Missing trans rights in Italy: future battles

Italy was among the first European countries to recognize the right to gender rectification, with Law 164 of 1982. Yet, more than forty years after that achievement, the Italian regulatory framework presents deep gaps regarding the rights of transgender people. In the ILGA-Europe Rainbow Map 2025, Italy ranks 36th out of 49 European countries [1] — a figure that reflects the absence of fundamental laws on gender identity, discrimination, healthcare access, and family recognition.

This article analyzes the rights that are still missing, the legislative proposals under discussion, and the battles that associations are carrying forward to close the gap with the rest of Europe.

Gender self-determination: the court requirement

The first and most structural gap concerns the right to gender self-determination. In Italy, obtaining the rectification of legal sex and name on documents still requires court proceedings before a civil tribunal, as provided by Law 164/1982 and Legislative Decree 150/2011 [3][11]. This means a trans person cannot simply declare their gender identity at a registry office: they must file an appeal, produce medical documentation, wait for a hearing, and obtain a ruling.

How it works in other European countries

A comparison with other European legal systems makes Italy’s lag obvious. Denmark, in 2014, was the first European country to introduce gender self-determination: a declaration at the registry office is sufficient, without any requirement for diagnosis, evaluations, or judicial authorization. A similar model was adopted by Malta (2015), Ireland (2015), Portugal (2018), Belgium (2018), and Norway (2016).

In 2023, Spain passed the “Ley Trans,” which allows gender change on documents from age 16 through a simple declaration, without requiring medical diagnosis or hormonal treatment. For people between 14 and 16, parental consent is required, while for those between 12 and 14, judicial authorization is necessary.

In Italy, the process remains long, expensive (1,500-3,000 euros for a private lawyer, unless free legal aid is granted) and subject to variable timelines from court to court — averaging between six and eighteen months [3]. A situation that associations describe as incompatible with the principle of personal dignity.

What the Constitutional Court has said

With ruling no. 143 of July 23, 2024, the Constitutional Court introduced an important simplification: it declared unconstitutional the requirement of court authorization to access gender-affirming surgical interventions when the person has already obtained legal rectification [2]. However, the ruling did not eliminate the need for court proceedings for changing documents, which remains the mandatory step.

Absence of an anti-discrimination law

Italy does not have a national law that explicitly prohibits discrimination based on gender identity [5][6]. Hate crimes motivated by gender identity are not specific aggravating circumstances, unlike racial or religious discrimination (Mancino Law, 1993).

The failure of the Zan Bill

The most comprehensive attempt to fill this gap was the Zan Bill (bill no. 2005), named after MP Alessandro Zan. The text proposed extending criminal provisions against hate crimes and discrimination to grounds based on sex, sexual orientation, gender identity, and disability. The Zan Bill was killed in the Senate on October 27, 2021, when a secret ballot vote (the so-called “guillotine”) prevented the continuation of debate — to applause from the center-right [6].

Since then, no similar legislative proposal has been passed at the national level. MP Zan reintroduced the text in a revised version, but the current parliamentary composition makes a discussion in the near term unlikely.

Regional laws: an insufficient patchwork

In the absence of a national law, some regions have introduced local laws against homotransphobia: Liguria (2009), Marche (2010), Sicily (2015), Piedmont (2016), Umbria (2017), Emilia-Romagna (2019), Campania (2020), and Puglia (2024). However, these laws have limited effectiveness: they do not provide criminal penalties, do not apply across the entire national territory, and, as noted by various analyses, often remain “flags” lacking concrete implementation tools [12]. The result is variable-geometry protection that depends on the region where one lives.

Healthcare access: disparities and waiting lists

Access to gender-affirming care in Italy is characterized by deep territorial disparities and waiting times that can reach seven years for surgical procedures [4].

Specialized centers: few and concentrated in the North

There are approximately seven public centers for gender incongruence across all of Italy, located predominantly in the North and Center. The South, with the sole exception of Naples, is essentially uncovered. Regions such as Marche, Abruzzo, Sardinia, and Calabria have no dedicated center. For minors, specialized centers can be counted on one hand.

This uneven distribution forces many trans people to travel hundreds of kilometers to access a first visit, with costs and difficulties that compound already long waiting times. 39% of transgender women report problems accessing healthcare facilities, a figure three times higher than the average for the LGBT population [4].

The medication issue

Hormonal therapies for gender affirmation are prescribable by the National Health Service, but actual coverage varies from region to region. Emilia-Romagna was among the first regions to guarantee free medications, but in many areas trans people must bear costs out of pocket or rely on informal networks to access treatments.

The gender dysphoria bill for minors

In August 2025, the Council of Ministers approved a bill, on the proposal of Ministers Schillaci and Roccella, introducing new restrictions on the administration of puberty blockers and hormones for minors with gender dysphoria [9]. The bill requires mandatory diagnosis by a multidisciplinary team, authorization from a national pediatric ethics committee, and the creation of a national registry at AIFA with clinical information, diagnoses, and follow-up for each person treated.

Associations and numerous scientific societies have criticized the measure, denouncing the risk of “profiling” trans minors and a delay in access to care that the international medical community considers appropriate and necessary [9]. The bill also ignores the experience of countries such as Spain, the Netherlands, Belgium, and Germany, where therapeutic continuity for trans minors is guaranteed.

Non-binary identities: recognized but unprotected

Non-binary people — who do not identify as male or female — have no legal recognition in Italy. The civil registry system provides only two options: male or female.

Ruling 143/2024

With ruling no. 143 of 2024, the Constitutional Court recognized for the first time the existence of non-binary people, stating that the perception of not belonging to either of the two traditional genders “generates a significant situation of distress in relation to the personalist principle recognized in Article 2 of the Constitution” and may raise “an issue of respect for social dignity and health protection” [2][10][13].

However, the Court declared the introduction of a third gender through judicial means inadmissible, considering that such a change “would have a general impact, which necessarily requires a systemic legislative intervention” [2][10]. In other words: the Court recognizes the problem but considers it Parliament’s responsibility to resolve it.

To date, no legislative initiative has been launched in this direction. Countries such as Germany (which since 2018 has provided the “divers” option in documents), Austria, and Iceland have already introduced alternatives to the binary system.

Parenthood and family rights

Trans people who have children or wish to have them find themselves in a regulatory vacuum that generates paradoxical situations.

Dissolution of marriage

Article 4 of Law 164/1982 provides that the rectification ruling causes the automatic dissolution of marriage or the cessation of its civil effects [11]. This means that a married trans person who obtains legal rectification is automatically divorced — a provision that the Constitutional Court deemed legitimate in ruling no. 170 of 2014, while recognizing the legislature’s obligation to “introduce an alternative form of registered cohabitation” for the couple (now possible through civil unions).

Recognition of children

The issue of trans parenthood is not governed by specific legislation. Trans parents who have children born before transition see their personal data automatically updated on the child’s birth certificate after rectification, but the parental role (father/mother) remains tied to biological sex at birth in the practices of many municipalities.

Regarding adoption, trans people do not face a formal ban but are effectively exposed to prejudice in suitability assessments. Stepchild adoption — the adoption of a partner’s biological child — is possible for same-sex couples under Article 44 of the adoption law, but remains subject to case-by-case judicial interpretations, without a clear and universal rule.

The sterilization issue

For decades, Law 164/1982 was interpreted as requiring surgical intervention — and thus de facto sterilization — as a condition for obtaining legal rectification. This interpretation was progressively overcome by case law [11].

The Court of Cassation, with ruling no. 15138 of 2015, established that rectification does not necessarily require surgical intervention. In the same year, the Constitutional Court (ruling no. 221/2015) confirmed that Law 164 does not impose any surgical requirement as a prerequisite for rectification.

Despite these rulings, the European Court of Human Rights condemned Italy for violating Article 8 of the European Convention — the right to respect for private life — in relation to the practice of forced sterilization [7]. The Strasbourg Court held that making gender identity recognition contingent upon the renunciation of reproductive capacity constitutes a violation of a person’s physical integrity.

Today, the surgical requirement is no longer applied in judicial practice, but Law 164 has never been formally amended on this point, leaving a regulatory ambiguity that some associations continue to denounce [3].

Protections in schools

The school environment is one of the most critical for trans people in adolescence. According to available data, 43% of trans students have experienced bullying, and only 23% of minors report having received protection or support from the school institution.

The alias career

The main protection tool in Italian schools is the alias career (carriera alias): an internal protocol that allows students to be registered with the name corresponding to their gender identity in unofficial school documents — electronic register, badge, internal communications. The change has no legal value outside the school.

As of November 2025, 481 Italian schools have adopted the alias career in their regulations, of which 475 are public and 6 are private [8]. A steadily growing number — in January 2024 there were 322 — but still representing a minority of schools in the country.

Data indicates that when an institution adopts the alias career, bullying toward trans students decreases by 20%. However, the Ministry of Education has never issued national guidelines for its implementation, leaving the initiative to the discretion of individual school principals and boards. The absence of a uniform regulatory framework means that a trans student’s protection depends on which school they attend.

Sports participation

The participation of trans people in competitive sports is a topic that Italy has not yet addressed with specific legislation. Italian sports federations comply, in most cases, with the rules of their respective international federations, which in recent years have adopted increasingly restrictive policies.

World Athletics has excluded transgender women from international women’s competitions if they went through male puberty. FINA (now World Aquatics) has restricted the participation of trans athletes who did not begin transition before age 12. Even the International Chess Federation has introduced restrictions for transgender players.

A symbolic case in Italy is that of Valentina Petrillo, a Paralympic athlete admitted to competitions by the Italian Paralympic Committee — the first Italian sports federation to include a trans athlete. Her case generated a broad debate but did not produce national regulatory action.

The United Nations, meanwhile, has reiterated that all people — including trans, gender diverse, and intersex people — have the human right to participate in sport. In Italy, however, there is no regulatory framework that balances competitive fairness and inclusion.

The comparison with Europe: where Italy stands

Italy’s score in the ILGA-Europe Rainbow Map 2025 is 24 points out of 100 — one of the lowest in Western Europe [1]. The ranking evaluates 76 criteria across seven thematic areas: equality and non-discrimination, family, hate crimes and speech, legal gender recognition, bodily integrity of intersex people, space for civil society, and asylum.

At the top of the ranking are Malta (first in Europe), Belgium, Iceland, Denmark, and Spain — countries that have adopted gender self-determination laws, comprehensive anti-discrimination legislation, and uniform healthcare protections.

Italy is also among the countries that in 2024 did not sign the Belgian EU Presidency declaration on LGBTQIA+ rights, signaling a growing political distance from European standards [6].

What associations are demanding

The main organizations fighting for trans rights in Italy — including MIT (Trans Identity Movement), Arcigay, AGEDO, Rainbow Families (Famiglie Arcobaleno), and the Lenford Network — converge on a core set of demands [5]:

• Gender self-determination: eliminating the requirement to go through court for legal rectification, replacing it with an administrative procedure at the registry office.
• Anti-homotransphobia law: passing national legislation protecting LGBTQIA+ people from hate crimes and discrimination.
• Uniform healthcare access: establishing gender incongruence centers in every region, reducing waiting lists, and guaranteeing free hormonal therapies across the entire territory.
• Recognition of non-binary identities: introducing an alternative gender option in documents, as already done in Germany, Austria, and Iceland.
• Protection of trans parenthood: guaranteeing full recognition of the parental role after rectification and the right to adoption without discrimination.
• Protection of minors: opposing the proposal for a national registry of trans minors and ensuring timely access to gender-affirming care.
• School guidelines: issuing ministerial directives on the alias career and anti-bullying measures for trans students.

The overall picture

Italy finds itself in a contradictory position: it was among the first European countries to legislate on gender rectification in 1982, but in the last two decades it has not taken significant steps forward [3]. While much of Western Europe has adopted self-determination laws, anti-discrimination legislation, and healthcare protections, Italy has seen the Zan Bill fail, has not introduced recognition of non-binary identities, and has proposed new restrictions for trans minors.

Case law — from the Court of Cassation to the Constitutional Court, to the European Court of Human Rights — has partly filled legislative gaps, eliminating the surgical requirement for rectification, declaring unconstitutional the judicial authorization for interventions, and recognizing the existence of non-binary identities [2]. But rulings, however important, cannot replace comprehensive legislation.

The future battles for trans people in Italy are being fought on multiple fronts: from Parliament to the courts, from schools to clinics. The distance between the daily reality of trans people and the regulatory framework that should protect them remains wide. Closing it is not only a matter of civil rights but of consistency with the constitutional principles of equality, dignity, and health protection that Italy itself established.