NHS England released new guidance for hospital trusts addressing the use of single-sex wards, toilets, and changing rooms. The policy directs that these facilities should be allocated based on biological sex rather than gender identity, with the stated aim of ensuring privacy, dignity, and safety for all patients.
An internal NHS England impact assessment examined the effects of this guidance across various protected characteristics including age, disability, sex, religion, and ethnicity. The document acknowledged potential positive impacts for certain groups, including pregnant or breastfeeding women, individuals with specific religious beliefs, and minority-ethnic populations. It also noted that the policy could provide clearer legal guidance on single-sex spaces.
However, the assessment identified multiple potential adverse consequences for transgender individuals. These included possible delays in hospital admissions, increased instances of “corridor care” when single rooms are unavailable, and elevated risks of discrimination or being “outed” as transgender through ward placement decisions. The report raised concerns that trans patients might be placed in situations requiring accommodation on wards aligned with their biological sex rather than their gender identity, potentially causing psychological distress. The assessment also flagged the possibility that some individuals might avoid seeking healthcare altogether due to these concerns.
The guidance was informed by a 2025 supreme court ruling and updated guidance from the Equality and Human Rights Commission addressing how services should apply definitions of sex under the Equality Act. The NHS assessment suggested that negative impacts could be reduced through case-by-case decision-making that prioritizes clinical need and through exemptions for certain hospital settings such as accident and emergency departments and intensive care units. NHS England declined to provide additional comment on the matter.
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