NHS England Says Wards Should Be Allocated by Biological Sex
New guidance says trans patients in England should be cared for on single-sex wards or bays matching their biological sex rather than their gender identity, and that staff facilities should be used on the same basis. Where that is not clinically appropriate, alternative arrangements should be made. Trusts are told to offer enough gender-neutral and single-occupancy options.
This replaces guidance that allowed patients and staff to be accommodated according to gender identity, which was withdrawn after the Supreme Court ruled in April 2025 that “sex” in equality law means biological sex and that a single-sex space should admit only one biological sex. The new document stresses that decisions may still have to be made case by case, and that clinical need is the overriding priority in emergency and urgent care. Trusts are encouraged to audit whether they have enough alternatives. The practical difficulty is capacity rather than principle: recorded breaches of the old mixed-sex accommodation rules have risen every year since 2021, reaching 5,520 in August 2026 against 3,853 in June 2025. Maya Forstater of the sex-based rights charity Sex Matters welcomed the shift but warned about implementation, saying “NHS patient data is a mess, with potentially thousands of trans-identifying people recorded as the opposite sex”. The trans rights organisations TransActual and Trans+ Solidarity Alliance have said they are concerned.