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. 2025 Jun;48(6):1457-1471.
doi: 10.1007/s40618-025-02547-y. Epub 2025 Feb 15.

Stratified analysis of health and gender-affirming care among Italian transgender and gender diverse adults

Matteo Marconi  1 , Angela Ruocco  1 , Jiska Ristori  2 , Stefania Bonadonna  3 , Rosario Pivonello  4 , Maria Cristina Meriggiola  5 , Giovanna Motta  6 , Francesco Lombardo  7 , Maddalena Mosconi  8 , Alessandro Oppo  9 , Silvia Federici  3 , Luca Bruno  4 , Nunzia Verde  4 , Alessandra Lami  5 , Chiara Michela Crespi  6 , Martina Manoli  1 , Paola Matarrese  1 , Carmela Santangelo  1 , Luciana Giordani  1 , Maria Teresa Pagano  10 , Cristiana Barbati  10 , Sara D'Arienzo  11 , Alessandra Daphne Fisher  2 , Marina Pierdominici  12
Affiliations

Stratified analysis of health and gender-affirming care among Italian transgender and gender diverse adults

Matteo Marconi et al. J Endocrinol Invest. 2025 Jun.

Abstract

Purpose: This study aimed to provide the first comprehensive analysis of the health status of transgender and gender-diverse (TGD) adults in Italy, addressing disparities in physical and mental health and access to gender-affirming care. By combining self-reported health data with clinical evaluations and incorporating demographic and clinical variables, the research offers a robust and previously unavailable health profile of this population.

Methods: An anonymous online survey targeting TGD adults across Italy was conducted from June 2020 to June 2021. The survey consisted of self-reported health assessments and clinician-conducted evaluations, collecting data on chronic physical conditions, mental health disorders, infectious diseases, and gender-affirming care. Statistical analyses, including chi-square tests and logistic regression, identified associations between demographics and health outcomes.

Results: Among 959 participants, mental health disorders were prevalent, with over half experiencing depression and/or anxiety. Non-binary individuals reported poorer health compared to binary individuals. Chronic conditions such as thyroid disorders were more common in individuals assigned female at birth (AFAB), whereas those assigned male at birth (AMAB) had higher rates of osteoporosis and sexually transmitted infections. Key health predictors included age, education, employment, and engagement in gender-affirming hormone therapy.

Conclusion: The study reveals stark health disparities among TGD individuals in Italy, emphasizing the need for targeted health policies, expanded mental health services, and specialized healthcare provider training.

Keywords: Chronic disease; Gender identity; Healthcare disparities; Mental health; Non-binary; Transgender.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no competing interests. Research involving human participants and/or animals: This study received approval from the Ethics Committee of the ISS and the Ethics Committees of each participating clinical center, as follows: ISS, AOO-ISS 01/07/2019 0020061; Florence University Hospital (Florence), 29/10/2019 15521_oss; University of Turin (Turin), 17/10/2019 0101526; University Federico II (Naples), 27/09/2019 251/19; University of Bologna (Bologna), 17/10/2019 3696/2019; University of Cagliari (Cagliari), 27/11/2019 PG/2019/16576; Hospital S. Camillo-Forlanini (Rome), 09/10/2019 1887/CE Lazio 1; Istituto Auxologico Italiano (Milan), 29/01/2020 2020_01_28_05; Sapienza University of Rome (Rome) 23/07/2020 0555/2020 Rif. 5939. Informed consent: For Module 1, signed informed consent was not required from participants as the survey was conducted anonymously. For Module 2 a signed informed consent was provided by participants.

References

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