Good points. I am male and fluent, and Italy does have extreme gender bias compared to the USA. However, reflecting not only on my own experience but that of others who I know who have come to Italy and taken taxis many times, incidents are rare.
You occasionally read of a tourist coming in who hasn't done any research and doesn't know that a cab from the airport to just about anywhere in the city costs a fixed rate of 48 euros, and gets in a cab and is charged 500 euros to go the 13 miles downtown. There was something similar where a foreigner was just taken between terminals at JFK airport recently and was charged $500, and paid it, not knowing any better.
These things can happen anywhere. But it's generally not the case. Rome is very large, and I have to go to lots of different places in it. Because it has so many one-way streets it can seem as if you are always zig-zagging in the general direction of a destination, and are getting taken for a ride. Many times I've just given a cab driver the name of a hotel that I did not really know the location of, and they would always take me right there, through what turned out to be the correct way.
Yesterday, third day in a row, I had to take a cab in San Francisco to the Ferry Building about a mile away. I didn't exactly know the route, but I knew it was close, and I had to get there quickly or else I'd miss my ferry. After a few blocks I noticed that the meter wasn't on, and I said to the driver, "Why isn't your meter on?" The guy told me it is "fixed rate." I said BS, and made him turn the meter on.
That was the third San Francisco cab driver who tried to rip me off in three days, and I speak english, obviously. I just don't get a sense that you need to be as worried about it when taking a cab in Italy as you have to be in the USA, and I speak the language of both countries.
I think if you get into a cab, you can say in english, "how much will it cost to go to the Colosseum?" Beforehand, you can ask at your hotel how much it should cost, and be armed with that information when you get into the cab. At the airport, when you get into a cab, just ask how much. If they don't say 48 euros, call the attendant that is there. A little bit of awareness can go a long way.
There is always a criminal element in any sector of society, but I don't think it's particularly prominent in Italian cab drivers. I think you're more likely to get ripped off at home.