Trans women finally banned from female hospital wards in new NHS guidance

It replaces previous NHS advice that allowed transgender people to use facilities corresponding to their gender identity.

NHS England said: “Single-sex services, such as hospital accommodation, should be provided on the basis of biological sex.”

It adds that “trans people should be accommodated in line with their sex as registered at birth" or offered alternative arrangements, including single rooms where appropriate.

Two separate documents are being issued to NHS organisations. One addresses patients’ privacy, dignity and safety in hospital accommodation, while the other covers staff facilities, including changing, washing and showering areas and toilets.

The patient guidance applies to sleeping accommodation and bathroom facilities in acute and community hospitals, as well as mental health units.

It said: "Trans people and other people with the protected characteristic of gender reassignment should be accommodated in line with their sex as registered at birth, while also ensuring that clinical needs are met, and privacy, dignity and safety are maintained for all, including other patients.

"In instances where it would not be clinically appropriate to deliver care to a trans patient on a ward or bay that aligns with the sex they were registered at birth, providers should identify alternative arrangements."

Single rooms are among the options available when a patient cannot appropriately be accommodated on a ward designated for their biological sex.

The guidance acknowledges that clinical requirements may occasionally conflict with the provision of same-sex accommodation.

In such cases, clinical needs should take priority, although these situations are expected to be rare.

It cites the Equality and Human Rights Commission’s (EHRC) code of conduct, which states that for services "necessary for everybody, it is very unlikely to be proportionate to put a trans person in a position where there is no service that they are allowed to use".

The document continues: "In these rare circumstances, staff should take extra care to protect the privacy, dignity and safety of all patients. The reasons for the placement decision should be clearly recorded and reported nationally as breaches of this guidance."

The staff guidance instructs NHS organisations to review their existing policies and ensure compliance with the EHRC code of practice, which provides for single-sex toilets and changing rooms.

It said: "To ensure compliance with their legal duties, NHS organisations should review and update existing policies relating to the use of staff facilities (for example, changing, washing and showering areas, toilets and staff accommodation) or develop guidance if it does not exist."

Hospitals and GP surgeries must also ensure that every member of staff has access to suitable facilities.

The guidance suggests "single occupancy or mixed-sex facilities with individual lockable rooms" as possible arrangements for transgender staff.

NHS trusts are required to audit their facilities to establish whether they meet the new requirements.

The changes follow a high-profile employment tribunal involving nurses at County Durham and Darlington NHS Foundation Trust.

The tribunal found that the trust had harassed and discriminated against nurses by allowing a transgender female colleague, who was biologically male, to use their changing room.

Following the Supreme Court ruling, then health secretary Wes Streeting pledged to issue updated guidance “in the coming weeks”, which has only now arrived.

The publication comes amid wider delays in implementing the judgment across public bodies, with certain councils, police forces and government departments still yet to implement changes.

The Government is also expected to issue guidance for other departments, including education, justice and defence.