Serious concerns regarding the use of puberty blockers were raised by the Italian Psychoanalytic Society (SPI) in a letter addressed to the Italian Prime Minister Giorgia Meloni.

The society's president, Sarantis Thanopulos, called for "rigorous scientific discussion" of gender issues in young people, noting that "current experimentation" without careful scientific evaluation raises grave concerns.

Thanopulos listed serious considerations for the contraindications of puberty-blocking medications in the letter that was posted on the society's website on January 12.

He explained that because sexual identity development is still taking place, the diagnosis of "gender dysphoria" in the prepubescent age is based solely on the statements of the individuals involved.

Only a small percentage of young people who claim they do not identify with their gender later on in adolescence, the psychoanalyst noted, "confirm this position."

According to Thanopulos, "putting a person's psychosexual development on hold or stopping it altogether until a stable identity definition has developed is in direct opposition to the fact that this development is a central factor in the process of definition."

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

The SPI president made the suggestion that the Italian Psychoanalytical Society would be happy to contribute to any future scholarly debate on how to handle young people's gender issues.

The Italian Psychoanalytic Society was established in 1925 and is a part of both the European Federation of Psychoanalysis and the International Psychoanalytical Association.

For those who were diagnosed with "gender dysphoria," the Italian Medicines Agency made hormone replacement therapy free of charge across the country in 2020.

In December 2022, Maddalena Mosconi, a psychologist in Rome who works with young people, told Elle Magazine that she has noticed an increase in cases of gender incongruence in children in recent years.

"We had a 315% increase in the number of tracked cases from 2018 to 2021," Mosconi claimed.

"The pandemic and its effects, such as lockdown and isolation, left many children wondering who they were and whether they were boys or girls. When they come to us, a process that includes testing and an observation period begins and lasts at least six months. Only then do they begin hormone therapy; these are 12- to 13-year-old children, with whom we continue to work in psychotherapy sessions while delaying adolescent puberty for two to three years.

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

Children can start receiving transgender hormone therapy in other EU countries at younger ages, like 12 in the Netherlands and 15 in Slovenia and Denmark.

Endocrinologist Dr. Alessandra Fisher stated in 2021 to the Italian newspaper La Repubblica that, under current Italian regulations, hormone therapy can be started before the age of 16.

"The guidelines recommend that sufficient cognitive maturity has been attained to understand that the effects of the treatment are only partially reversible, rather than specifying a chronological age to begin hormone therapy." Although it can happen later or earlier, this maturity typically comes at the age of 16, according to Fisher.