NHS England says trans patients should use hospital wards according to biological sex

NHS England says trans patients should normally be cared for on hospital wards according to their biological sex, under new guidance that also says clinical needs must take priority and alternative arrangements should be made when a ward placement is not clinically appropriate. [3]

The guidance says decisions should be made case by case, taking account of the dignity and safety of the trans patient and other patients. NHS England has also issued advice for trusts on staff facilities, including changing rooms and toilets, and encouraged them to audit whether enough alternatives, such as gender-neutral or single-occupancy facilities, are available. [3]

The change reverses previous NHS England guidance, which allowed patients and staff to use wards or facilities in line with their gender identity. That guidance was withdrawn after the Supreme Court ruled in April 2025 that “sex” under equality law means biological sex. [3]

NHS England data cited by the BBC shows reported breaches of its previous mixed-sex accommodation guidance rose from 3,853 in June 2025 to 5,520 in August 2026. [3]

The new policy has drawn sharply different reactions. Sex Matters welcomed it but raised concerns about how it would be applied, while TransActual and Trans+ Solidarity Alliance said staff could be left unclear about how to care safely for trans patients and warned of operational difficulties in hospitals with limited resources. [3]

Bethany Hutchison, a nurse who was among those involved in a successful tribunal claim over a trans colleague’s use of female changing facilities, welcomed the guidance. She said the test would be whether NHS trusts followed it. [3]

The guidance follows a series of disputes over single-sex facilities in the NHS. In a separate Scottish case, an employment tribunal found that nurse Sandie Peggie had been harassed by NHS Fife over its handling of rules on single-sex spaces, but dismissed her other claims of discrimination and victimisation. An appeal is under way. [3]