Changing gender in Italy: How to do? How much?

On the following page you will find a complete guide on how to change gender and name in Italy.

Here you will be able to have all the necessary information at hand, without having to uncomfortably switch from one website to another, in the attempt of reconstructing the necessary steps in order to achieve gender and name change.

Every year in Italy I receive a 37% increase in the number of contacts willing to change their gender, both from man to woman (MtF) and from woman to man (FtM). Those contacting me are not only Italians, but also foreigners (with residency in Italy or abroad) whom request my assistance for the legal process involved in gender reassignment.

I am Gianluca Piemonte, an Italian lawyer with expertise in the legal process during the transition process, but not only: I also have the knowledge to fully describe the other steps involved during this journey, which are the psychological, hormonal and surgical path.

Solely in 2020, this page has been saved by saved by 26% of its visitors (an impressive number for those who have knowledge of Google analytics data).

If you have any questions, feel free to use the WhatsApp chat to contact me, that will automatically open up at the bottom right corner of your screen.

The Italian law on gender change

The law 164/1982 was the first to be issued in Italy for what concerns gender change, but included a mandatory surgery. As a matter of fact, two procedures had to be undertaken in court:

  1. The first step, was to obtain the authorization to carry out gender reassignment surgery
  2. After the operation, the next step was to obtain the authorization to change gender and name on all personal documents

The subsequent amendment with law 150/2011 (art. 31) did not, however, clarify the matter concerning the mandatory aspect of it and the Italian courts did not issue any compliant sentences.

What have the Italian judges established?

However, since 2015, the situation in Italy has fortunately changed. The judges turned towards a more favorable interpretation for all transsexuals whom wanted to start their transition journey. Surgery for the change of sex is no longer mandatory but a possible option for the MtF transition or constructive for the FtM transition.

The transition journey for gender change

The transition journey for sex change includes three necessary paths and a possible, and optional, fourth one:

  1. Psychological path
  2. hormonal therapy
  3. Legal process in court
  4. Surgery (optional)


The surgical operation, as already mentioned above, is therefore no longer mandatory. As a consequence, it is now possible for individuals to change their own name without undergoing any surgical intervention.

But now, let’s take a closer look at the journey of changing gender in Italy.

1# Psychological path


The first part of the process is going to be named in a conventional way, that is, as a psychological path, because it will take into account the “mental aspects”.

Report (or expert opinion) with a gender dysphoria diagnosis

During this first stage, it is of fundamental importance that gender dysphoria be diagnosed in a report (or through an expert opinion). The report can be written by a professional (psychologist or psychiatrist) who can assist the patient either through private service or through public service of the National Health System (S.S.N.).

The psychological report written in a foreign language has to subsequently be translated into Italian in order to be used during the trial in Italy. Therefore, any other relationship with an Italian doctor will no longer be necessary.

Here are the main differences.

Private service

A relationship with a private professional (psychologist or psychiatrist) is obtained in a much shorter span of time and avoids too much bureaucracy. To summarize, it is possible set the first appointment within 1 or 7 days.

The average cost of a session with the psychologist is around 40 euros, whereas 100 euros with a psychiatrist. Above that, an advantage is that private service can provide support and help, both for the choice of changing sex and for any difficulties that might arise during the transition. Generally, these professionals suggest undertaking a path that usually includes 6 meetings.

Public service (S.S.N.)

On the other hand, a relationship with somebody within the public service is achieved in a longer span of time and has a lot of bureaucracy involved. To summarize, the first step is to obtain a prescription from the family doctor, to then be enrolled public structure waiting lists for gender dysphoria (which are hospitals, polyclinics, etc.).

Meetings at public specialized centers only require a payment of a € 36 ticket, and cover approximately 8 sessions.

2# Hormonal therapy


The second step is hormonal therapy prescribed by an endocrinologist. Hormones modify secondary sexual characteristics, creating the effect of:

  • Masculinizing, in the FtM transition
  • Feminizing, in the MtF transition

Above that, hormonal treatment for gender change is useful for:

  • Inhibiting body manifestations that are typical characteristics of the sex to which they belong (for example beard growth, menstruation etc.)
  • Changing of the tone of voice (lower or higher)
  • Affecting the musculature

These effects obtained through the hormonal treatment of transsexuals are called “real life test” or “RLT”.

Gradually, the individual will start living and integrating into society with the physical appearance of the opposite sex. In order to obtain the sex change, it is advisable for the patient to have a specific prescription for hormonal treatment signed by an endocrinologist.

It is strongly advised to have already started hormonal treatment at the time of submitting the appeal to the court, matter that will be discussed in the next paragraph.

The endocrinological report written in a foreign language can be translated into Italian and consequently used during trial in Italy. For this reason, any additional relationship with an Italian doctor won’t be necessary.

3# Legal process: Appeal in court


Only an Italian court has the power to grant the authorization through a sentence:

  • Gender rectification (FtM or MtF)
  • Change of name
  • An eventual surgical operation

Who can initiate the legal procedure

The appeal can be filed by:

  • Italians residing in Italy
  • Italians residing abroad, enrolled in AIRE
  • foreigners owning Italian citizenship
  • foreigners without Italian citizenship, if sex rectification is forbidden in their country or has been denied (for the violation of human rights)

The appeal can also be filed on the behalf of Italian minors’ parents, considering the fact that cases of gender change among minors has been registered in the last few years.

FIND OUT MORE: If you want more information, you can read my article Gender Change for minors. When is this possible?

Filing of the appeal

The appeal must necessarily be filed by a lawyer, due to the fact that it is not possible for the individual to defend himself/herself in court. The court legally responsible by territory is to be considered the place of residency of the transsexual.

On the other hand, for what concerns Italians enrolled in AIRE and foreigners with or without Italian citizenship, I use different strategies.

Thanks to the issuance of the new law, it is now possible to electronically file the appeal to obtain documents and all trial records. This allows me to be able to assist transsexuals located in all Italian provinces around Italy.

Which documents are necessary for sex change?

Attached to the appeal, one should essentially include:

  • A psychological evaluation, with a diagnosis of gender dysphoria
  • An endocrinological evaluation, with the prescription of an already initiated the hormone treatment
  • A certificate of non-objection, to prove that you are not married
  • A certificate of residence, to demonstrate the territorial jurisdiction of the court

For what concerns foreigners or Italians enrolled in AIRE, the attachment of documents regarding residence or the acquisition of citizenship will be required.

The specialized lawyer will be able to file further documents, in order to avoid unnecessary postponements on the behalf of the judge, whom might request new documentation: this way, time may be saved.

Court hearings

The first hearing usually takes place 2-3 months after the appeal is filed, based on the date set by the court.

The judge then proceeds to evaluate all documentation and facts indicated in the appeal, in order to decide whether to designate a technical consultant (C.T.U.) or to defer to a final hearing.

The designation of a C.T.U., I repeat, should not be seen as an obstacle on the behalf of the judge, but on the contrary, as a way to ascertain gender dysphoria with the guidance of a trusted advisor to accompany the judge. The lawyer must attend the hearings, whereas the person involved should at least attend the first or second hearing.

The physical appearance, along with the ongoing hormonal treatment, may be a point in favor for what concerns the persuasion of the judge that will find himself/herself in front of an individual with a different appearance from the gender indicated in the documents.


It is not possible to predict the exact duration of the legal process, given the fact that every court  has different timings from city to city, but the average duration is around 10 months, if followed by a specialized lawyer.

Needless to say, the role of the lawyer is fundamental, due to the fact that effective defensive strategies can be adopted, consequently making the procedure process faster. That’s why the assistance of a specialized lawyer can really make a difference and make you save up to 45% of procedural time.

Choosing an Italian lawyer for the legal process

Many take for granted the fact that asking for a change of gender in court might be enough in order to obtain an Italian lawyer. For this reason, many seek for the first lawyer available in their city, no matter which specialization, for a matter greater comfort. However, the legal process for gender reassignment in Italy actually requires a specialized lawyer for gender change, who can also offer other advantages:

  • A greater knowledge for what concerns the subject and procedural strategies
  • Possibility to save money and procedural times if the appeal is written more professionally
  • Knowledge of other similar previous cases to take into account

ATTENTION: The legal process in the Court of First Instance is not a routine procedure. This means that NOT all sex change appeals are automatically accepted by the court.

It comes down to a legitimate trial (with the participation of the Public Ministry) in which the judge must be convinced to authorize the rectification.

For this reason, a well-structured and reasoned appeal redacted by a lawyer is necessary.

A fundamental thing to do, is to attach to the appeal all of the other Italian sentences that have already authorized the change of gender. As you have read, I am a lawyer specialized in this gender rectification procedure under the Law 164 and I am looking forward to hearing your story and following your case, no matter in which Italian province you are located. All you have to do is contact me through the form located on the CONTACT US page and tell me your story. I am here to defend your rights and take care of all the bureaucracy involved in the gender change process.

4# Surgery (optional)


As already mentioned, starting from 2015 surgery is no longer mandatory in order to request gender change in Italy. It is now possible to choose one’s own gender and name on the documents, even without undergoing surgery.

Therefore, if you are not interested in undergoing any operation, you may skip this part and continue reading next paragraph.

On the other hand, If you are interested, you should be aware that the authorization granted by the Court for the operation is necessary in these particular cases:

  • Removal or reconstruction of a primary sexual organ (genital and reproductive)
  • Surgery to be carried out in Italy
  • Surgery to be carried out abroad, in case it is required by the national law of the original country of the translated sentence

Those willing to carry out this operation often ask me if there is a deadline for having an operation after the sentence.

To be exact, there is no specific time to decide, since it is possible to experience a new life with the MtF or FtM transition in order to better understand the new reality.

This path after the transition may be short or even very long.

Others, instead, ask me if this sentence can also be used for surgical procedures abroad. The answer is yes, given that the decision of the Italian Court can also be recognized abroad (for both Italians and foreigners). Either way, in order to be operated outside of Italy, it is necessary to previously check what the foreign law provides.

Which documents can be changed?


The gender rectification currently ruling allows all documents belonging to the transsexual to be changed, this involves:

  • Birth certificate
  • ID (Identity card)
  • Drivers license
  • Passport
  • Diploma
  • Graduation diploma
  • In general, any document issued by the Italian Public Administration (such as tax codes, etc.)

Change of idendity

With gender rectification, the previous identity becomes replaced in all documents. This way, it is possible to avoid suffering from prejudices during job interviews, new social or personal relationships. The former identity will only be known:

  • By the police
  • Through the whole entire extract of the birth certificate, which can only be requested by the direct person involved
  • Through a certificate released by the Court


The sentence of rectification of sex attribution determines the dissolution of marriage for individuals who were previously married. However, it is possible to convert the marriage into a civil union if you still want to maintain a sentimental and economic bond with the other partner.

With the new identity, you can get married again:

  • in Italy, with people of the opposite sex
  • or abroad, with people of the opposite sex or of the same sex if permitted by local law

How much does it cost to change gender in Italy?

The cost of changing gender in Italy depends on many factors and can’t be considered standard for every person. Each path is subjective and has a different cost.


Psychological path cost

  • Private service: the average cost of a psychological session is 45 euros (psychiatrist 100 euros). The cost of the psychologist’s final report is around 250 euros (psychiatrist 500 euros)
  • Public service (S.S.N.): 35 euro ticket per visits and an additional 35 euro ticket for the final report

Hormonal therapy cost

  • Private endocrinologist: the average cost per session is 60 euros. The cost of the report along with hormonal treatment prescription is included in the service.
  • Public endocrinologist: the ticket costs 35 euros for each session. The cost of the final report with the hormonal treatment prescription is included in the service.
  • Hormones: they can either be paid for on behalf of the the National Health System or by paying a fee.

As mentioned previously, those already in possession of  a psychological or endocrinological report written in a foreign language may get it translated into Italian. That way, the only cost would be that of the translation into Italian.

Legal court procedure cost

The cost of the court procedure depends on the income of the person who has to change gender:

  • If the personal income is less than 11,493.82 euros a year. It is possible to start the legal process with a free legal aid, that way, the state would be paying the lawyer and the court costs. Also foreigners in possession of a residency permit may also benefit from the free legal aid to obtain a free procedure.

ATTENTION: ONLY ones own personal income must be considered and NOT also the income of family members living under the same roof, since the procedure for sex rectification is strictly considered as a very personal right. Therefore the amount must NOT be added to that of each cohabiting family member, as is generally required by other procedures.

  • If the personal income exceeds € 11,493.83 per year. The lawyer’s fee would in this case depend on every single law firm and on the particular case. The fare difference also depends on the lawyer’s own personal service and specialization. Whereas legal expenses might be high depending on the courthouse ( starting from euros to 545 euros for registration), administrative expenses are not as high (around 50 euros for requests concerning certified copies and related notification).

The choice of ones personal psychological and endocrinological path is not tied to the legal process.

This indicates having the possibility to benefit from the public service to obtain a psychologist or hormonal treatment and at the same time have a paid attorney at your service.

Or the option of obtaining a fee-charging psychologist, hormonal treatment and a lawyer through the free legal aid.

My assistance is offered both through free legal aid and fee-charging, but always characterized by low, non-excessive costs.

Feel free to contact me to find out if you are entitled to obtain free legal aid or to get a free quote. Considering the importance of the transition path, the best advice would be to choose a professional expert in the field and to not focus too much on saving money. As a matter of fact, the legal step in court is for about 76% of the cases the last step but it is the most fundamental one to complete ones journey.

Differences concerning those who have already changed gender abroad

If you have already changed gender abroad, the foreign documentation can also be used in Italy.

It is necessary to get it translated into Italian and then to subsequently show it to the Judge, in order to facilitate the Italian transition process:

In this case, it is necessary to show the Italian judge:

  • A provision that rectifies the gender abroad (eg Brazil), both in the original and translated language.
  • A new foreign passport with the changed gender

Conclusions on the change of sexuality in Italy

As you have read in this article, the transitional path is primarily composed by 3 necessary steps and an additional optional one:

  1. Psychological path, with the guidance of a psychologist or psychiatrist
  2. Hormonal therapy, with the guidance an endocrinologist
  3. Legal process, with the guidance of a specialized lawyer
  4. Surgical operation (optional, not mandatory)

The first step is therefore a psychological path, at the end of which you will have to have to obtain an official final report with a diagnosis of gender dysphoria.

Once you have completed the first step, you will then be able to start hormonal therapy (in some cases, depending on use of “lighter” drugs, this step may be taken before the diagnosis of gender dysphoria).

With the guidance of a specialized lawyer you will be able to start the legal process in court, to ask for gender rectification authorization (from FtM to MtF) and the name change (from male to female or female to male).

In addition, it won’t be necessary to convert ones previous name, but rather to choose a completely new one depending on their will (for example, you can change Alessandro to Nadia, and not necessarily change it to Alessandra).

For what concerns surgery, this step will not be mandatory, so one will be free to choose to do it or not.

How to contact lawyer Gianluca Piemonte, expert in gender reassignment

I have already been able to help numerous people all over Italy during their transition path, a path  that will change your life. I already know your anxieties and worries tied to this delicate choice, since I have carefully listened to many stories concerning both Italians and foreigners.

Due to the particularity of human rights and personalities, I will personally treat each and every single case with particular care and attention, without the use of practitioners or interns.

Tell me your story, goals and long-term plans for change. I will be happy to help you too during this transition process, taking care of all Italian bureaucratic aspects.

Remember that if you have a personal income of less than 11,493.82 per year, my assistance for the court trial is free and paid for by the state (even if you are a foreigner, but in possession of an Italian residency permit). When calculating this income, remember to not to add the incomes of other family members living with you, but only yours, that is, of the person who has to make the transition to MtF or FtM.

CONTACT ME NOW for free and get more information:

  • By writing an email to:
  • By writing on WhatsApp: at the number +393284878806 or by clicking on the icon at the bottom right corner of your screen
  • By filling out the FORM below

[contact-form-7 id=”1842″ title=”Form pagina Come cambiare sesso”]

Isabella Godina’s translation

Scroll to Top