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Alongside this, specialized gender services have reported an increase in referrals of youths reporting non-binary identities. In Italy, studies investigating gender identity and expression in gender non-conforming youths are lacking, as are data regarding the non-binary population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The present study aimed at dimensionally exploring how transgender and non-binary Italian adolescents identify and express their gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>Gender expression in trans binary youths and non-binary youths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Gender Diversity Questionnaire (GDQ; Twist &amp; de Graaf, 2019) was used to investigate gender identity, gender fluidity, and gender expression in a sample of 125 adolescent patients from the Gender Identity Development Service (SAIFIP) in Rome and the Gender Incongruence Unit of the Careggi Hospital in Florence, between April 2019\u2013June 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of participants (74.4%) identified as trans* binary and the remaining (25.6%) participants identified as non-binary. Trans binary participants reported a stable gender identity, whereas non-binary participants reported a more fluid gender identity across time and contexts. Almost all participants rated external appearance as important to their gender expression, yet trans binary participants attributed more importance to the body in this respect. Body discomfort and pubertal stage emerged as the most influential factors in participants\u2019 experiences of gender. Participants who were assigned male at birth expressed significantly more desire for puberty blockers, whereas those who were assigned female at birth had a stronger desire to engage in breast\/chest surgery. Non-binary participants sought different medical interventions relative to trans binary participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>These results may be useful for clinicians working with transgender youths as they provide awareness regarding the features of young people who identify within and outside of binary constructions of gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strengths &amp; Limitations<\/jats:title><jats:p>This study provides useful data in gaining insight into understanding the variety of experiences and challenges of gender non-conforming youths. However as the sample was recruited from specialized services, it may not represent the entire gender non-conforming population in Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results describe the range of gender identities and expressions among gender non-conforming youths attending gender specialized services in Italy, thereby improving our understanding of the variety of identities experienced and the specific medical needs of both trans binary and non-binary adolescents.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jsxm.2022.03.215","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T21:18:30Z","timestamp":1648761510000},"page":"1035-1048","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":22,"title":["Gender Identity and Non-Binary Presentations in Adolescents Attending Two Specialized Services in Italy"],"prefix":"10.1093","volume":"19","author":[{"given":"Marta","family":"Mirabella","sequence":"first","affiliation":[{"name":"Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Piras","sequence":"additional","affiliation":[{"name":"Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandro","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra D.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Andrology, Women\u2019s Endocrinology and Gender Incongruence Unit, Florence University Hospital , Florence , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Lingiardi","sequence":"additional","affiliation":[{"name":"Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Mosconi","sequence":"additional","affiliation":[{"name":"Gender Identity Development Service, Hospital S. 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