NHS England says trans people should use hospital spaces according to biological sex, with case-by-case exceptions

New ward guidance

The NHS England guidance says trans patients should usually receive care on single-sex wards or bays aligned with their biological sex, rather than their gender identity. It was issued on Thursday.

However, the document says decisions may need to be made individually. Clinical needs must be met, and the dignity and safety of the trans patient and other patients maintained.

The previous approach could allow a trans woman to choose a women's ward, or a trans man to opt for a men's ward. The new guidance also says gender-neutral spaces should be offered to avoid discrimination.

Facilities for patients and staff

Alongside its patient guidance, NHS England published advice for trusts on organising staff changing rooms, toilets and other single-sex facilities. Trusts are encouraged to audit whether they offer enough alternatives.

Examples include gender-neutral or single-occupancy toilets. NHS data shows breaches of the previous mixed-sex accommodation guidance have risen every year since 2021, involving members of the opposite sex placed on single-sex wards.

Groups differ over impact

Sex Matters, a charity focused on sex-based rights, welcomed the guidance as a “momentous shift back to reality”, but said it was concerned about how the rules would be applied. TransActual and Trans+ Solidarity Alliance said they fear NHS staff may be unclear about how to care safely for trans patients under the guidance.

Wider equality disputes

The NHS has faced several prominent disputes over the interpretation of equality law and workplace rules. The article says a tribunal found that a trust had indirectly discriminated against claimants, but provides no further detail about that finding.

Bethany Hutchison, a nurse involved in the action and now president of the Darlington Nurses Union, welcomed what she called the “clear and necessary guidance”. She said whether trusts follow it would be the test, adding that enforcement should not rely on individual nurses’ courage and personal sacrifice. The article also says Peggie had complained about a doctor who was a trans woman using female changing rooms.