Regulatory uncertainty in management of individuals with intersex traits in Italy: A medico-legal and bioethical perspective

Individuals with intersex traits continue to experience a significant lack of protection within the Italian legal and healthcare system. The absence of specific legislation and standardized clinical guidelines contributes to practices that vary across regions and institutions, generating uncertainty in the medico-legal sphere and raising bioethical concerns about autonomy, non-maleficence, and justice. In particular, the persistence of early surgical interventions without the individual's consent remains controversial, especially when contrasted with the consent-based frameworks emerging in other European states. This article provides an in-depth analysis of the Italian normative vacuum, highlighting its consequences for clinical practice and the medico-legal landscape, with reference to the risk of future claims of biological damage resulting from physical and psychological harm. By situating the Italian scenario within a broader European context, including reforms in Malta, Germany, Portugal, Greece, Iceland, and Spain, the article demonstrates how Italy lags behind in recognizing and protecting the rights of individuals with intersex traits. The conclusion calls for urgent legislative and clinical reform that integrates international human rights principles and ensures the consistent application of bioethical standards in intersex healthcare.