In the week that Donald Trump repealed endless progressive legislation, including that combating discrimination based on gender identity and sexual orientation, it would be easy to be downcast about what global ramifications this will have. Yet here’s a hopeful and quietly moving documentary about a clinic in Milan that provides clinical IVF and gender affirming care, even in the populist Italy of Trump ally Georgia Meloni.

Dr. Maurizio Bini is a consultant at Niguarda public hospital, one of the few public hospitals in Italy allowed to provide IVF and gender affirming treatment. He and his team walk the tightrope of legislation and restriction while providing the best service he can. Gianluca Matarrese‘s documentary crew observes Bini meeting with a diverse series of prospective parents and people who wish to transition.

Apart from a burst of contextual invective against trans rights and ‘designer babies’ that opens the documentary – including from Meloni herself: ‘It is not taboo to say that motherhood is not for sale’ – there is no overt polemicising here beyond obvious editorial decisions and the opinions and advice offered by Dr. Bini. Matarrese’s team very much adhere to a fly-on-the-wall approach.

Matarrese’s documentary aims to go past the headlines and the ideological discourse to demonstrate the expertise and compassion that Bini and his team bring to their patients. It is much harder to dismiss someone outright when you hear their story. One of the avuncular Bini’s great strengths is to tease out his patients’ situations with delicacy and humour. And some of these intimate, deeply personal stories are striking, and instructive of Italian society as a whole.

There’s a mixed race woman deciding the skin tone of her child and  settling for Caucasian as, ‘Sad to say, we’ll avoid lots of problems’. We meet a prisoner currently in a women’s prison so desperate to fully realise their masculine identity that they’re champing at the bit to get into a men’s facility. And Bini asks someone transitioning to female in a small village of 4000 people about her father’s reaction. ‘He’s afraid of what he doesn’t know,’ she says.

It is interesting that the IVF, which was volcanically controversial for decades before achieving its current position in the mainstream, is combined in one department with transition therapy, the new bête noire of conservative thought on modern medicine. It was supposed to be temporary according to Bini, but it makes sense given both are controlled by hormones. Elsewhere the eccentric Bini brings in a violinist to play for the embryos in storage, calls up the recalcitrant parents of a trans man to reassure them, and takes some workmen to task for their noise.

These little interludes add a bit of much-needed variety to GEN_ as a narrative. As much as the stories of Bini’s patients are interesting, moving, and occasionally harrowing, there is a stasis to the film’s structure and it’s all very soberly presented. In most cases we only see a patient once so it’s hard to get a sense of their progress. We also see little in the way of the impact the restrictions have on Bini and his team. Beyond his occasional explanations of how he navigates the system – ‘If you stick strictly to the law, you can’t help your patients’ – it appears he’s able to practice fairly unchallenged. That’s great if that’s the case, but as we’re told just how difficult it is to practice his area of medicine in Italy as it is today, it would be in the interest of the narrative to provide some evidence.

It’s obvious though that Bini’s relationship to his patients is the central thread, as it should be. The point is to show that each person has their different reasons, and each story is unique. They are not, as one person puts it, ‘theories’, to be judged on political, ideological, or economic terms as a homogenous lump. It is in this focus on the individual – and Bini’s resolute care and compassion for his patients as individuals – that the film succeeds, despite a lack of dynamism to the narrative itself.

Screening as part of Sundance Film Festival 2025