Dr. Maurizio Bini in GEN_ by Gianluca Matarrese, an official selection of the 2025 Sundance Film Festival. Courtesy of Sundance Institute | photo by Bellota Films / Stemal Entertainment / Elefants Films.

Gianluca Matarrese Talks GEN_ and the Politics of Intimacy

Sundance doc observes a Milanese doctor and miracle worker

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12 mins read

“Intimacy is political,” says GEN_ director Gianluca Matarrese. “It’s in that intimate space that we really understand the ethical decisions of healthcare.”

Matarrese’s film GEN_ has its world premiere at the 2025 Sundance Film Festival in the World Cinema Documentary competition and invites audiences to enter a deeply personal space: the relationship between doctor and patient. GEN_ offers a cinéma vérité portrait of the goings on at Milan’s Niguarda public hospital where Dr. Maurizio Bini provides essential services for gender and reproductive rights. He interviews patients, including many transgender teenagers seeking gender affirmation surgery. Other patients are couples and singles—straight, gay, lesbian, cisgender, transgender, and more—who request his skilled services with in-vitro fertilization.

Gianluca Matarrese, director of GEN_, an official selection of the 2025 Sundance Film Festival. Courtesy of Sundance Institute.

GEN_ observes as Dr. Bini provides an empathetic ear for his patients. Moreover, this empathy proves doubly political in Italy where a newly elected right-wing government complicates the already conservative laws governing people’s bodies. In Italy, for example, adoption and surrogacy are illegal for same-sex couples. Going abroad for surrogacy is illegal for anyone as of October 2024. Impeding legislation (now passed) limits in-vitro for some older than 49 years of age.

“The political forums where people are making decisions about other people’s bodies and reproductive rights lack that intimacy,” adds Matarrese. “It’s really interesting that we get that dynamic.”

Matarrese says he learned of Dr. Bini through his friend, author Donatella Della Ratta (a co-writer of GEN_). He says his friend was researching fertility, procreation, and transitioning while undergoing fertility treatment herself. “She was talking to her gynecologist in Rome, and he was a very good friend with our Dr. Bini,” explains Matarrese. “He said, ‘You should go and interview and study and observe this one, Bini, because he really is a one-of-a-kind doctor.’”

And one of a kind Dr. Bini is: he’s personable, funny, and mildly cantankerous. A running element in the film follows Dr. Bini’s clashes with the contractors doing construction in the hospital. He doesn’t want his patients or delicate procedures disturbed during work hours. Yet the hushed silence of his office allows Matarrese to capture a doctor who gives patients his full attention when many arenas of the public sphere do not.

The director says that his first meeting with Dr. Bini gave him an immediate sense of how to frame the film: with a fly on the wall glimpse within Dr. Bini’s office and select corners of Niguarda hospital. “I knew the film was about the relationship between the doctor and the patient, and the quality of exchange that happens.”

Matarrese respects the space between Dr. Bini and his patients by shooting the in-office conversations from unconventional angles. Sometimes faces are partially obscured. Some patients appear in fragments while others occupy the full frame. Other angles let elements of the office occupy the foreground of the film. The effect invites audiences to become active listeners. It’s not really about the treatment, but who seeks the treatment. The “why” opposed to questions of “who” and “how.”

“I’ve been doing this film for years and I’ve been doing a lot of queer film festivals as a filmmaker and as a juror,” says Matarrese, who has directed several features and shorts in the past five years, including Fashion Babylon, A Steady Job (Il Posto), and The Last Chapter, which won the Queer Lion at the Venice Film Festival. “I was watching a lot of films on these topics: even if it’s about procreation and especially for transition, they’re often from a point of view from the self and very often treated with a lot of pain.”

A patient in GEN_ | Courtesy of Sundance Institute. Photo by Bellota Films / Stemal Entertainment / Elefants Films.

Matarrase says he didn’t want to fall into the trap of making audiences feel pity for participants as if they were viewing them from above. “I really wanted to be on the same level of the conversation and also be political by showing all the difficulties that administration and bureaucracy represents,” he adds.

Initially, he says he expanded the scope by touring down various corridors of the hospital and following some of Dr. Bini’s colleagues, but that approach lost the personal dynamic. “It was more of a Wiseman style of film then where you are exploring the institution,” he says, noting that one edit was a Wiseman-esque four hours and evoked Welfare and Hospital. But instead of feeling like someone else’s film, GEN_ finds a distinct voice.

“I always put my eye and my gaze on what I have in front of me. This was the intimacy: what happened in front of my eyes,” explains Matarrese. The director says he was able to confront the political elements of fertility and gender identity indirectly through this firsthand observation approach.

“For me, films are encounters,” says Matarrese. The director says that he likes to give a character portrait to convey the larger context and conversation. “I did that with my first film, Everything Must Go. It’s about my family and the crisis they had in the shoe store company, and then showing the crisis of a family. I’m actually talking about the bigger picture,” says Matarrese. “The economy of Italy and the economy of fashion world in Fashion Babylon. The system of healthcare and the process of hiring for Il Posto, and in this case going really small in the intimacy of this relationship. The bigger picture is about what happens in this country.”

Moreover, by offering a character-driven approach with Dr. Bini, GEN_ observes how listening and engagement can change one’s mind. The elderly doctor readies for retirement throughout the film and he doesn’t make excuses for being a man of another generation. Besides his jovial demeanour, empathetic ear, and quick wit, Dr. Bini often makes comments that could surprise a viewer. Sometimes he’ll misgender a patient or use a dead-name while convincing parents to consent to treatment. Audiences who said the doctor in Emilia Pérez was too politically incorrect to feel real might need to eat crow after seeing GEN_. But Dr. Bini’s use of language often serves to comfort parents while informing them about decisions that are in their child’s best interests.

A still from GEN_ by Gianluca Matarrese, an official selection of the 2025 Sundance Film Festival. | Courtesy of Sundance Institute. Photo by Bellota Films / Stemal Entertainment / Elefants Films.

Matarrese laughs when asked about the good doctor’s political (in)correctness and says he was generous in the edit, but had to show things as they were.He is a man of another time, that’s for sure,” notes Matarrese. “And we have also the position of the younger generation. The future is this new doctor coming, this young woman [who is taking over Bini’s patients when he retires] and she’s really modern.” Besides observing the patients, the film captures the knowledge transfer between Dr. Bini and his protégé.

“Bini has the very old role of the good doctor,” says Matarrese. “Despite his humour, despite some clumsiness in his expressions, he’s a good example of someone who’s making his job a real calling. Everything he’s doing is for the good of the patient. I have admiration for someone like that.”

Matarrese adds that observing Dr. Bini with his patients day by day also gives some perspectives about the experience that shapes these viewpoints and his observation about trends and common factors among his patients. This observation reflects the challenges that some of Dr. Bini’s patients face with a society that asks them to choose between binary identities, or asks people to self-identify as ill in order to receive gender-affirming care. The film also observes Dr. Bini work with couples as they make tough decisions regarding in-vitro, alluding to conversations about ethics and eugenics as the doctor cautiously wades through donor preferences.

Even though GEN_ deals with highly politicized bodies, the observational angle lets Matarrese be indirectly political. The camera doesn’t go outside the hospital except to observe Dr. Bini as he forages for mushrooms in the forest. It’s a novel motif after Dr. Bini shares that he admires mushrooms because they don’t reproduce on binary terms. But the stakes and politics arise in the conversation with questions of age, or perhaps faith when one patient refuses to freeze too many embryos based on her religious views.

“The act of doing this film in this country, it is already a political act,” says Matarrese. “We have a conservative government in Italy. I didn’t want to be confrontational—just a matter of fact. It’s a context where he has to exist, the doctor and this space. This space is a little miracle.”

GEN_ has its world premiere at the 2025 Sundance Film Festival.

Pat Mullen is the publisher of POV Magazine. He holds a Master’s in Film Studies from Carleton University where his research focused on adaptation and Canadian cinema. Pat has also contributed to outlets including The Canadian Encyclopedia, Paste, That Shelf, Sharp, Xtra, and Complex. He is the vice president of the Toronto Film Critics Association and an international voter for the Golden Globe Awards.

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