NHS England biological sex guidance in hospitals

NHS England has introduced new guidance regarding the use of single-sex spaces in hospitals, mandating that transgender patients and staff be accommodated according to their biological sex rather than their gender identity. This directive follows a UK Supreme Court ruling clarifying that the term ‘sex’ within the Equality Act 2010 refers to biological sex.

Under these rules, transgender women may be excluded from female-only wards and transgender men from male-only wards. While patients should generally be accommodated in line with their sex as registered at birth, the guidance emphasizes that clinical needs must remain the priority. In cases where biological sex-based accommodation is not clinically appropriate, hospitals are instructed to find alternative solutions, such as single-occupancy rooms, to protect the dignity and safety of all individuals.

The guidance also extends to staff facilities, such as changing rooms, toilets, and showers, to ensure sex-segregated privacy. An internal NHS England impact assessment has warned that the policy could lead to adverse outcomes for transgender patients, suggesting that a lack of available gender-neutral spaces might result in “corridor care,” treatment delays, and increased risks to physical and mental wellbeing.

In a related legal development, the County Durham and Darlington NHS Foundation Trust amended its Uniform and Dress Code Policy to require staff to use changing facilities according to their biological sex. This follows a three-year legal dispute involving seven female nurses at Darlington Memorial Hospital. The Trust apologized and paid £187,000 in damages to the claimants following an employment tribunal ruling, with total costs reported to exceed £1.2 million.