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Transgender patients to be placed on wards according to their birth sex, NHS England decides
The policy says hospitals should use biological sex for wards and facilities, while allowing case-by-case exceptions when clinical needs require different arrangements.
On Thursday, NHS England published updated guidance requiring single-sex hospital wards and staff facilities be provided based on biological sex, replacing previous policies that permitted access aligned with gender identity.
An April 2025 Supreme Court ruling determined that 'sex' and 'woman' in equality law refer to biological sex, necessitating withdrawal of previous guidelines allowing self-identification in single-sex hospital spaces.
Guidelines mandate hospitals identify alternative arrangements such as single-occupancy rooms when it is not 'clinically appropriate' to place a trans patient on a ward of their biological sex, ensuring clinical needs remain priority.
Sex-Based rights charity Sex Matters welcomed the update as a 'momentus shift back to reality,' while TransActual and the Trans+ Solidarity Alliance warned the policy creates 'unworkable operational challenges' in resource-strapped hospitals.
Data shows breaches of mixed-sex accommodation guidance rose to 5,520 in August 2026, up from 3,853 in June 2025, highlighting operational strain as hospitals navigate legal disputes over staff privacy and facility access.
Guidelines stipulate that nursing staff must also use changing rooms and toilets that correspond to their biological sex, following a protest by nurses who changed in front of their transgender colleagues.