The Attitudes Towards Surrogacy Scale: preliminary validation and psychometric properties in the Italian context

Surrogacy elicits different attitudes influenced by ethical, cultural, and political factors. While scales for assessing attitudes towards surrogacy exist, their validity in sociopolitical contexts remains underexplored. Therefore, the current study aims to adapt and validate the Attitudes Towards Surrogacy Scale in the Italian context, where in December 2024 the domestic ban on surrogacy has been extended to encompass any surrogacy arrangements undertaken abroad by Italian citizens.

To reach this aim, in 2025, we implemented three independent studies to test the instrument's structure, internal reliability, measurement invariance, and its nomological and convergent validity.

Exploratory factor analysis (Study 1, N = 613) and confirmatory factor analysis (Study 2, N = 1,107), showed a two-factor structure of the scale and pointed out excellent fit, internal reliability, and measurement invariance across participants' gender and age. Finally, Study 3 (N = 334) evaluated convergent and nomological validity of the scale, pointing out significant associations with religiosity, political orientation, heteronormative attitudes, and anti-LGBTQ+ conspiracy beliefs.

The Italian version of the ATSS is a reliable and valid instrument for assessing attitudes towards surrogacy within a restricted legal context. This instrument may represent a promising tool helping provide insight to policymakers and public health organisations in designing and evaluating initiatives concerning surrogacy.

The results of the current work may provide the foundation for future research, as well as inform public discourse, policy debate, and educational intervention related to reproductive rights and family diversity in Italy.