’Gen_’ review: A Milan hormone specialist treats fertility and gender issues

Dir: Gianluca Matarrese. France/Switzerland/Italy. 2025. 104mins

The worlds of IVF treatment and gender affirmation may seem like unusual bedfellows but they come together under the care of Dr Maurizio Bini, a soft-spoken medic at Milan’s Niguarda public hospital who specialises in hormone treatment. Gianluca Matarrese’s non-sensationalist and observational documentary transports us inside Dr Bini’s consulting rooms in the run-up to his retirement. While the sheer number of patients seeking help means Matarrese eschews the sort of beginning to end of treatment arcs often favoured by many documentarians, he instead invites us to fall into Dr Bini’s rhythm of approaching each patient individually and equally.

This humanistic film invites us to see beyond the charged rhetoric

Matarrese continues to demonstrate an impressive work-rate with eclectic subjects, which have recently included the education-set TV documentary Les Beau Parleurs and docufiction L’expérience Zola. Given the current hot potato political nature of fertility treatment and transgender healthcare in the international sphere, it’s not surprising Gen_ is already notching up its second festival appearance at Thessaloniki Documentary Film Festival after its premiere in Sundance. More festival dates seem highly likely, along with streaming further along the line.

Dr Bini is an affable and warm presence at the heart of the film, which also captures him in his off-hours foraging for mushrooms. “What I like about them,” he tells a patient, “Is people don’t know there are males and females.” The moments spent outside his office emphasise the medic’s connection with the natural world as well as providing lyrical interludes, where the score from Matarrese’s regular composing collaborators Cantautoma can take flight and help to break up the back and forths across his desk. Music is also invited into the hospital at one point as a professional violinist turns up to serenade the embryos – another indication that Dr Blini’s approach, while rooted in science, has a psychological dimension. 

Inside his office, the camera is hand held and fly-on-the wall style, giving an intimate sense of proximity, while objects that occasionally obscure our view are used to subtly preserve the anonymity of certain patients. 

Dr Bini is pragmatic and patient-focused in his approach, “Doctors sometimes have to make decisions between what is right and what is legal,” he says, referring to a recent change in Italian law that has seen the upper age for IVF treatment restricted to 46. He’s equally down-to-earth in his dealings with transgender patients, explaining their options and their position under the law. This means that, for example, he explains that a couple can currently adopt but, if one officially changes their gender marker, that will not be legally possible.

This knowledge of the law is matched by his compassion, as we see him reassuring various patients – not just in Italian but also in Arabic and Mandarin Chinese. Dr Bini’s clear explanations mean this documentary is information rich for the viewer. He not only lays out the various impacts of fertility and hormone treatment, but is seen navigating ethical issues, including the choice of sperm and egg donors. This is also about wider pastoral care, as he offers to call up relatives of a trans man to help explain the situation to them, gently but firmly tackling prejudice. His calm assurance is moving, as we see the relief washing over many of his visitors, both cisgender and transgender, simply because he recognises them immediately for who they are and what they want.  

While there is a certain amount of repetition involved in Dr Bini’s dealings, it demystifies his work and serves to emphasise his constant alertness to the needs of each individual.  News reports heard at the start of the film and later on a car radio indicate the high voltage nature of the political  debate that swirls around fertility and transgender rights. This humanistic film invites us to see beyond the charged rhetoric to the reality of the life-enriching fulfilment Dr Bini is bringing to those in his care.