The gender affirmation path varies from person to person, and the legal proceedings may also depend on multiple factors. For this reason, it is not possible to establish the duration of the gender affirmation process. According to data reported by the major associations in the sector, the gender affirmation process can vary from a few months to more than a year.  Neither is it possible to establish a general rule regarding costs, which will again depend on several factors: aesthetic surgery, recourse to cosmetic medicine and/or pharmaceutical drugs, the benefit of free legal aid, the fees of the chosen lawyer, whether or not the court appoints a Technical Consultant (CTU), to name a few.

Yes, they can. The judge, in fact, must grant the request for legal name change and gender marker update, even after the sex reassignment medical-surgical treatment. Which means that prior, unauthorized surgery does not preclude the right to update identification documents.

The Court order authorizing legal gender recognition determines the dissolution of the marriage. As a point of fact, the order accepting the application for legal gender recognition determines the dissolution of the marriage.

In this regard, we must specify that in many Courts it will be necessary to file a subsequent act requesting the dissolution of the marriage after one of the spouses has undergone a gender affirmation procedure. If, however, the spouses intend to continue their union, Article 27 of the Law on Civil Unions (Law 76 of 2016) provides that “on the date of the legal gender recognition, where the spouses have expressed their willingness not to dissolve the marriage or cease its civil effects, there follows the automatic establishment of a civil union between persons of the same sex”. In other words, if the spouses --one of whom has had his/her gender updated– declare to the judge their wish not to dissolve the marriage, their relationship becomes a civil union.

Yes, they can. A person who has gone through legal gender recognition will be considered of the chosen gender for all purposes, as per court order. Therefore, if they wish, they can marry a person of the opposite gender. The rules for adoption established for married couples will apply.

Yes, they can. A Civil Union  can be contracted with a person of one's own gender.

In principle, according to the Ministerial Decree of November 3, 1989, when a given medical service cannot be obtained in a timely manner or in an adequate form at hospitals or highly specialized centers in Italy, it is possible to get it abroad, and then request a reimbursement (of as much as 80%) from the Italian Health System.

It should be noted, however, that presently the competent ASL (local health unit) has a wide margin of discretion in granting this reimbursement. If denied, it is necessary to start a lawsuit in Court to ask for reimbursement. We suggest that you contact your local health unit, apply for reimbursement for gender affirmation surgery performed abroad, and possibly have a legal expert accompany you throughout the procedure.