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. 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. 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. The measures used included a sociodemographic questionnaire, Cardiff Fertility Knowledge Scale, Parenthood Motivation List, Reproductive Intentions Scale, and open-ended questions addressing decision-making and barriers. Results revealed moderate overall fertility awareness with notable gaps among men, younger participants, those with lower education, and marginalized groups, underscoring uneven reproductive knowledge distribution. 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. Overall, the 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.