The National Health Service (NHS) in England has instructed hospitals to allocate single-sex wards according to patients’ biological sex rather than gender identity, changing how transgender patients are accommodated.
The guidance also covers toilets, bathrooms and staff changing facilities. It replaces earlier advice that allowed transgender patients and employees to use spaces matching their gender identity.
Published 18 months after the Supreme Court’s April 2025 ruling on the meaning of sex under the Equality Act 2010, the policy requires transgender patients to be placed according to their sex registered at birth. Hospitals should consider alternatives, including private rooms, where such placements are clinically inappropriate.
However, medical needs must take priority when single-sex accommodation cannot be maintained. Hospitals must document and report these exceptions while protecting every patient’s privacy, dignity and safety.
NHS organizations have also been directed to review staff facilities and ensure suitable options remain available to everyone. These could include individual toilets or changing rooms with lockable doors.