Reflections

Moderator Laura Perler opens the conversation by highlighting the central tensions exposed by the film: the conflict between empathy and the legal regulations embedded in the political climate surrounding reproductive medicine and gender-affirming care in Italy. Director Gianluca Matarrese explains that, while he initially filmed the clinic as a whole, he soon realized that the core of the film lay in the intimate encounters between doctor and patient. Rather than documenting the institution, he chose to remain present in these consultations, where the tension shaping Bini’s work becomes most visible.

Matarrese describes Bini’s practice as operating “on the border” between legality, responsibility, political hostility, and scientific duty. It is a space that few doctors are willing to enter, precisely because topics such as gender transition and reproductive rights are heavily politicized – “weaponized by politics,” as Matarrese puts it. Bini considers himself an “atypical doctor,” not because of the medical nature of his work, but because it involves practices that many of his colleagues avoid due to the potential legal consequences and political backlash. Despite this unconventional role, he remains respected within the healthcare system and the state, if only because someone must assume responsibility for these patients.

One example highlights the precariousness of Bini’s position: He keeps puberty blockers in his office, as he explains, “not to use them, but to have them.” For Matarrese, this practice captures the delicate balance Bini maintains – remaining prepared to care for patients while formally complying with legal restrictions. It exemplifies how medical responsibility and legal risk are tightly intertwined within a system where providing care always involves navigating uncertainty.

Medical anthropologist Julia Rehsmann connects these observations to broader patterns within healthcare. She argues that empathy and bureaucracy are not opposites; rather, knowing the rules in depth enables doctors like Bini to navigate them creatively. In her view, Bini’s position is highly unusual: he is one of the few practitioners who bridge assisted reproduction and transgender medicine, working across fields that are often institutionally and ideologically separated. Perler extends this point by noting that both trans healthcare and assisted reproduction revolve around bodies and identities that conservative societies often classify as “unnatural,” despite medicine’s broader ambition to regulate nature and the body. Rehsmann situates this within an anthropological perspective: both fields express the same underlying human aspiration to shape one’s life in alignment with one’s identity. Whether this involves forming a family or bringing one’s embodied self into harmony with one’s lived experience, the underlying motivation is remarkably close.

This connection also exposes a structural vulnerability. With Bini’s forthcoming retirement, the rare institutional bridge he represents between IVF services and transgender healthcare is likely to disappear; his successor has indicated that she will not continue this combined line of work. This raises a broader question about continuity, responsibility and the fragility of care infrastructures that depend so heavily on the dedication of a single practitioner.

When asked about his filmmaking approach, Matarrese describes the intimate access in Gen_ as the result of a careful “chain of trust”: Patients trusted Bini, Bini trusted him, and through this relationship, they allowed the camera into moments that would normally remain private. This trust also shaped the film’s aesthetic. Working with minimal equipment in a confined clinical space, he kept physical distance and used hidden microphones to avoid intruding on patient encounters and their personal space. The spatial constraints became part of the film’s language: a restrained camera, muted sound, and slow pacing that mirror the vulnerability of the situations. Together, these choices foreground an observational style of filmmaking that is both ethically cautious and quietly immersive.

One viewer questioned whether the film’s hopeful tone risked overlooking the pain, failure, and despair that often accompany real experiences in trans healthcare and reproductive medicine. Matarrese responded that he intentionally avoided sensationalizing suffering. In a political climate where these topics are frequently weaponized, he wanted to foreground the ordinariness of patients’ lives, rather than reinforcing dramatic representations. Showing everyday consultations that were done with care and empathy, he explained, was a way to counter narratives that reduce trans and reproductive stories to crisis and controversy. Overall, the intention is to offer a sense of hope, rather than reinforce pain.

From my perspective as an audience member, this exchange opens a broader reflection on Bini’s position. His calm, conversation-based approach to care extends beyond the clinical setting into the public sphere. Through media formats such as his podcast Let’s Talk About Sex, public talks, and now Gen_, Bini intervenes in a highly polarized debate – not through slogans, but by making complexity visible, resisting stigma, and insisting that embodied lives deserve dignity rather than moral judgment. In presenting medicine not as a purely technical field, but as a relational practice embedded in emotional and political realities, Gen_ reveals how laws, norms, and public debates materialize in everyday clinical encounters. Aligning closely with the mission of the Global Science Film Festival, the film communicates scientific knowledge through lived experience and shows how intimate spaces of healthcare are – and have always been – deeply political. In this sense, Gen_ demonstrates that Bini’s work does not merely navigate politics, but reshapes them as well.