NHS Reverses Transgender Accommodation Policy Amid Safety Concerns
New guidance mandates patient placement by biological sex, overturning 2019 policy after legal challenges and financial penalties.
Carla Rooney
NHS bosses will issue new guidance requiring hospitals to accommodate patients according to their biological sex.
This policy shift follows an employment tribunal ruling that found the County Durham and Darlington NHS Foundation Trust liable for harassment. The Trust paid £187,000 in damages after nurses shared a changing room with a transgender woman.
A Scottish employment tribunal in December 2025 also found NHS Fife harassed nurse Sandie Peggie. This ruling stemmed from its interpretation of rules on single-sex spaces; the Equality and Human Rights Commission (EHRC) code previously stated single-sex services must be used on the basis of biological sex.
NHS trusts must now audit their facilities to meet the new requirements. Critics warned the previous policy was unsafe and placed women at risk of sexual assault.
A number of NHS trusts continued to allow trans women onto female wards in defiance of court rulings, awaiting national NHS guidance. Sex Matters claims NHS patient data is a mess, with potentially thousands of trans-identifying people recorded as the opposite sex.
TransActual and Trans+ Solidarity Alliance claim the guidance will not survive contact with reality in resource-strapped hospitals. They state it will create unworkable operational challenges, asserting the Government's failure to address this legal mess puts politics over patient care.