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FAQ – Gender Affirmation

This guide provides clear and concise information about gender affirmation in Italy, the rights of transgender people, and the related procedures, from an inclusive perspective that respects diversity.

The guide refers to the Istanbul Convention, which defines gender as “the socially constructed roles, behaviours, activities and attributes that a given society considers appropriate for women and men”.

The information on this page has been developed based on content from the InfoTrans portal.

Every person has their own sexual identity, made up of several interconnected components:

  • biological sex

  • gender identity

  • gender expression

  • sexual orientation

Biological sex

Biological sex is generally defined based on various factors, including genetic makeup, genital anatomy, and hormonal profile. At birth, based on these observed characteristics, a sex (male or female) is assigned.
Some people are born with sex characteristics that do not fit typical definitions of male or female; in these cases, they are referred to as intersex people.

Sexual orientation

Sexual orientation refers to emotional, romantic and/or sexual attraction towards other people. There are many sexual orientations, and all of them are natural.
Examples include heterosexual, homosexual (gay and lesbian), bisexual and pansexual orientations.

Gender expression

Gender expression is the way a person expresses their gender in everyday life, through behaviour, appearance, clothing, hairstyle, makeup, body language and voice. Gender expression varies depending on culture, place and historical period.

Gender identity

Gender identity refers to a person’s deeply felt, internal sense of their own gender. A person may identify as a woman, a man, both, neither, or as a gender different from the binary categories. All gender identities are valid.

The term transgender refers to people whose gender identity and/or gender expression does not correspond to the gender assigned to them at birth. This experience is often described as gender incongruence.

A cisgender person is someone whose gender identity corresponds to the gender assigned at birth.

Being transgender is not a disease. Some transgender people may experience distress related to this condition and may choose to undergo a gender affirmation process, which can include hormone therapy and/or surgical interventions, but this is not mandatory.

Please note: being transgender is not related to sexual orientation.

Some transgender people may intervene on their body to make it more like the way they feel through a medical gender affirming path that comprehends different stages, such as hormonal and/or surgical treatments.

Not all transgender people choose to undertake a medical gender affirmation process. There is no single, mandatory pathway, and each process is tailored to the individual’s needs.

There are international recommendations, such as the Standards of Care issued by WPATH (World Professional Association for Transgender Health), which healthcare professionals refer to when providing hormone therapy.

Psychological support may be part of the process, but it is not mandatory. It can help individuals gain greater awareness and clarity about their gender identity, especially if there is uncertainty.

The duration and costs of the process vary from person to person and depend on factors such as medical procedures, medications, aesthetic interventions and legal assistance.

People who wish to start a medical gender affirmation process can contact specialised centres.
The website Infotrans.it provides a list of public and National Health Service–affiliated healthcare facilities across Italy that offer these services. To consult them, visit the “Services Map” section.

5. What is hormone therapy?

Hormone therapy is a personalised medical gender affirmation process.

Masculinising hormone therapy

Masculinising hormone therapy reduces typically female sex characteristics and induces male characteristics through the administration of testosterone. The first changes usually appear after 3–6 months and may include the cessation of menstruation, voice deepening and increased body hair growth.

De-masculinising hormone therapy

This therapy reduces typically male sex characteristics through the use of anti-androgen medications, which block the effects of testosterone. It may take several months to reduce body hair, and additional procedures such as electrolysis may be required.

Feminising hormone therapy

Feminising hormone therapy induces typically female sex characteristics through the administration of oestrogens. Oestrogens redistribute body fat, promote breast development and, together with anti-androgens, make the skin smoother.

According to WPATH and other international guidelines, the following criteria must be met in order to access hormone therapy:

  • persistent and well-documented gender incongruence

  • ability to give informed consent to treatment

  • if present, physical and/or mental health conditions that could interfere with treatment outcomes must be appropriately addressed

  • understanding of the effects of hormone therapy on fertility and discussion of fertility preservation options

Gender-affirming surgical procedures involve modifying sex characteristics in order to align a person’s physical appearance with their gender identity.

Please note: in Italy, authorisation issued by the court of residence is required through a judicial ruling.
An exception applies to breast augmentation surgery for people who were assigned male at birth.

Ministerial Decree of 3 November 1989 allows for reimbursement of up to 80% of the costs for surgical procedures performed abroad when they are not available in Italy within an appropriate timeframe.
The reimbursement is granted at the discretion of the local Health Authority (ASL). In case of refusal, it is possible to appeal to the court.

Yes. In many countries around the world, LGBTQIA+ people face violence, persecution and discrimination, and their rights are not recognised.
In Italy, you have the right to apply for international protection.https://www.jumamap.it/en/faq-request-for-international-protection/

For more information and support:

Arci National Helpline for Asylum Seekers and Refugees
Free number: 800 905 570 / +39 351 137 63 35 (WhatsApp/Lycamobile)
Monday to Friday, 10:00–17:00
numeroverderifugiati@arci.it

You can also consult the map of legal help desks dedicated to LGBTQIA+ people [https://www.jumamap.it/wp-content/uploads/elenco-sportello-lgbtqia.xlsx].

Please note: it is strongly recommended to contact a support organisation or protection body before going to immigration offices.

Yes. In Italy, changing one’s identity documents (“legal gender recognition”) is a right recognised by Law No. 164/1982.
Legal gender recognition allows personal data such as name and sex to be changed on official documents following a gender affirmation process. Privacy and non-disclosure of the person’s original gender identity are guaranteed.

To change documents, it is necessary to submit an application for legal gender reassignment, accompanied by psychological, diagnostic and medical documentation related to the gender affirmation process, as well as a birth certificate.

Transgender people who have undergone surgical procedures abroad can also obtain legal document changes in Italy.

If you believe you have experienced discrimination or violence, you can contact an anti-discrimination help desk.
Cronache di Ordinario Razzismo has compiled a list of help desks throughout Italy that support people who have experienced discrimination of any kind. Different forms of discrimination and oppression often overlap, and these services can provide assistance and protection.

Se vuoi, nel prossimo messaggio posso:

  • adattare il testo specificamente agli standard di Juma Map, oppure

  • preparare una versione più breve / sintetica da affiancare alle FAQ complete.

Download the list of legal help desks dedicated to LGBTQIA+ people

To learn more:

What is JumaMap

JumaMap – Services for Refugees is a map designed to help you quickly find useful services near you.
Here you can search for places to sleep, eat, study Italian, and get health, legal or psychological support, as well as many other services dedicated to migrant people and people experiencing homelessness.

The platform is available in 17 languages.
You can change the language from the menu at the top and choose among: Albanian, Amharic, Arabic, Bengali, Chinese, Dari, Farsi, French, English, Pashto, Punjabi, Russian, Somali, Spanish, Tigrinya, Ukrainian, Urdu, Wolof.

You can also access JumaMap on your mobile phone: visit www.jumamap.it

Welcome Center

If you need in-person help, you can come to the Welcome Center:

Monday
10:00 – 14:00 — Social orientation desk

Tuesday
10:00 – 14:00 — Psychological support desk (ages 18–26)
14:00 – 17:00 — Health support desk
14:00 – 18:00 — Social orientation desk
14:00 – 18:00 — Legal support desk

Wednesday
10:00 – 14:00 — Social orientation desk

Thursday
10:00 – 14:00 — Legal support desk (ages 18–26)
14:00 – 18:00 — Social orientation desk

Friday
10:00 – 14:00 — Social orientation desk
16:30 – 19:30 — Legal support desk

Digital support

Tuesday 9:30 – 14:00
Wednesday 10:00 – 15:00
Thursday 9:30 – 16:30

Toll-free number for asylum seekers and refugees

For information and phone support, call Arci’s toll-free number for asylum seekers and refugees:
800 905 570 (Italy)
+39 351 1376335 (WhatsApp, Lycamobile and from abroad)

It answers Monday to Friday, 9:30–17:00, with a multilingual voicemail always active and a network of cultural-linguistic mediators available in 35 languages.
You can also write to: numeroverderifugiati@arci.it

Toll-free number for migrants with disabilities

NABILA is a service offering listening, support and guidance to migrant and refugee people with disabilities or other vulnerabilities.
You can call the toll-free number 800 999 977.
If you prefer speaking in person, you can book an appointment at Arci Nazionale’s Immigration Office:
Via dei Monti di Pietralata 16 – Rome.

Listening and support space for migrant minors and young people

U-Report On The Move is a safe space where you can receive legal support and also talk, freely and safely, about your feelings, your problems and whatever is worrying you.
A trained professional listens to you and helps you find the right support for your needs.
The service is available Monday to Friday, from 9:00 to 18:00.

To use it, simply send a message on Facebook Messenger, through the U-Report On The Move platform.
A team of psychologists replies to messages and offers personalised and attentive support.