Reproductive Health and Trajectories among the Italian Reproductive-Aged Population.

Introduction: Fertility awareness, parenthood aspirations, and reproductive intentions are key psychosocial dimensions shaping reproductive health trajectories. However, these factors remain underexplored in minoritized groups facing fertility-impacting conditions. Trans* populations, in particular, often face systemic obstacles such as discrimination, limited access to inclusive fertility services, socio-legal restrictions, and pervasive cisnormative assumptions. Understanding how these barriers affect reproductive knowledge and desires is critical to designing equitable clinical and policy interventions. Purpose: This study aimed to examine fertility awareness, parenthood aspirations, and reproductive intentions across diverse reproductive-aged populations in Italy, with a focus on high-risk groups. Specific objectives include assessing demographic and health-related influences on reproductive knowledge and desires, comparing trans* and cisgender participants, and identifying unique predictors of parenthood aspirations. Method: A cross-sectional survey was administered online to participants aged 18–49, residing in Italy. Stratified sampling ensured adequate representation across gender identities. Recruitment occurred through social media, reproductive clinics, universities, and LGBTQ+ associations. Measures included: sociodemographic questionnaire, Cardiff Fertility Knowledge Scale, Parenthood Motivation List, Reproductive Intentions Scale, and open-ended questions addressing decision-making and barriers. Results: Individuals in high-risk categories showed lower fertility awareness than the general population. Younger participants displayed reduced knowledge compared to older cohorts. Trans* participants reported comparable parenthood aspirations but lower reproductive intentions, reflecting systemic barriers rather than lack of desire. Parenthood aspirations in trans* individuals were linked to non-traditional family forms and flexible affective configurations. Conclusions: Findings contribute to understanding reproductive health disparities, inform inclusive reproductive health education, and guide policies fostering equitable access to family-building resources for marginalized populations.