Putting an end to illegal practices: towards the right to health and safe beauty

No more deaths from illegal procedures: BTX Bar champions the right to health and safe beauty. With ArcigayandCest subsidized pathways for trans people have been launched

The death of Mirela, a 44-year-old trans woman who passed away in Pisa following anunderground injectiontreatmentillegal oil, once again highlights two major issues: the stigma faced by trans people and thehigh cost of aesthetic medical treatments, which have always been the preserve of an elite. Aesthetic medicine, which can be a fundamental tool for gender affirmation and physical and mental well-being, cannot remain accessible only to a few, nor be left in the hands of the black market.

Procedures such as liquid silicone injections, banned in Italy since 1993, unfortunately continue to circulate within the trans community, where the lack of access to safe and affordable care drives too many people toward desperate choices and improvised, clandestine, and dangerous practices. The consequences are devastating: infections, irreversible complications, destructive surgical mutilations, and, as in Mirela's case, death.

Black market and dangerous practices: the Mirela case highlights the need for prevention and safety

“Liquid silicone andsynthetic oil, like Syntol, can cause severe embolisms, chronic infections, material migration, and permanent damage to tissues and lymphatic vessels. There is no guarantee of safety in these illegal procedures—reminds the Dr. Camilla Di Pasquali, Medical Director of BTX Bar Italia. The risks include bacterial or toxic contamination: without health checks, traceability, or medical professionalism, this isn't aesthetics—it’s Russian roulette,” she adds.

“Mirela’s death,” states Regina Satariano, President of the Transgender Counseling Center , who was the first to report the case, enabling the investigation to begin—must not be in vain. It must translate into prevention and health protection within a more inclusive society that does not leave the most vulnerable people in the hands of the black market.”

BTX Bar, together with trans associations such as CEST,TGenus,Gruppo Trans APSandArcigay National Trans Network , has launched a joint initiative, “Beyou,” which provides financial support dedicated to the trans community, specifically to undermine clandestine practices and offer real access to professional, certified, and safe care.

During the BTX Café in June, a cultural event held at the medical clinic in Porta Venezia, Milan, associations and activists denounced the prevalence of illegal procedures still being performed today: from industrial silicone injected without hygiene to counterfeit products purchased through unauthorized channels.
For this reason, BTX Bar is relaunching its handbook for a Safe Aesthetic Medicine, previously introduced in recent months, which gathers practical rules for identifying reliable professionals, products, and facilities and protecting yourself from the black market.
Controls have been stepped up in recent months, but enforcement alone is not enough: we need a culture of safety, ethical responsibility, and a commitment to ensuring the trans community has access to safe and respectful solutions.

ForMiki Formisano, President of CEST, an association within the Italia Trans Agenda network “Mirela’s death is an open wound. Her body tells the story of a society that still fails to offer safe and accessible alternatives. Choosing safety should not be a privilege, but a right.”
ForChristian Cristalli, head of trans policies at Arcigay: “Clandestine practices kill. We cannot accept that a lack of protections, economic opportunities, and information drives trans people to risk their lives, as in the case of Mirela.”