Learn Italian: Siccome il problema è grave, sono dovuto andare all'ospedale. - Since the problem is serious, I had to go to the hospital.

When using a modal verb like dovere (to have to) in the past tense, the choice between avere and essere usually depends on the action verb that follows it. Since andare (to go) takes essere, the modal verb also takes essere, making it sono dovuto andare.

If a woman were saying this sentence, would dovuto change?

Yes. Because the helping verb is essere in this sentence, the past participle must agree with the gender of the person speaking. A female speaker would change the ending and say sono dovuta andare.

Why is it il problema and not la problema?

Although it ends in -a, problema is a masculine noun. Many Italian words ending in -ma (like il programma or il sistema) are masculine. This is why it takes the masculine article il.

Can I move siccome to the middle of the sentence?