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Italian Psychoanalytic Society expresses ‘great concern’ over use of puberty blockers

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The Italian Psychoanalytic Society (SPI) has sent a letter to Prime Minister Giorgia Meloni expressing “serious concerns” over the use of puberty blockers.

Sarantis Thanopulos, the president of the society, called for “rigorous scientific discussion” of gender issues in young people, noting that the “current experimentation” without careful scientific evaluation raises serious concerns.

In the letter published on the society’s website Jan. 12, Thanopulos outlined contraindications to the puberty-blocking drugs that should be seriously considered.

“The diagnosis of ‘gender dysphoria’ in prepubescent age is based on the statements of the individuals concerned and cannot be subjected to careful evaluation while sexual identity development is still in progress,” he said.

The psychoanalyst noted that “only a minority proportion of youths who state that they do not identify with their gender confirm this position in adolescence after puberty.”

Thanopulos argued that “suspending or preventing a person’s psychosexual development pending the maturation of a stable identity definition is contradictory to the fact that this development is a central factor in the process of definition.”

“Even in cases where the declared ‘gender dysphoria’ in prepubescence is confirmed in adolescence, the stalled development cannot result in a body that is sexually different from the original one,” he said.

The SPI president offered that the Italian Psychoanalytical Society will gladly contribute to future scientific discussion of the treatment of gender issues in young people.

The Italian Psychoanalytic Society was founded in 1925 and is a member of the International Psychoanalytical Association and of the European Federation of Psychoanalysis.

In 2020, the Italian Medicines Agency made hormone replacement therapy free of charge nationwide for people who received a diagnosis of “gender dysphoria.”

Maddalena Mosconi, a psychologist who works with minors in Rome, told Elle Magazine in December 2022 her clinic has seen a surge of cases of gender incongruence in kids in recent years.

“From 2018 to 2021 we had a 315% increase in the number of tracked cases,” Mosconi said.

“The pandemic and its consequences, such as lockdown and isolation, confronted many kids with the question of ‘Who am I?’, ‘Am I a boy or a girl?’ When they come to us, a journey begins that lasts at least six months with testing and an observation period. Only after that do they start hormone therapy, we are talking about 12- [to] 13-year-old youths, with whom adolescent puberty is paused for 2–3 years, in which we continue to work with psychotherapy sessions.”

According to 2017 data from the European Union Agency for Fundamental Rights, a person had to be at least 18 to access transgender hormone therapy in Italy.

In other EU states, the children can access transgender hormone therapy at younger ages, such as at 12 years old in the Netherlands and at 15 years old in Denmark and Slovenia.

Dr. Alessandra Fisher, an endocrinologist in Florence, told the Italian newspaper La Repubblica in 2021 that according to the current guidelines in Italy hormone therapy can be started before the age of 16.

“Rather than indicating a chronological age to start hormone therapy, the guidelines recommend that sufficient cognitive maturity has been reached to understand that the effects of the treatment are only partially reversible. This maturity typically occurs at age 16 but can be reached later or earlier,” Fisher said.

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