Sex reassignement with or without surgery. New ethical and juridical pathways

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COD: 01-2918 Categorie: ,

Rosagemma Ciliberti, Matteo Gulino, Ilaria Baldelli, Alessandro Bonsignore, Ilaria Gorini

Ann. Ital. Chir., 2019 90, 2: 95-99

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INTRODUCTION: The access to sex-reassignment surgery is based on the existence of an unequivocal dyscrasia between the
morphological sex and the objective evidence that emerges from in-depth analysis of the individual’s personality. In Italy,
such type of surgical intervention is subject to the authorization of a judge.
MATERIAL OF STUDY: Authors examine the recent Italian Constitutional judgement which has addressed the right to
change legal sex status without the need for sex-reassignment surgery.
DISCUSSION: The Italian approach is in line with scientific evidence that the physical and mental well-being of an individual
does not always require the surgical rectification of primary sexual features. Thus, sex reassignment surgery is not
to be considered mandatory; rather, it should be aimed at ensuring the transsexual individual’s stable psychological and
physical good. From an ethical point of view, the Court’s decision is very important, since it does not subordinate such
fundamental rights as gender identity, healthcare and equality to prior, highly invasive surgery.
CONCLUSIONS: The authors point out that critical issues and obstacles to the full implementation of the right to gender
identity remain, in that this right is still subject to the authorization of a judge. This approach does not seem to be in
line with the recent World Health Organization (WHO) decision to remove the “gender incongruity” from the list of
mental and behavioural disorders (as it is in the current International Classification of Diseases-10, so far), to decrease
the stigma surrounding such a condition.

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