosterone is the cornerstone of medical transition for many trans men. Administered via intramuscular injections, topical gel, or more rarely patches, it produces a series of gradual changes [5]:

• First weeks/months: cessation of menstruation, increased libido, body fat redistribution
• 3-6 months: deepening of the voice, facial and body hair growth, oilier skin
• 6-12 months: increased muscle mass, further virilization of facial features
• 1-3 years: full maturation of vocal changes, beard growth, possible changes in hairline/baldness

Every body responds differently. Some trans men develop a full beard in a few months; others wait years to see the first hairs. Comparing oneself to other journeys—online or in real life—can cause frustration, but it is important to remember that this variability is biological, not a flaw in the process.

Mastectomy (top surgery)

For many trans men, a bilateral mastectomy (often called “top surgery”) is one of the most significant procedures of their transition. Dysphoria related to the chest is among the most intense and debilitating: it forces the use of binders (compression garments) that can cause pain, breathing difficulties, and rib damage if used improperly.

The study by Olson-Kennedy et al. (2018) showed that post-operative satisfaction for mastectomy is very high, with a significant reduction in dysphoria and an improvement in quality of life [10]. In Italy, the surgery is performed at specialized NHS (National Health Service - SSN) centers, although waiting lists can be long.

Phalloplasty and metoidioplasty

Genital surgeries for trans men are more complex and less frequently requested compared to mastectomy. The main options are phalloplasty (reconstruction of the penis using a skin flap) and metoidioplasty (which utilizes the clitoral growth induced by testosterone). Not all trans men desire or choose these surgeries, and the decision is strictly personal.

Masculinity and identity

What kind of man do you want to be?

One of the most complex and fascinating experiences of a trans man’s journey is the construction of his own masculinity. Society often proposes rigid and toxic models of a “real man”: strong, stoic, dominant, heterosexual. A trans man is in the unique position of being able to consciously choose what kind of man he wants to be.

Some trans men embrace a traditional masculinity and find authenticity and comfort in it. Others build a more fluid, soft, unconventional masculinity. There is no right or wrong way to be a trans man—just as there is no right or wrong way to be a man.

Sexual orientation

Sexual orientation is independent of gender identity. Trans men can be heterosexual, gay, bisexual, pansexual, asexual—anything. A gay trans man is a man attracted to other men. A heterosexual trans man is a man attracted to women. It seems obvious, but confusion on this point is still widespread.

The issue of dating is a complex territory. When do you tell the person you are interested in that you are trans? How do you handle rejection? How do you experience sexuality in a body that might not meet a partner’s expectations? These are questions every trans man faces in his own way, and for which there are no universal answers—only individual paths.

Specific challenges

Gynecology

Even after years on testosterone, many trans men continue to need gynecological care: cervical screenings, ovarian checks, fertility management. Going to a gynecologist in a masculinized body, with an ID document that might still bear a female name, is an experience that many trans men describe as profoundly alienating.

Training for healthcare professionals on this topic is still lacking in Italy. Finding a gynecologist who knows how to treat a trans male patient with competence and respect can be a real challenge.

Binders and safety

Before a mastectomy—and for those who do not want it or cannot access it—a binder is the most common tool for reducing the appearance of the chest. However, prolonged or incorrect use of binders can cause problems: rib pain, breathing difficulties, skin irritation, and in rare cases, rib fractures.

Safety rules are essential: do not wear a binder for more than 8-10 hours a day, do not sleep in it, do not do intense physical activity in it, and do not use elastic bandages or duct tape instead of a binder designed for this purpose. Alternatives also exist, such as trans tape (specific kinesiology-style tape) and compression tank tops (lightweight compression shirts) for days when a binder is too much.

Military service and documents

In Italy, legal gender recognition (changing one’s name and gender on documents) is regulated by Law 164/1982. After Constitutional Court ruling 221/2015, undergoing surgical interventions is no longer mandatory to obtain this rectification. However, the process remains judicial and can take months or years.

In the meantime, a trans man lives with documents that do not match his appearance. This creates difficult daily situations: at security checks, at the bank, at the post office, at the pharmacy. Every time someone looks at the ID and then looks at the person, there is a moment of vulnerability.

Resources and community

In Italy

• Infotrans.it: institutional portal with information on FtM transition paths [3]
• ONIG: map of gender identity centers in Italy [9]
• MIT (Movimento Identità Trans): counseling and support desk
• Local FtM groups: in many cities there are specific self-help and mutual aid groups for trans men, often organized by Arcigay or independent collectives

Online

Online communities for Italian trans men are growing. Facebook groups, Telegram channels, and Reddit communities offer peer-to-peer spaces to discuss specific topics: testosterone, mastectomy, passing, work, relationships. As with all online spaces, it is important to verify medical information with qualified professionals.

Visibility as a construction

The invisibility of trans men is not a destiny. It is a condition that can change—and is changing, slowly. Every trans man who chooses to tell his story, who makes himself visible in his context, who exists openly in the world, contributes to expanding the collective imagination.

Not everyone can or wants to be visible, and this is a legitimate choice. But for those who can, visibility is an act that changes not only their own life but also the lives of the trans youth who will come after them. Because a fifteen-year-old who doesn’t see anyone like him thinks he is the only one in the world. And no one should ever feel that way.