Rotten Endocrinology in Italy

By Agata Rossi

There is something truly and undeniably rotten in the Italian Society of Endocrinology, (Società Endocrinologia Italiana, SEI). The SEI is a small cog in an international medical scandal, which has resulted in irreversible iatrogenic harm to thousands of children throughout the world, including Italy.

This is not breaking news although the release of the Cass review in England, a four-year investigation into the use of puberty blockers by the respected paediatrician, Dr Hilary Cass, former Chair of the Royal College of Paediatrics and Child Health (RCPCH), helped expose the enormous medical and academic corruption in the field of "gender-affirming care".

The Italian Society of Psychoanalysts has long voiced concern regarding the medicalisation of children suffering from "gender dysphoria" and queried the validity of the claims made by the SEI that children are at an increased risk of suicide, self-harm and depression should they not be put onto a medicalized pathway of puberty blockers.

The professional battle has played out in the mainstream Italian press, with a more sympathetic view being given to the side of the endocrinologists. In January 2023, ONIG, (Osservatori Nazionale Sull’Identità di Genere - a collective group of Italian medical and cultural societies) wrote a public letter to Italian Prime Minister, Giorgia Meloni, defending the use of puberty blockers for dysphoric children, claiming their reversibility and lifesaving properties.

However, in May 2021, Sweden’s world-renowned Karolinska Institute stopped using puberty blockers due to the irreversible adverse effects and, prior to that, in June 2020 Finland took the same decision, preferring a non-medicalized approach to the treatment of paediatric dysphoria.

On February 5, 2024, Sarantis Thanopulos, a psychoanalyst based in Naples and President of the Società Psicoanalitica Italiana, wrote a letter to the Editor of Quotidiana Sanità expressing his concerns that an ideological approach to dysphoric children at Careggi Hospital in Florence was taking precedence over evidence-based medicine. Thanopulos requested evidence supporting the claims that puberty blockers were indeed “lifesaving” and expressed concern at the lack of psychological assessment before starting treatment that, in 98% of cases, was not simply a “pause” but the first step on an irreversible pathway which included cross-sex hormones and surgery.

Despite the very concerning initial findings of the Italian governmental inspection at Florence’s Careggi Hospital’s Gender Department being made public a few weeks ago, the now proven false narrative that puberty blockers are lifesaving continues in the Italian press. Italian mothers whose children have been treated by endocrinologist, Alessandra Fisher and psychologist, Jiska Ristori truly believe that their children will “kill themselves” if they stop taking the puberty blocker, Triptorelin. Not only is the lack of informed consent medically negligent but also unbelievably cruel and a betrayal of the trust between a medical practitioner and their patients. Fisher and Ristori’s young patients and their parents deserve the truth that the evidence base for the use of puberty blockers is built on deceptive practices with medical practitioners referring to each others’ guidelines; in effect a fraudulent circular base of evidence, which is now an international scandal.

I am sure that the Italian psychologist, Sarantis Thanopolus will take absolutely no pleasure in being internationally vindicated. Like many others around the world, he will simply feel immense sadness at the unacceptably high number of children and adolescents who have been irreversibly harmed due to the biggest academic and medical scandal in modern medical history.

An Italian equivalent of the English Cass Review is now urgently needed. The position of the Società Italiana Endocrinologia’s continued use and support of Triptorelin is now completely untenable.