An internal NHS England impact assessment has identified potential adverse effects on transgender individuals resulting from new guidance on single-sex spaces in hospitals. The guidance, published recently, directs healthcare trusts to assign patients to single-sex wards, toilets, and changing rooms according to biological sex rather than gender identity.
According to the impact assessment document, transgender patients may experience delays in care and increased instances of “corridor care”—a practice where patients are accommodated in non-traditional spaces when ward capacity is limited. The report warns that unavailability of private side rooms could force transgender individuals into situations where they are placed on wards aligned with their biological sex, potentially causing significant distress. Additionally, the assessment notes risks of discrimination through involuntary disclosure of transgender status and suggests some transgender people may avoid healthcare altogether due to these concerns.
The document acknowledges that the policy aims to protect privacy, dignity, and safety for patients generally, and identifies benefits for specific groups including pregnant or breastfeeding women, individuals with certain religious beliefs, and minority-ethnic populations. However, it indicates the guidance may negatively affect relationships between transgender and cisgender people, as staff may need to balance competing needs and could create division among patient groups. The assessment also warns that some women who do not conform to conventional gender presentation might face questioning about their sex to access single-sex facilities.
The new NHS England guidance follows a supreme court ruling that clarified the terms “woman” and “sex” in equality legislation apply only to biological definitions. An updated code of practice from the Equality and Human Rights Commission acknowledges that transgender individuals are likely to experience disadvantage under these standards. The NHS assessment suggests potential mitigation strategies, including prioritizing clinical need in placement decisions and noting the guidance does not apply in emergency or intensive care settings, but NHS England declined to comment further on the report’s findings.
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