New guidance from NHS England states that single-sex wards, toilets, and changing rooms will now be allocated based on biological sex, rather than gender identity. This means trans women will no longer be accommodated in female-only wards.
The rules, published on Thursday, specify that trans people should be "accommodated in line with their biological sex" while ensuring their clinical needs, privacy, dignity, and safety are maintained, along with those of other patients. In situations where clinical needs and same-sex accommodation requirements cannot both be met, clinical needs are to be prioritised.
Updated guidance for NHS England staff also requires organisations to audit their provisions to protect the "privacy, dignity and safety of all staff". For NHS trusts with mainly single-sex facilities, "suitable and accessible alternatives, such as single‑occupancy or mixed-sex facilities with individual lockable rooms, can be provided".
This new guidance follows a Supreme Court ruling last year which clarified that the terms "woman" and "sex" in the Equality Act refer to biological women and biological sex. Previous NHS England guidance allowed patients and staff to be accommodated based on their gender identity.